Making High Impact Changes for Children and Young People with Long Term Conditions 13th November 200

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Making High Impact Changes for Children and
Young People with Long Term Conditions13th
November 2008Long Term Conditions
Collaborative Delivering sustainable
improvements in patient centred services for
people with long term conditions

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Aims

• Identify improvements in managing childhood
  asthma
• Raise awareness of relevant LTCC High Impact
  Changes (HICs)
• Develop ideas for tests of change
• Explore data sharing

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Whole System Burden of LTCs

• 80 of all GP consultations
• 60 of all inpatient bed days
• 70 of all emergency admissions
• 80 of all prescribed medicines
• Long term care needs
• Shifting the balance of care
• Self management carer support issues
• Health inequalities

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Ways of working

• Generic approaches
• Health improvement
• Local Authority Partners
• Voluntary Sector
• eCare and eHealth
• Telehealth/Telecare
• QIS
• NES
• Rehabilitation
• Palliative care
• Other improvement programmes

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What is a Collaborative Improvement Programme?

• A Collaborative Programme is a comprehensive
  way of creating specific improvements for
  patients based on evidence-based principles for
  spreading best practice. It has proven
  improvement techniques developed from the
  learning of thousands of improvement projects.
• (NHS Modernisation Agency Improvement
  Leaders Guide 2002)

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Collaborative

• Creates time and opportunity
• Supports practitioners and local teams to take
  action and test changes
• Supports understanding of care delivery processes
  and clinical systems
• Focus on spreading existing knowledge as well as
  the creation of new evidence base
• Supports development of capacity / capability for
  change sustains spreads good practice
• Patient focused and looks at services from user
  perspective

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Using improvement tools and techniques to test
potential solutions through a systematic plan
Developing the capability and capacity for change

• Embedded sustainable improvements
• Performance management
• Culture of continuous improvement

• Recognition of the need for change
• Discomfort with the status quo

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The fundamental improvement questions

• What are we trying to achieve?
• Know exactly what you are trying to do have
  clear aims and objectives
• How will we know that change is an improvement?
• Measuring processes and outcomes
• What changes can we make that will result in an
  improvement?
• What have others done? What hunches do we have?
  What can we learn as we go along?

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Plan, Do, Study, Act
What changes are we going to make based on our
findings
What exactly are we going to do?
Act Plan Study Do
did we do it? When and how
What were the results?
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What do we mean by testing on a small scale?

• Use interviews or calculations to test
  feasibility
• Use volunteers or team members to do the tests
• Use a small sub-population
• Use one location
• Conduct the test for a short period of
  time. Ideally over one week.

Source D. Berwick
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Whole system transformation
Delivering the Vision


High Impact Changes - WHAT
Improvement Actions - HOW
LTC Collaborative Change cycles
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Examples of High Impact Changes

• We support people with long term conditions and
  their unpaid carers to be involved in person
  centred care planning
• We commission peer support groups for people with
  long term conditions and their carers and
  provided relevant, accessible information
• We have information systems that support
  registration, recall and review for people with
  multiple conditions and support data sharing
  across partners

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Workshop

• Involve patients/carers in development of the
  service
• Tailor the service/making it relevant to the
  service user
• Develop peer support groups
• Extend Personal Action Plans to all
• Explore opportunities to improve patient safety
• Facilitate collection/sharing of data

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How to contact us

• Iona Philp, Regional Manager
• iona.philp_at_scotland.gsi.gov.uk ?07500126157
• Susan Bishop, National Programme Manager
• susan.bishop2_at_scotland.gsi.gov.uk ? ?07825861323
• Dr Anne Hendry, National Clinical Lead
• anne.hendry_at_lanarkshire.scot.nhs.uk ??07734290106
• http//member.goodpractice.net/ContinuousImproveme
  ntToolkit/Welcome.gp
• Shared Space - http//www.elib.scot.nhs.uk