1.2 from gaun yersel to older and better joint improvement team
TRANSCRIPT
From Gaun Yersel to Older and Better
Anne Hendry
National Clinical Lead for Quality
JIT Associate
7 steps for changing the world
• A compelling vision• A story• Actions / Stepping stones• Securing the improvement• Engaging the workforce• Making the change work locally (everywhere)• Resilience, authorisation and a guiding coalition
Cocreating our Vision
Throughout Scotland, people with long term conditions and those who support them, feel valued, confident and enjoy full and positive lives
Culture of Quality and Ambition Collaboration, capacity & capability
Self Management
7 High Impact Changes
High Level Outcome Statements Bundles of Improvement Actions
Partnership We empower people living with long term conditions, their carers and the voluntary sector to be full partners in planning, improving quality and enhancing the experience of care.
Mutuality
Self Management
WorkforceDevelopment
Integrated Care
We support people with long term conditions and their unpaid carers to be involved in person-centred care planning.
We commission self management support for people with long term conditions and their carers and provide relevant, accessible information
We train staff to have the right knowledge, skills and approach to long term conditions care.
We provide better, local and faster access to healthcare, social care and housing services for long term conditions
Quality ImprovementWe strengthen the contribution of Managed Clinical/Care Networks (MCNs) in improving support for people with long term conditions
Clinical Information SystemsWe have information systems that support registration, recall and review of people with multiple conditions, and support data sharing across all partners.
Implementation & Improvement Support • LTC Programme Board – governance and key
strategic partners eg NES; LTCAS; NHS 24
• Delivery group – Operational exec and clinical leaders witrh a focus on performance
• LTC Collaborative - local programme teams with a focus on improvement
• Engagement – LTC are everyone’s business
Improvement Activists• Visible leaders across professions • Influential at all levels and across system • Leverage in professional structures • Influence on corporate focus• Influential in workforce planning • Lead roles in practice development
• Users and carers
2 Million Lives : people not patients
Digital Story Library
Top Tips and Practical Guidance
Spread and Adoption
Buddying, Networking and Practice Exchange
Sutor Ward Invergordon
0.0
10.0
20.0
30.0
40.0
50.0
60.0
Aug-06 Feb-07 Aug-07 Feb-08 Aug-08 Feb-09 Aug-09 Feb-10 Aug-10 Feb-11
LOS Discharges
Extended Community
Team Meetings
+
Spot Purchase Home Care
Food for Thought ……. Using Local Improvement Data
Driving National Performance Bed Days per 100,000 population for T6 Long Term Conditions
Monthly Trend
0
100
200
300
400
500
600
700
800
900
1,000
Month of Discharge
Mo
nth
ly B
ed
Da
ys
pe
r 1
00
K p
op
Scotland 12 month moving Average Scotland 12 month moving Average Scotland Monthly T6 Bed Days
Scotland Trajectory Target Scotland Trajectory Target Linear (Scotland Trajectory Target)
LTCC launch High Impact
Changes and support
15% reduction in bed day rate
The Next Challenge Reshaping Care
Reshaping Care for Older People
‘Older people in Scotland are valued as an asset, their voices are heard, and older people are supported to
enjoy full and positive lives in their own home or in a homely setting.’
Implementation & Improvement • Shared Vision – An Older and Better Scotland
• 3 workstreams – co-production and community capacity building; housing and care settings; care pathways
• Change Fund as catalyst to lever change in spend
• Local Change Plans agreed by NHS, council, third sector and independent sector partners and agreed Joint Commissioning plans by 2012 / 13
• Improvement network and support from JIT
• Core set of measures of success
Reshaping Care Pathway
Integrated Community Team
NHS Lothian
3000
3500
4000
4500
5000
5500
6000
6500
Mar-09
May-09Jul-0
9Sep-09
Nov-09Jan-10
Mar-10
May-10Jul-1
0Sep-10
Nov-10Jan-11
Mar-11
May-11Jul-1
1Sep-11
Nov-11Jan-12
Mar-12
An
nu
al B
ed D
ays
per
1,0
00 P
op
ula
tio
n
Area Rates of All Emergency Admission Bed Days Scotland Rates of All Emergency Admission Bed Days
Area Trajectory Target Scotland Trajectory Target
Area Trajectory Baseline / Milestone Scotland Trajectory Baseline / Milestone
Area Linear Trajectory Scotland Linear Trajectory
Management information only. Not for onward distribution.
75+ emergency bed days
Expected trend in emergency bed use (65+) at 2006/07 rates ( P Knight)
6000
6500
7000
7500
8000
8500
9000
year
occu
pied
bed
s pa
tient
s ag
ed 6
5+
Year to 30 Sept 10 (prov)
Actual bed use
Expected at 2006 / 07 rates
Demand Management
~ 500 beds