Scottish Healthy Communities Collaborative

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Scottish Healthy Communities Collaborative
Carolyn Wilson PK Falls Service Manager
Jackie Doe SHCC Project Manager
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Scottish Healthy Communities Collaborative

• Partnership project between NHS Tayside, Perth
  and Kinross CHP and Local Authority.
• 2 pilot sites in Scotland Perth and Kinross,
  Argyll and Bute
• Supported by National Primary Care Development
  Team Healthy Communities Collaborative
  (England)
• Award winning success in English Sites

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What we are doing

• Bringing together teams of local people who are
  supported by professionals from different
  agencies to make improvements in preventing
  falls.
• Redressing inequality
• Increasing Social Capital

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Another way of looking at that

• teams of
• local people
• Health staff
• Council staff
• Voluntary sector staff
• Private sector staff

• Reduction in falls
• ? social capital
• ? networking
• ? other improvements

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The Specific Aims of the Healthy Communities
Collaborative

• To reduce falls in the over 65 age group within
  the geography of the sites by 30
• To reduce falls in identified care homes by 30
• To reduce referrals from the care home to a step
  up facility (hospital) by 50
• To set up falls registers

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More importantly

• Every 5 hours an older person is killed by an
  accidental fall in the home.
• 80 of deaths from accidents are in the gt65 age
  group.
• 40 of care home admissions are as a result of
  falls
• 42 reduce activity after a fall
• 1 in 20 patients suffering a hip fracture die
  during their stay in hospital
• Huge effect on confidence, isolation,
  independence for individuals and families

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Whos going to do this?
Voluntary /Charitable/Private e.g. Age Concern,
WRVS, Care Home Managers, Care and Repair
?? ??
????
Community Members
Health/Local Authority e.g. Nursing, OT,
Podiatry, Home Care managers, Wardens, PK
Leisure
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What this looks like

• 3 teams of 8-10 people in each
• Perth City-Letham, Hillyland, Feus Road,
  Fairfield
• Blairgowrie, Rattray, Alyth
• Crieff, Comrie, Gilmerton, Muthill
• Each in a defined area with a population of
  around 10 000 people
• A local care home in each area
• A falls register in each area

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The Community Action Model
Topic
Stimulates Desire for other topics
Successful action
Enhances Community Development
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How will we do it?
Community Development
Collaborative methodology
Community Action
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The Collaborative Process

• An improvement method that relies on spread
  and adaptation of existing knowledge to multiple
  settings to accomplish a common aim.

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Collaborative Culture

• Firm on results
• Forgiving (no blame)
• Flexibility (ideas methods)
• Facilitative (Group learning and rapid doing)
• Fun!!!

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(No Transcript)
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Mock up of sitting room with lots of fall hazards
- competition to identify risks
Spot the Falls Hazards!
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Falls in older people

• Exercise
• Medicines
• Lighting
• Eyesight
• Footwear / Feet

• Understanding the Need
• Reducing Personal Risk
• Reducing Environmental Risk

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After Sites are Chosen Participants
join
Action Phase Reducing personal and environmental
risk
Action Phase Understanding the need
Pre work
Learning Workshop 1
Learning Workshop 2
Learning Workshop 3
Orientation Event
Feb 05 March05
June 05 Nov 05
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Role of team members.

• Be part of a team
• Agree priorities for their area and generate
  ideas
• Attend 3 residential Learning Workshops held in
  Perth
• Test out changes spread and sustain them
• Steer the Steering Group
• Participate in local interim events
• Use the tools

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The PDSA Cycle for Improvement
Act
Plan

• Objective
• Questions/predictions
• Plan to carry out the
• cycle
• (who, what, where,when)
• Plan for data collection

• What changes
• are to be made?
• Next cycle?

Study
Do

• Complete the
• analysis of the data
• Compare data to
• predictions
• Summarize
• what was learned

• Carry out the plan
• Document
• problems and
• unexpected
• observations
• Begin analysis
• of the data

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Why use PDSAs?

• They allow us to measure if we have made an
  improvement
• They are a common sense approach to improvement
• They are quick and simple
• They are Doable
• We can record results

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Blairgowrie Team learn Plan, Do, Study, Act
Methodology
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Measurement for Improvement

• Why do we measure?
• Track progress
• See improvement
• Demonstrate Success

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Two parts to measurement

• Falls Data
• Collected from a number of sources
• Monthly
• Measured against the baseline
• Social Capital
• Collected from a number of sources
• At beginning and end of Collaborative

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Using data

• Data will be used with local knowledge to
  understand the local picture
• Monthly results allow us to
• Focus the work
• Identify gaps
• See successes (and failures)

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How will we know when we have succeeded?

• Falls reduced in each of the team areas
• Increased knowledge and awareness of falls in our
  communities
• Improved confidence in participants
• Stimulated a desire for making changes and
  improving other topics
• Better networks and connections

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Team remit

• Results
• Timely reports
• Sharing their experiences good and bad
• Participate constructively
• Proactive in spreading the learning
• Communicate with organisations in their local
  area
• Engage with all parts of their communities

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Its nice to know Im still employable at my
age! Flora (on right) from the Crieff team
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Quality Improvement Questions
Challenges of creating, sustaining and spreading
innovation

• How might the skills be transferred into a wide
  variety of diverse cultural settings and how
  might these differences affect-
• Engagement with the community
• Influencing community development and community
  action
• social capital gains
• receptiveness to new concepts
• spreading out the model

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Quality Improvement Questions
Challenges of creating, sustaining and spreading
innovation
Does the Collaborative methodology approach work
with the general population, and if so, why might
this be? How can we ensure sustainability once
the driving force withdraws?
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Quality Improvement Questions
Core local research needs

• The SHCC uses 2 main measures for improvement
• Falls monthly data
• Social capital questionnaires (very time
  consuming)
• Are there any better methods for measuring social
  capital?