Pouring IT On

Gareth Paterson - Regional Manager LTCC

http://dilbert.com/strips/comic/2010-05-08/

SummaryHow does the aim of SCIMP relate to the

Long-term Conditions Agenda?Workstreams and the use of information in

LTC care?The integration of plug and play.Analysing information pathways.Audience Participation

IntroductionSCIMP’s principal objectives include promoting,

assisting and developing the processes to enable the safe and effective sharing of clinical information across NHS Scotland organisations.

LTCC helps local staff to deliver improvements in patient

centred services and change the way care is provided for

people with long term conditions across three workstreams Complex care, Self Management and

Care Pathways.

Correct systems in place to capture dataAgreed minimum dataset and key indicatorsMeasurement of impactIdentify local trajectoriesUse Better Together programme to capture

qualitative indicatorsIdentification of critical success factorsPDSAStatistical process control, Digital stories,

“Talking Points”Story Boards, Process Outcomes, Change

Outcomes

Project Focus

“a proactive approach focused on high-risk patients with a combination of medical, nursing, pharmaceutical care and social care needs”

Implementing care management is a complex and far reaching development that will involve changes to the way we deliver care and how we share and manage information flows.

Complex Care

Case Management

Identification of Risk

Information Flow

Kaiser Permanente

Person centred care.Adopting an enablement approach.Proactive care that is multidisciplinary.Integrated working.An anticipatory approach to assessment, care

planning and review.Coordination of care.Clarity about responsibility and accountability.Communication with patient, carer, care team

and all agencies.Patient reviews that are carried out

systematically on a multidisciplinary and multi-agency basis.

Collaborative working.

Condition Pathways

Self ManagementMaking the Connections – Food For Thought

“Effective self management relies on the provision

of

accurate, relevant, timely and accessible

information

from a trusted source on a basis which people feel is

sensitive to their situation.”

Services from e-systemsPerson Centred

Safe

Effective

To Achieve all these things it is necessary to analyse the flow of information to understand why we need it and how the information

adds to the quality of the service we provide.

In what ways do ‘Quick Wins’ need to be supported within the system?What process changes are needed to

integrate new systems?

What ways can the manual be modified?

Can we use present available hardware in a different way to augment new systems? Email? Video conferencing? Phone conferencing?

What are we trying to accomplish?

“A bad system allows a good person to behave badly while a good system makes a bad person behave well.”

With the adoption of new systems we may be in danger of abandoning active data collection for passive supply systems.

The challenges of successful Information FlowLike any flow information can be diverted

redirected, misdirected and dammed.

Passive Flow = “Delayed Care”

Passive planning = “Reactive Care”

Date of Birth-----------------

AGE-----------------

Under 40/40-65/Over 65-----------------

OLD/YOUNG

Information Identity

AGE O/Y Over 65 AGE

Information Chain Analysis

Information Stream

Transmission

Large Databases

Inconvenient Access

Waiting

Over-processed

Over-production

Incorrect Information

7 Brakes on information flow

Analysis of Constraints

What is necessary for the development of ‘Information Pull’?

Where does information get hung-up?

Primary Care

Secondary Care

Acute Care

Social Care

Third Sector

Community Care

Pouring IT on What is the impact of IT on those individuals with Long-term conditions?

1. Proactive information gathering and process development offers faster integration of new systems in the organisation.

2. Maintaining a proactive information gathering mentality reduces brakes on flow and increases responsiveness.

3. By proactively sourcing information required for medical processes, procedures and treatments clinicians can have more confidence in the information.

4. Establishment of procedures reduces unnecessary variation.

Examples of Enhanced Information Flows?EPCS. ECS. EKIS.SPARRAACPPersonal PassportClinical PortalMultidisciplinary ForumDigital StoriesEstimated Date of Discharge

Anticipatory CareA “thinking ahead” philosophy of care.

Working with people and those close to them to set and achieve common goals.

Anticipatory care planning is applied to support those living with a long term condition to plan for an expected change in health or social status.

To allow this information that already exists needs to be made available by another individual.

Audience Participation

Work Shop Identify one line of information flow that you

know is not as fluid as it could be?

In the group consider what part of the information is valuable and why?

Consider the examples of waste that you know of.

Write down three ways in which one of these flows could be changed to reduce the impact of this waste within the information flow?

Output1. Identify what information is required

1. Identify the pathway

1. FLOW

1. Active vs Passive Flow.

Questions?