5. NHSScotland Quality Improvement Hub
website
Your one-stop shop of free resources to support you
and your team deliver quality improvement
Implementation Education Networks
Measurement
Support and And
For QI
Learning Resources
Improving Practice and Outcomes for
Safer, More Effective, Person-Centred, Efficient Care
6. NES Quality Improvement Education
Programme
Supporting the delivery of high quality care
Develop a national Scottish
Curriculum Framework for Support healthcare teams
Quality Improvement to build capacity in QI
knowledge and skills
Identify and develop Deliver a range of targeted
different cohorts of QI educational solutions
practitioners across NHS
Scotland
Support the
implementation of a
Identify gaps in education knowledge management
provision across strategy which enables
quality care
NHS Scotland
7. Crossing the Quality Chasm
Knowledge-Practice Gap
• 45% defect rate in US
healthcare system – patients
not receiving care as
recommended in the evidence
base. (McGlynn et al,2003)
• 17 years to get research
recommendations into
practice (Balas et al 2000)
8. Aims of Knowledge into Action
Define a new knowledge management approach
which builds on local and international best
practice to:
- Help practitioners to apply knowledge to
practice
- Integrate better use of knowledge in quality
improvement work
- Support practitioners to translate knowledge
to deliver safe, effective, person-centred care
9. Emerging vision
An integrated network of knowledge brokers working in close
partnership with improvement teams and clinicians to
translate knowledge into action through services for :
– enquiry and problem definition
– expert search and synthesis of evidence from
research and experience
– delivering knowledge in actionable formats, e.g.
decision support.
– exchange and dissemination of knowledge
10. Knowledge into Action Support for
Sepsis and VTE Collaborative
Sourcing and Synthesising Community of Practice
Know-what and Know-how
Territorial Board and Special Board partnership
11. Latest evidence
• Involving Clinical Librarians at the Point of Care:
Results of a Controlled Intervention Academic
Medicine 86(12), December 2011, pp 1508-1512
“….30 of 34 medical residents (88%) reported having
changed a treatment plan based on skills taught by
the clinical librarian,
and 27 of 34 (79%) changed a treatment plan based
on the librarian's mediated search support. “
12. SPSP Fellowship – The Fellows
Renal Critical Pharmac
Unit Care y
Genera
l Ward
Psychiatr
y
Acute
Receivin
Pharmacists Nursing Medical
g Units
Primary
Care
A&E
Operatin Chronic
Cardiolo
g Pain
gy
Theatres Service
13. SPSP Fellowship - Learning
• A One Year program
Surgical Safety Checklist Medicines Reconciliation
Training in QI
Safe Patient Centred Rounds Medicines Reconciliation
Sepsis
Effective Reducing SSI Reducing Cardiac Arrest Rate
Reducing CRBSIs in ICU
SBAR Daily Goals
Patient Centred
Heart Failure Bundle
Handovers Reducing VAP in ICU
14. SPSP Fellowship – Back to Work
Improvement Work
Advisory Leadership
SPSP Fellows
Strategic Teaching
19. Building a network of networks
Purpose :
• Increase pace and momentum of networks to support NHS
Scotland to deliver sustainable quality and achieve 2020
vision
• Provide coherent linkages between a range of existing clinical
and non-clinical networks and communities
• Increase capacity and capability in QI knowledge and skills an
leadership for QI
• Inform and support spread, delivery of NHS Scotland
leadership and workforce strategies through spread of best
practice in clinical engagement, leadership and QI
development
• Maximise value through collaboration with other networks and
resources
23. Format
• Zone 1 Hub • Rotate every 10
• Zone 2 Knowledge minutes (whistle will
into Action blow for you to move on
• Zone 3 SPSP Fellows – Explore Questions that
Matter
• Zone 4 Improvement – Encourage Everyone’s
Advisor’s Contribution
– Listen for Insights and
Share Discoveries
• 15 minutes for
Questions at the end
Notas del editor
The Hub is committed to building quality improvement capacity and capability throughout NHSScotland in a sustainable way, rather than creating dependency. In order to improve quality of patient care it is important that we are able to measure the impact of changes to the way we deliver care. A key aim of the Quality Improvement Hub is to bring improvement science into the everyday work of NHS staff and to spread and sustain quality improvement at the local level. This aim is supported by the development of quality improvement networks which are open and accessible to all staff. The Hub has a philosophy of 'skill sharing' and 'community building'. This section of the Quality Hub Website (formerly the Evidence into Practice Portal) provides clinicians and service improvement managers with both " know-what" -e.g. validated evidence and guidelines to support safe and effective care - and "know-how" -e.g. tools, measures and examples support for implementation.
Overview of NHS Education Quality Improvement Education Programme
At McMaster teaching hospitals it was common practice for patients’ notes to include a key research paper relevant to their care & for this to be discussed at ward rounds. Sacketts team at John Radcliffe used an Evidence Cart on rounds. They asked & answered 2 questions for every 3 patients with the searches changing 1/3 rd of clinical decisions. An EBM training course of 7 1hr sessions & provisions of EBM resources significantly improved evidence based practice patterns namely therapies proven to be beneficial in RCTs & more likely to be based on high quality RCT’s. Clinical informaticist or librarian case related medical search influenced patient management & diagnostic thinking in 20% of cases. Cost equivalent to labs
The Fellowship was created to train front line clinicians in improvement methodology to support the SPSP The Fellows came from a variety of clinical areas and professional groups.
The Fellows undertook a one year program which aimed to teach the use of the MFI Supported by their employers with a release of time and local sponsorship. The Boards were recompensed by HIS. They received a number of lectures and tutorials at residential sessions, but predominantly learned theory through self directed reading and experience They undertook a project based in their workplace and used this to learn to use the MFI Projects have ranged over many patient groups and clinical areas and produced meaningful improvements in patient care A number have been published. Fellows also got the opportunity to visit high performing organisations to learn from the best, and to meet many working in the field of QI
The Fellows return to the day job where their improvement work continues. They undertake many projects, while continuing in their clinical role. Skills and knowledge continue to develop through experience of new improvement work well after the formal teaching is over. This has been helped by the continued involvement of HIS and the development of a network of Improvement Practitioners. Boards are keen to use Fellows’ skills to drive local goals although a common experience is that there is no ‘natural’ role for a Fellow. How best do we use them? New roles have developed often through the work of the Fellows themselves, both locally and nationally, in driving the work of the SPSP and aims of the Quality Strategy. Cohort 5 is due to commence their course this autumn. It is hard to know what overall impact the Fellowship has had on overall NHS performance, or what may be expected from around 50 people. It is fair to say that the Fellows continue to drive improvement and the full impact may not be felt for some time.
They joined with varying levels of knowledge and skill in Improvement Science and commenced a fascinating journey of learning
Through the Institute for Healthcare Improvement, the IA Professional Development Programme was taught by world recognised leaders in improvement science and this first cohort of IAs in Scotland have benefitted from 9 months of learning new skills to help build the knowledge of healthcare staff across NHS Scotland
They will tell you about their experience and show you how you too can become involved in improvement activity in your healthcare system.
Person-Centred - Mutually beneficial partnerships between patients, their families, and those delivering healthcare services which respect individual needs and values, and which demonstrate compassion, continuity, clear communication, and shared decision making. Clinically Effective - The most appropriate treatments, interventions, support, and services will be provided at the right time to everyone who will benefit, and wasteful or harmful variation will be eradicated. Safe - There will be no avoidable injury or harm to patients from healthcare they receive, and an appropriate clean and safe environment will be provided for the delivery of healthcare services at all times.
