Helping People to live well / Research and innovation. We are empowered / We keep things simple

Transcription

1 Report to: Paper number: 2.2 Report for: Board of Directors (Public) Information / Discussion Date: 27 July 2017 Report authors: Report of: FoI status: Fredrik Johansson, Consultant Psychiatrist Martina Agho-Chimbumu, Project Manager Vincent Kirchner- Medical Director Report can be made public Strategic Aims Supported: Cultural Pillar Supported: Helping People to live well / Research and innovation We are empowered / We keep things simple Title: Quality Improvement (QI) at Camden & Islington - Progress Report Executive Summary This report is to provide the Board with an update on the progress of the C&I QI initiative. Since launching in January, the QI initiative is gaining momentum and its implementation across the Trust is progressing: The QI Hub launched in May 2017 and continues to be developed. The Hub has started work on the four central drivers in achieving a culture of continuous improvement in C&I engaging staff to feel empowered and energised, building capacity through education and training, supporting teams to deliver QI projects and developing QI Champions across the Trust. We have procured 250 licences per year for two years from the Institute of Healthcare Improvement (IHI) Open School online training course to train staff in improvement science and systems thinking. So far 246 staff have expressed their interest in doing the IHI online training course 121 staff have enrolled and 69 have started the Open School courses which they can complete over the coming year. The Improvement Academy was chosen to develop and a training packages for senior management, the board of directors, service users and carers in QI methodology. The first wave of training for 40 senior staff members is due to take place on 24 July Since the QI Hub started we are supporting 6 QI projects with more are at a planning stage as well as advising on other improvement work in the Trust we anticipate that the number of projects will increase rapidly as engagement and capability increases.

2 Recommendation to the Board The Board of Directors is requested to: CONSIDER and DISCUSS on progress of QI Steering on the strategic importance of a Quality Improvement programme Risk Implications Focus on current financial challenges, upcoming CQC visit and resources for the central QI team may impact the successful implementation of the key deliverables of the QI programme Finance Implications Funding of posts at a cost of 32,175 per annum. Time staff will take out of their normal duties to do QI projects. Equality and Diversity Impact / Single Equalities Impact Assessment This is Trust-wide initiative open to all and benefiting everyone. 2

3 Introduction The Trust Board agreed the development of a QI programme in the November 2016 Board meeting. Work started in January QI methods and culture is in essence about empowering staff and giving them the skills, authority and responsibility to make changes in their services, effectively and quickly in order to improve the quality of what we do. This flows from our cultural anchors. QI methodology enables individuals and teams to lead their own improvement projects, measure change in systematic ways and for successful improvement to be scaled-up rapidly across the Trust. This report provides the Board with an update. Main Aim Our vision is to create a culture of sustainable, continuous improvement across C&I and over the next five years we aim to: reduce levels of avoidable patient harm; improve staff satisfaction so that we are in the top 20% of providers; and improve patient experience so that we are in the top 20% of Mental Health providers for the Friends and Family Test. Key Objectives To engage with staff and patients to ensure everyone knows about QI and feels empowered and energised to get involved in improving care. To build capacity and capability through a programme of QI education and training to enable staff to lead on QI activities and initiatives. To support teams to deliver QI projects and programmes which are co-designed with patients, service-users and the public. To develop a cohort of QI Champions across the Trust who have the leadership capacity and capability to enable others to get involved in QI. Progress made against key deliverables/milestones The implementation of the QI programme across the Trust is gaining momentum and progressing steadily. 1. Engage an improvement Partner The engagement of an improvement partner (an estimated one off cost of 50-80,000) has been put on hold. To support the development of strategic supports for QI across the Trust, the Improvement Academy can deliver a 1-day critical friend consultancy session to the Trust Board at a cost of 2,850 (+VAT).

4 2. Build a central QI team The central QI team is currently being set up to manage the QI hub. The team will be made up of a number of QI coaches led by a QI Clinical Consultant. The table below shows the composition of the team and progress made so far. Item: Detail: WTE: Cost: Update: Senior QI Coaches Strategy Lead 0.1 Cost neutral Lucy Reeves (Chief Pharmacist) is helping to develop the QI Hub Clinical QI Coaches Programme officer Consultant Psychiatrist ,000 Freddie Johansson has been appointed as QI Clinical Consultant. Started on 1 May Psychologist ,175 Executive agreed for the funding of 0.5 WTE and the post is due to be advertised with some expression of interest from internal candidates. Head of Quality & Patient Experience Staff members on 12 month secondment Band 6 Programme Officer This post has now been removed from the QI hub as it has been significantly changed and no longer has obvious synergy. 2 x 0.6 Cost to two Divisions per year 1 Cost neutral Two divisions will put forward a staff member each on a 12 month secondment for the QI Hub with the staff members continuing to be funded by the Division. They will develop expertise in QI and focus on supporting projects in their division. Currently they have 0.2 WTE allocated to QI work and further time will need to be negotiated with the divisional leads. R&R has put forward Darryl Taylor. Acute Division had several interested staff members and through interviews appointed Luneta Tajblova. Agreement to identify from existing Trust resources. Data Analyst Band 6 Data Analyst 2 x 0.5 Cost neutral We have two staff members in Clinical Audit and Service Improvement who will share this role because QI will largely take over from clinical audit. They already have the data analysis skills. Total Funding Requirement 32,175 4

5 3. Interim training for the workforce We have procured the Institute of Healthcare Improvement (IHI) online training programme and went live on the 1 April A total of 250 IHI Open School licences were purchased for a two year period funded with money ( 13,000) from Health Education England. Invitation to register for the IHI online course has been communicated to all staff. The uptake has been very positive with 246 staff expressing their interest to do course, with 121 staff enrolled and 69 have started the Open School courses which they can complete over the coming year. A number of training and development programmes are being developed or have started to be delivered by the QI Hub. 4. Quality, Service Improvement and Redesign (QSIR) Course The initial proposal was to purchase the QSIR course to train the QI Hub which in turn would train the workforce in QI. However, QSIR will only accept a cohort of students if they come from across a STP footprint. The Improvement Academy programme has been identified as an alternative. We have procured the following training from the Improvement Academy for the QI Hub, staff members with management responsibilities, service users and carers: Package 1- Delivery of 2.5 day training, comprising: a) 1-day silver for individuals QI workshop for up to 40 attendees. It is recommended that all Execs, NEDs, ADs, CDs and Band 8 managers attend; and b) 1.5-day train the trainer workshop for up to 10 attendees which will be for the QI Hub and other key people. The plan is to purchase two of package 1 at a cost of 9,500 (+VAT). Package 2 - Observation of training: observation of one trainee trainer delivering silver training for teams. The plan is to purchase two of this package at a cost of 1,600 (+VAT). Package 3 - Delivery of a 1-day face-to-face Bronze training for service users and carers at a cost of 2,150 (+VAT). Key Risks The key risks identified are: recruitment of a the Senior QI Coach - Psychologist post; sustainability of the secondment of a clinician from each of two Divisions per year to the Clinical QI Coach positions - we currently have 2 QI coaches seconded for 0.2 sessions with aim to increase this when the programme accelerates in terms of project number; identification of QI programme officer; and current significant financial challenges and associated cost-saving programmes and focus of senior management on CQC visit will reduce available resource in the coming months for engagement of spread of QI culture, projects and ideas, and may prevent a critical mass of involvement to affect large-scale change at least in short-term. 5

6 Key Goals and achievements for the next 6 months QI Hub team development and training including the Improvement Academy training to be completed. Improvement Academy training for Board, Senior Managers, Service user and Carer groups. Develop a Communication strategy and work with the communication team in raising awareness, providing tools and resources to staff, and celebrating QI work to quickly share learning and improvement to allow scaling-up of successful changes. Begin design and delivery of QI training for local teams, and provide engagement workshops with local teams to support QI projects our first condensed QI training for clinical teams will take place on 12 July Establish data sets and data collection processes to monitor progress of the high level aims of QI programme patient experience, staff satisfaction and avoidable harm reduction. Develop a repository of QI projects and the first QI projects to be started. The QI Hub are supporting 6 QI projects currently with several more in the planning stage we had set initial aim of having 5-10 projects underway by 6 months from starting the QI Hub. We anticipate that number of projects will increase rapidly with increasing number of staff trained in the QI method and building engagement across the Trust. We will work with teams and senior managers to identify how QI methods can be applied to the CQC visit action plan and the Trust s cost-saving initiatives and support these where requested the QI Hub is contributing to work and ideas on the inpatient length of stay project and service user care plan development and recording of capacity and consent. Fill position of QI Psychology post and identify Project Officer and provide with necessary training and development. 6