Format for Workstreams sessions

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Format for Workstreams sessions

• Introductions at your table
• Improvement Bootcamp overview and other
  improvement journeys
• Components of a learning system how does our
  work stack up?
• Workstream presentations 30 mins each including
  QA
• Table top reflection on own learning and
  application of improvement methodology

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The Bootcamp Experience from this..
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The Bootcamp Experience to this
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Components of a Learning System

• System level measures
• Explicit theory or rationale for system changes
• Segmentation of the population
• Learn by testing changes sequentially
• Use informative cases Act for the individual
  learn for the population
• Learning during scale-up and spread with a
  production plan to go to scale
• Periodic review
• People to manage and oversee the learning system
• From Tom Nolan PhD, IHI

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• Our Work to Tackle Poverty in South Lanarkshire
• Kay McIntosh , South Lanarkshire Council

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Our Community Planning Partnershiph

• The South Lanarkshire Community Planning
  Partnership works to improve the quality of life
  for people in South Lanarkshire by improving
  service delivery.

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Current Projects

• Parenting skills and fostering good attachment in
  children increasing uptake of income
  maximisation service for pregnant mums /new
  families
• Working to reduce the impacts of substance misuse
  on children - work to increase uptake of LARC by
  women accessing substance misuse services.
• Supporting children to achieve their potential at
  age 2, 5 and 8 work to increase attendance at
  27-30 month assessments

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Income Maximisation..Why?....

• Around 18 of children in South Lanarkshire live
  in poverty
• Can be as high as 60 in some communities
• Lack of money /debt can have impacts on children
• and parents health
• Welfare Reform having negative impacts on the
  poorest families
• Starting a family can trigger additional money
  worries/issues

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Our Aim

• To increase the proportion of referrals to the
  Money Matters Telephone Advice service from
  Midwifery Services (ensuring early intervention
  at pregnancy stage) and increasing uptake of
  benefits

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Applying the Science.

• Midwife identified
• Baseline established
• Consider tests of change
• Test
• Measure
• Analyse
• Test, measure

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Key Wins

• 6 of Midwifes clients have accessed the service
• 5 have benefited financially
• NHS referrals have increased from 4 a month to 25
  in August

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Next Steps

• Scale up ..
• E Kilbride Locality - 1 midwife - new referral
  process
• Hamilton midwife to share knowledge and
  practice across the team and apply new referral
  process
• Money Matters to provide monthly feedback on NHS
  referrals

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Key Lessons Learnt

• A good opportunity to raise awareness of EYC
• Starting small is manageable
• Get all key stakeholders involved from day 1
• Involve the people we want to support
• Run charts best in delivery offices
• Regularly review progress
• Dont be put off by unexpected/poor results

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Key Wins in the Area of
Measurement
referral process changed Women (with an interest
or need) contact details phoned into helpline
data protection issues raised re case studies.
Midwife not to use. Midwife only working 1 day
this week
Test new referral process. All women given case
studies leaflets/encouragement
Midwife on A/L
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Lessons Learned in the Area of Measurement
Dont wait until the end of the year to look at
numbers/data. Everyone needs to be measuring
not just managers A good story needs told with
words and 1,2,3,.
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Testing and Lessons Learned

• Start small
• Simple Effective
• Common sense
• Time to reflect

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Plans for next 3-6 months

• Continue to test the scaled up model.
• Ongoing review discussions with key partners.
• If outcomes are positive - further scaling up.
• Manage the implications of this

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Healthy Start Vouchers - Orkney
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Orkney CPP

• In Orkney, the people working with children and
  young people strive to make sure that each day,
  each child and young person gets
• the right help, at the right time, in the
  right way

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Current Projects

• Reduce by half the number of failed appointments
  across NHS Orkney dental services for all
  children age 0-8 by March 2014
• 95 of eligible families will receive healthy
  start vouchers by Jan 2014

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Key Wins in Presented Area of Work

• Empowerment of families
• Commitment of shopkeeper to help
• Collaborative working

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Key Lessons Learnt

• Initially thinking too big
• Attention to detail
• Dramatic scale that can be achieved
• Concentrate on finding the right people to get on
  board with you

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Key Wins in the Area of Measurement
Prior to EYC - local activity to advertise and
promote healthy start vouchers
Collaborative working commenced
Focus of activity to engage geographically hard
to reach families using PDSA
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Antenatal survey has told us
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Lessons Learned in the Area of Measurement

• Ownership of data
• Patience and trust in methodology
• The power of a run chart

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Key Wins in the Area of Testing

• Understanding methodology
• Sharing successes
• Families sharing with each other
• Building confidence

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Lessons Learned in the Area of Testing

• Specific aim being clear about what we want to
  achieve
• Follow up learning what works/doesnt work
• Scaling up reaching out to all families who
  can benefit

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Plans for next 3-6 months

• Introducing PDSA activity with another health
  visitor for Hoy and then for other islands with
  other health visitors.
• Look at availability of healthy start vouchers on
  the islands.

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TABLE DISCUSSION

• Who are individuals and/or teams currently
  working on/in this area? Are they currently using
  Quality Improvement methods/PDSA cycles to guide
  their learning?
• Reflecting on the emerging knowledge within this
  area, and todays plenary session on scaling up
  your work, what are some considerations you need
  to plan for to get to scale for your project?