care pathways flow · multivoting change idea standardise define s d measures pre-phase a p s d...
TRANSCRIPT
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FLOW
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FLOW
Dot to Dot –
Improving the patients’ journey through
care pathways
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Rules
Best of 3
Winner then plays another winner
Loser follows their champion and supports vocally
Until we have a FLOW eRPS Champion
Paper > Rock
Scissors > Paper
Rock > Scissors
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Improving Flow at MCA Expo ’16
RPS Champion 2016
6th June 2016
Nick Miller
Tom Downes
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FLOW
Welcome and Introduction to
Improving Flow
Nick Miller Improving Flow Manager
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MCA Improving Flow
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Two Types of Knowledge
Subject Matter
Knowledge
Improvement
Science
&
Coaching
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Improvement Science
& Coaching
Subject Matter
Knowledge
Discovering
great
care
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Flow improvement -
The structure
Diagnosis -
Change
Ideas
Treatment
- PDSA
SDSA
‘Standardise’
Value
inVolve
Vision
Values
Visualisation
Assessment
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How it happens
•12 care pathways, 24 coaches
•Clinical & Flow Coach
•BIG Room meetings
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The Big Room
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Global
Aim
Themes
‘Post-it
Frenzy’
Build a Big
Room
Specific aim
Change
Ideas
Brainstorming
Change Concepts
Benchmarking and
visits
Process/Value
Stream Map
Fishbone
Spaghetti
Diagrams
Selection criteria &
Multivoting
Change
idea
Standardise
A P
S D Define
measures
Pre-
Phase
A P
S D
Coached weekly
meetings
Patient
stories
System
data
Reflective
learning
A P
S D
Improving Flow:
Roadmap
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The future
Cohort 2 October 2016
3 hospitals
Cohort 1 coaches become faculty
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FLOW
Welcome to the Coaches
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Portia Chikwanha
Amanda Turner
Claire Powell
Nick Lee & Lee Alexander
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Acute Paediatric Pathway
Amanda Turner and Latha Rengaraju
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Introducing FLOW
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“BIG ROOM”
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“BIG ROOM”
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Flow Programme – Acute Paediatric Pathway Progress – May 2016
PRIMARY DRIVERS SECONDARY DRIVERS
WARD BASED MEDICINE DISPENSING
REDUCE LENGTH OF DISCHARGE PROCESS EARLY DISCHARGE DECISION
PRIORITISE PAEDIATRIC TTOS IN PHARMACY
EARLY COMPLETION OF DISCHARGE PAPERWORK
REVIEW INFECTION PREVENTION POLICIES
REDUCE A&E WAIT TIMES
REVIEW TERMINAL CLEAN PROCESS
STREAMLINE PATIENT JOURNEY / 3PM WARD ROUND BY HOTWEEK CONSULTANT
REDUCE LENGTH OF STAY EARLY SENIOR DECISION MAKING
REVIEW BY SENIOR BEFORE HANDOVER
Aim
- Pharmacist available on ward for dispensing @10 am
- Additional items being added to ward dispensing list
- 7am ward round/discharge by Registrar
- Paediatrics now being prioritised
- Compiling list of prescribing errors that commonly cause delay to share amongst junior doctors
- Discharge paperwork being completed on night shift by SHO
- Infection prevention to attend meeting on 12th
May
- Val Quelch (Hotel Services) attending meeting on 27th
May
- To be discussed and agreed at next Consultant Meeting
- To be discussed and agreed at next Consultant Meeting
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CHALLENGES
•TIME
•BIG ROOM
•MANAGING EXPECTATION
•COMMUNICATION
•ROBUST DATA
•TRANSFERRING OWNERSHIP
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WHAT’S GONE WELL
•INVESTMENT
•ENTHUSIASM
•ENGAGEMENT
•SMALL CHANGES
•POSITIVE FEEDBACK
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FLOW