Adrian Pennington

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Adrian Pennington National Director CHD
Collaborative
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Our Goal
to improve the experience and outcome for people
who have, or are at risk of developing heart
disease by redesigning the whole pathway of care
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Health Impact of CHD
Equivalent to 6 jumbo jets crashing every week
for a year killing all passengers and crew
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Rapport

• Improvements and Impact - Searches for
  knowledge, innovation and improvements at every
  NHS Trust/PCT at each stage of patient journey
• Targets/PPF/Aggregate Data - Specifically tells
  you if your processes are capable of meeting
  targets
• Variation - Helps you to understand your systems
  and manages variation using Statistical Process
  Control (SPC)
• Waiting Times - Helps you to eliminate delays and
  reduce waiting times
• Demand and Capacity - Analyses demand and
  capacity
• Communication - Encourages teamwork and
  communication group e-mail and contacts
  directory

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Revascularisation
85 Labs being built
CHD Collaborative Launched
Only 7 new cath labs built in the period
gt25,000 Angiography, 1000 EP, 2500 Pacemakers
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Aggregate DataEchocardiography/Bed days
savedActual and Forecast
218 Acute Trusts
44 Acute Trusts
1 day
5.25 days
Target 2000 beds saved for alternate use by
March 2005 Echo, Transfers for angiography, PCI,
cardiac surgery, Heart Failure management, Early
Discharge, Etc Financial Impact 2000 at 150 per
day times 365 109,500,000 per annum -
(exceeds total 6 year programme budget)
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Understand the inconsistency within your
system England Political Agenda drives
managers Clinical agenda operates against
political Both working to same aim understand
the links Examples Hidden Waits Revascularisati
on waiting times Resource implications medical
innovation
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Availability of staff
Medical innovation
Competency of staff
Clinical Audit, protocols
Accessibility
Point of entry
Clinical risk
Competency framework
Timing
Interpretation
Patient journey
Beneficial to patient care
Duplication
Consistency
Data collection / duplication
Clinical acceptability
Information culture
The problem How do we assess the impact of
modernisation?
Improvement culture
External Performance Management
Measurement ability
Targets
No baselines
NSFs
Capability
Equity
No reporting system
Attitude of senior management
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Outcome variance
Our outputs

Outcome
Organisational ability
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God gives every bird its food, but he does not
throw it into their nest J.G.Holland
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Solution Framework
Clinically Beneficial
Inclusive Performance Framework
Avoids Duplication
Tools for Analysis
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The Tools SPC, 6 Sigma Clinical
Microsystems Polarity, AI, etc
Demand Capacity
Process Map Review
Service Improvement
Demand Capacity 2
LDP Priority
Revenue / Capital Investment
Health Community owned process
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Variables across a health system
Culture Work force Clinical Governance Risk
Management Equipment Environment Resource Process
Equity Quality Numbers Case Mix Capability
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Ades Advice
Small changes, breed a cycle of continuing
change Never change big, to much to do whilst
maintaining existing standards of practice PLAN
BIG SHARE BE HONEST AND OPEN GIVE APPROPRIATE
SUPPORT