An Associated University Hospital of

Brighton and Sussex Medical School

Trust Board summary

October 2018 v1.1

Overview of KPO

• Our aim is to pursue perfection, putting our patients at the

forefront of everything we do, improving safety and quality

by reducing variation and waste in every process. Our

SASH+ work supports an accelerated transformation in

quality by providing us with a structured approach to

continue our improvement journey taking us from a good to

an outstanding organisation.

• Our kaizen promotion office (KPO) team lead the

transformation programme; they provide the structure,

methods and rigour behind the successful implementation

of the SASH+ improvement methodology, alongside

training and developing others to lead using the new

methods.

Strategy alignment

Organisational goals and

SASH+ links

VS updates

VS1 – Cardiology

Improvement work currently paused as team embed improvements agreed at

previous RPIWs. Progress against this is being monitored monthly via

performance reviews

VS2 – Outpatients: ophthalmology

Baseline for revised high level metrics for this value stream are currently being

collated

Second RPIW for ophthalmology being planned which will focus on booking of

follow up appointments following a clinic consultation

VS3 – Management of diarrhoea

Improvement phase is now complete after 6 RPIWs. Now moved to

implementation phase which will include roll out of 25 improvements identified in

RPIWs. A heat map of all of improvements and all wards will be used to monitor

implementation

VS updates

VS4 – Sepsis

3rd RPIW currently being planned for focussing on how staff receive

education and training around sepsis when they join the Trust

VS5 – Discharge

Launch event complete with more than 40 staff and patient

representatives involved. Current state high level value stream validated

and future state value stream agreed. Baseline of high level metrics data

currently being collected. 1st RPIW focussing on setting estimated date

of discharge was held in September 2018 and lead time reduced from

23½ hours to 29 minutes

VS6 – Diagnostic imaging

A value stream sponsorship team has been established and Dr Ed Cetti

is the executive sponsor. The scope of this value stream will be from

request for outpatient CT scan to report being available. Observation and

data collection is underway and the launch is planned for 21 November

and the first RPIW is scheduled for January 2019.

Education and training – roll out plan

Planned for

17/18

Planned for

18/19

Planned for

19/20

Induction All new starters (1101) All new starters

(1100 anticipated)

All new starters

(1100 anticipated)

5S and waste taster

sessions – for all new

and current band 1 – 4s

6 sessions per year -

bi monthly

20 – 30 staff per

session

6 sessions per year -

bi monthly

20 – 30 staff per

session

6 sessions per year -

bi monthly

20 – 30 staff per

session

One day introduction –

for all new starters,

junior doctors and staff

on FTC > band 4

6 sessions per year -

bi monthly

20 – 30 staff per

session

6 sessions per year -

bi monthly

20 – 30 staff per

session

6 sessions per year -

bi monthly

20 – 30 staff per

session

KSS junior doctors

introduction day (HEE)

N/A Monthly sessions for

20 – 30 staff planned

to commence

October 2019

Monthly sessions for

20 – 30 staff planned

Mistake proofing 1 session delivered for

25 staff in March 18

2 sessions per year

planned for up to 60

staff

2 sessions per year

planned for up to 60

staff

Promoting innovation 1 session delivered for

31 staff in January 18

2 sessions per year

planned for up to 60

staff

2 sessions per year

planned for up to 60

staff

Education and training – roll out plan

Planned for

17/18

Planned for

18/19

Planned for

19/20

L4L 4 cohorts of 25 - 30

staff planned to

commence each year

4 cohorts of 25 - 30

staff planned to

commence each

year

4 cohorts of 25 - 30

staff planned to

commence each

year

0%

5%

10%

15%

20%

25%

30%

35%

0

10

20

30

40

50

60

70

80

Cohorts 1 & 2Jun 16 to Jun

17

Cohorts 3 & 4Feb 17 to Mar

18

Cohorts 5 & 6Sep 17 to Oct

18

Cohorts 7 & 8Jan 18 to Dec

18

Cohorts 9 &10

Jul 17 to May19

Commenced

Graduated

Cumulative L4L total

Cohort target

Attrition

Education and training – roll out plan

Planned for

17/18

Planned for

18/19

Planned for

19/20

ALT 2 cohorts of 10 staff

planned to commence

1 cohorts of 5 staff

planned to

commence each

year

1 cohorts of 5 staff

planned to

commence each

year

0

2

4

6

8

10

12

ALT originalcontract

SJ, AH, HG,KM

ALT cohort 1ZP, SC, PT,

SR

ALT cohort 2Feb 18 toMay 18

BP

ALT cohort 3Jun 18 toSep 18JF, LW

ALT cohort 42019

ALT cohort 52020

Commenced

Certified

Target

RPIW cert

Cumulative RPIW cert

Cultural Assessment Tool Results

2018

Presentation title

3534 people within SASH were invited to take part in the survey. 1243 people

completed the questionnaire. This represents 35.2% of those invited to

participate.

Organisation Score – overview

The following table shows the mean scores across the organisation for all of

the cultural dimensions measured by the CAT

Cultural Assessment Tool Results 2018

SASH

Presentation title

The following table shows the comparison of mean scores for all the cultural

dimensions by Knowledge or experience of VMI Partnership

NB: In the mean data tables significantly different scores are shown in red or green. Figures shown in red indicate that we can be 95% certain that the score is significantly

lower than the overall mean score (p<0.05). Figures shown in green indicate that we can be 95% certain that the score is

Significantly higher than the overall mean score (p<0.05).

SASH results indicate that in 2 of 9 dimensions measured, SASH score higher than average where staff have participated

in activity relating to the NHS Partnership with VMI ‘SASH+’

CAT score comparisons

2016 2018 Difference

Values 3.98 4.14 +0.16

Vision 3.66 3.80 +0.14

Objectives 3.98 4.02 +0.04

Feedback 3.49 3.72 +0.23

Support 3.56 3.73 +0.17

Compassion 3.93 4.04 +0.11

Learning, Quality &

Innovation

3.56 3.76 +0.20

Team Working 3.93 3.95 +0.02

Collective

Leadership

3.69 3.82 +0.13

SASH+ staff knowledge comparison from CAT

survey

Heard about

SASH+

Not heard about

SASH+

Taken part in

briefing or

learning

2016 2018 2016 2018 2016 2018

Values 3.95 4.12 3.88 4.11 3.96 4.20

Vision 3.55 3.81 3.30 3.57 3.68 3.90

Objectives 3.86 3.96 3.88 3.92 4.03 4.21

Feedback 3.43 3.72 3.31 3.60 3.45 3.85

Support 3.46 3.74 3.21 3.61 3.56 3.76

Compassion 3.88 4.01 3.70 3.85 4.00 4.09

Learning 3.50 3.75 3.33 3.62 3.46 3.87

Team

Working

3.84 3.91 3.77 3.84 3.92 4.13

Leadership 3.60 3.80 3.43 3.66 3.71 3.90

Trust headlines • Trust level

- Announced CQC inspection due 16/17 October

- The BBC’s team from The One Show has completed filming of SASH+ work for an item they are

planning to feature wc 15.10.18

- Continued attendance at and really positive feedback from quarterly Kaizen open days which

continue to be offered for regional and national stakeholders and health and social care

colleagues

• Safety - Implementation plan for management of diarrhoea value stream improvements now underway

- “App” developed to support the daily checking of key anaesthetic equipment in theatres which

demonstrates compliance and provides assurance that all relevant checks have been completed

- Sepsis value stream launched and third RPIW being planned for

• Access and flow - Discharge value stream now launched and planning for first RPIW

- VSST for 6th value stream now established – diagnostic imaging

- Real time updated clinical operations boards helping to support flow of hospital and capture bed

hours lost per day

Trust headlines cont.

• Value - Impact assessments being completed by all L4L and ALT graduates. This focuses on value in its

broadest sense including patient experience, staff experience, set up reduction, 5S

improvements, mistake proofing, quality defects, increased activity/productivity and reduced

costs. It also asks candidates to consider the spread and sustainability opportunities of any

improvements that have been made

- Lowest reference costs for any acute trust in the country

- Contributed to NHS providers national report of productivity and efficiency

- “Rooming in” process for fracture clinic patients has improved ability of consultant to see 24

rather than 8 patients per clinic

- Virtual clinic has reduced demand for low acuity new patient attendances by 4 – 5 patients for

every 20 patient clinic

- Top 20% scores for national staff survey results

• Culture - 9 people completed ALT including medical director

- 48 more commenced on L4L

- First NED has completed 6 taught modules of L4L

- Improvements on CAT scores across the board compared to 2016

- Secured contract with HEE to train all junior doctors across Kent, Sussex and Surrey in SASH+