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The journey -

The Small Business Research Initiative is an innovation challenge to industry. The object of this particular SBRI was to develop technology solutions to help reduce secondary care admissions and deliver new services and products to the NHS. The solution featured here is Message Dynamics’ ‘COPD Monitor’ which uses interactive voice technology to monitor patients’ wellbeing.  It is designed to improve patients’ quality of life, improve disease management, reduce admissions and reduce costs.  

Outcomes

The COPD monitor calls patients twice a week to record their state of health. Between September 2011 and February 2012, almost 1,500 calls were completed (a response rate of 91 per cent). Of these, 13 per cent generated an alert which starts an automatic escalation process. An initial follow up call by the unit’s nurses resolved 80 per cent of issues and the remaining 20 per cent required home visits. These home visits prevented nearly forty emergency admissions (representing a saving of at least £80,000). The investment in this project by the SHA has been £48,775. However, excluding the development cost the cost of the service to deliver this service is £375 – ie 25p per call. The return on investment ratio of this pilot is in excess of 200:1. An unanticipated benefit is that patients like talking to a computer; they do not feel they are wasting people’s time and patients report feeling less isolated. Clinicians are also noting that patients are becoming better equipped to understand and manage their own conditions.  

Patient setting

In-patient   X Out-patient   X Community based   X
Mental health Chronic illness   X Cross-systems   X
 

Clinical area

Staying healthy   X Maternity and newborn Children and young people Acute care   X
Planned care Mental health Long-term conditions    X End of life
 

Information, tools and techniques used

SBRIs start with a ‘problem space’ which can be defined quite closely to respond to a specific issue.  Prince project management underpins the thinking of the programme management team and helps provide a balance between process structure and outcome focus.  

Geography

The programme covers the South Central SHA area.  

Timescale

SBRI was launched in July 2010 and companies were given six weeks to bid. Sixty-nine companies from the UK and overseas responded in September 2010 and in November, Message Dynamics was one of four companies that received funding to take their proposal to a ‘proof of concept’ (POC) by February 2011. The product was adopted in September 2011 and is now offered to all patients referred to the specialist COPD service at Heatherwood and Wexham Park Hospital.  

Contact details and further information

Duncan Goodes, Head of Innovation Promotion: Duncan.Goodes@nesc.nhs.uk [post_title] => Small Business Research Initiative [post_excerpt] => [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => small-business-research-initiative [to_ping] => [pinged] => [post_modified] => 2013-01-16 15:15:37 [post_modified_gmt] => 2013-01-16 15:15:37 [post_content_filtered] => [post_parent] => 0 [guid] => http://clients.electricstudio.co.uk/tvhiec/wpcms/?post_type=improvement-science&p=3408 [menu_order] => 0 [post_type] => improvement-science [post_mime_type] => [comment_count] => 0 [filter] => raw ) [1] => WP_Post Object ( [ID] => 3407 [post_author] => 8 [post_date] => 2013-01-16 15:09:54 [post_date_gmt] => 2013-01-16 15:09:54 [post_content] =>

The journey -

This programme aimed to improve quality, reduce spend and increase efficiency inmusculoskeletal (MSK) services in East Sussex. Data on efficiency and spend in MSK services were presented to 70 participants at an event called Shaping the Future, where a number of key issues and possible solutions were identified.  These included high rates of fractures and falls admissions, high rates of arthroscopy and of elective admissions, fragmented MSK services and variation in referral rates. The programme has since focussed on pursuing solutions to these issues, including peer-review by GPs of referrals, agreeing surgical policies for arthroscopy and eight further orthopaedic procedures and introducing physiotherapy triage as an alternative to orthopaedic referral.  In order to achieve change in systems and results, it has been necessary to influence culture and behaviour and seek consensus across a number of systems. Alongside this, an integrated MSK service has been procured in Hastings and Rother and commissioning of a similar service is being considered for the remainder of East Sussex in conjunction with other local commissioners.  

Outcomes

Savings achieved in arthroscopy totalled £1.8million in 2010/11 and a further £600K in 2011/12 Interim outcomes for physiotherapy triage are encouraging, and there is increased interest in MSK from a primary care perspective.  A service specification and business case has been agreed for a Falls and Fracture Liaison service for East Sussex and work is underway to implement Shared Decision Making – critical to ensuring that patients are fully aware and have the option to participate in decisions about their care, particularly where more than one treatment option may be available.  

Patient setting

In-patient  X Out-patient   X Community based   X
Mental health Chronic illness   X Cross-systems   X
 

Clinical area

Staying healthy Maternity and newborn Children and young people Acute care
Planned care  X Mental health Long-term conditions   X End of life
 

Information, tools and techniques used

The programme has used a range of national and regional best practice tweaked for local use. For example, the Framework for Musculoskeletal Services, National Institute of Clinical Excellence, surgical policies from other PCT areas, data from the NHS Atlas of Variation and the South East Public Health observatory.  

Geography

The programme covers East Sussex, including East Sussex Downs and Weald and Hastings and Rother PCTs; in the process of becoming three CCGs in Hastings and Rother; Eastbourne, Hailsham and Seaford; High Weald Lewes and Havens. Partners involved in the work include East Susses Healthcare Trust, The Horder Centre (a private orthopaedic service), Brighton and Sussex University Hospitals and a range of independent physiotherapy, MSK and orthopaedic outpatient services.  

Timescale

The programme started in 2010 and is still ongoing.  

Contact details and further information

Fiona Streeter, Service Development Team Leader, East Sussex: fiona.streeter@nhs.net

[post_title] => Reducing spend and increasing efficiency in MSK services [post_excerpt] => [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => reducing-spend-and-increasing-efficiency-in-msk-services [to_ping] => [pinged] => [post_modified] => 2013-01-16 15:09:54 [post_modified_gmt] => 2013-01-16 15:09:54 [post_content_filtered] => [post_parent] => 0 [guid] => http://clients.electricstudio.co.uk/tvhiec/wpcms/?post_type=improvement-science&p=3407 [menu_order] => 0 [post_type] => improvement-science [post_mime_type] => [comment_count] => 0 [filter] => raw ) [2] => WP_Post Object ( [ID] => 3405 [post_author] => 8 [post_date] => 2013-01-16 15:03:56 [post_date_gmt] => 2013-01-16 15:03:56 [post_content] =>

The journey -

This programme aims to build on an already strong local history of collaboration and engagement to drive forward some ambitious integrative changes to the local healthcare system across a range of identified pathways.  It involves a long-term, systematic culture change. The programme has concentrated initially onthree care pathways (cardiology, diabetes and rheumatology) to showcase and test cases for change in order to be able to create much greater integrated systems of care in the future.  

Outcomes

Outcomes are not yet fully identified, as this is both a large-scale and a long-term change programme.  However, there are already demonstrable improvements to patient experience and outcomes within the defined pathways.  

Patient setting

In-patient Out-patient Community based
Mental health Chronic illness  x Cross-systems  x
 

Clinical area

Staying healthy Maternity and newborn Children and young people Acute care
Planned care Mental health Long-term conditions   x End of life
 

Information, tools and techniques used

This is a clinically led programme.  The formation of Clinical Pathway Groups enables focused change management and redesign to be led by a multi-disciplinary focus group, using up to date dashboards to inform quality and financial improvements across a range of workstreams within each defined pathway  

Geography

South Devon Healthcare NHS Foundation Trust, South Devon and Torbay Clinical Commissioning Group, Torbay Council, Devon County Council, NHS Devon plus a range of voluntary, charitable and not-for-profit organisations and patient participation groups.  

Timescale

The programme started in 2011 and is still ongoing, although each pathway consists of multiple workstreams, some of which receive in-year focus over others.  

Contact details and further information

Louise Hardy, Louise.hardy@nhs.net [post_title] => Integration and Collaboration: Clinically-Led Initiatives in South Devon and Torbay [post_excerpt] => [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => integration-and-collaboration-clinically-led-initiatives-in-south-devon-and-torbay [to_ping] => [pinged] => [post_modified] => 2013-01-16 16:54:17 [post_modified_gmt] => 2013-01-16 16:54:17 [post_content_filtered] => [post_parent] => 0 [guid] => http://clients.electricstudio.co.uk/tvhiec/wpcms/?post_type=improvement-science&p=3405 [menu_order] => 0 [post_type] => improvement-science [post_mime_type] => [comment_count] => 0 [filter] => raw ) [3] => WP_Post Object ( [ID] => 3403 [post_author] => 8 [post_date] => 2013-01-16 14:59:05 [post_date_gmt] => 2013-01-16 14:59:05 [post_content] =>

The journey -

The anticipatory care planning team brought together GPs, nurses and other healthcare professionals, with support from specialists where necessary. It was designed to improve the quality of patient care, reduce unnecessary admissions and thereby to reduce costs. The programme involved the public and patient involvement (PPI) forum for south and east Dorset, working with the PCT.  A multi-disciplinary team spanning health and social care was then formed to work on anticipatory care planning.  

Outcomes

There is evidence of fewer acute hospital admissions, reduced use of clinical specialists, improved patient care and reduced cost.  

Patient setting

In-patient Out-patient Community based   X
Mental health Chronic illness   X Cross-systems
 

Clinical area

Staying healthy Maternity and newborn Children and young people Acute care
Planned care Mental health Long-term conditions   X End of life
 

Information, tools and techniques used

No specific change management tools were used in this programme  

Geography

Dorset  

Timescale

Anticipatory care planning has now been adopted by urgent care and community teams and integrated into mainstream practice. Care is coordinated through a Single Point of Access which is hosted by South West  Ambulance. The scheme has been extended to other connecting health and social care teams to improve identification and management of those at risk of admission, care coordination and service integration. The approach has attracted Reablement resources and is working with the independent sector to mobilise community care packages to prevent risk and admission and better manage care following an acute illness.  

Contact details and further information

Elise Ripley, Patient and Public Involvement Development Manager, NHS Dorset.  Tel: 01305 361264, Elise.ripley@dorset-pct.nhs.uk Lesley Holt, SPoA Lead Nurse, South West Ambulance [post_title] => Anticipatory care planning [post_excerpt] => [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => anticipatory-care-planning [to_ping] => [pinged] => [post_modified] => 2013-01-16 17:05:33 [post_modified_gmt] => 2013-01-16 17:05:33 [post_content_filtered] => [post_parent] => 0 [guid] => http://clients.electricstudio.co.uk/tvhiec/wpcms/?post_type=improvement-science&p=3403 [menu_order] => 0 [post_type] => improvement-science [post_mime_type] => [comment_count] => 0 [filter] => raw ) [4] => WP_Post Object ( [ID] => 3398 [post_author] => 8 [post_date] => 2013-01-16 14:47:29 [post_date_gmt] => 2013-01-16 14:47:29 [post_content] =>

The journey -

The Reablement programme helps patients or their carers to be experts in their own care and maintain independence for as long as possible.  By giving tailored solutions that don’t foster dependence and supporting people to remain in their own homes, it ultimately aims to reduce health inequalities and build a cost-effective service that meets demand. The programme takes a systems approach. This has meant taking a long hard look at the way that services are delivered and has led to fundamental changes in service provision, rather than simply ‘doing the wrong things righter’, as one programme manager put it. Listening to patients and collaborating across professional and organisational boundaries are both central to what makes the Reablement programme work. In Somerset, the PCT and the county council jointly reviewed all their services that might be termed ‘reablement’. They worked in partnership with private and voluntary sector organisations and the new CCG to deliver better, more coordinated services.  

Outcomes

In Somerset, the Reablement programme has led to an increase in collaboration across the healthcare sector and made significant changes in how patients are assessed and what services are provided. An example is a patient with a history of sciatic pain who had a fall. Previously, he would have been hospitalised, but his GP contacted the Reablement team, who quickly established that he would prefer to be at home. The team devised a personal support package that enabled him to gradually increase his mobility without being admitted to hospital. Ultimately, the programme has delivered a number of real gains in service quality, patient outcomes, productivity and staff motivation. This includes significant reductions in hospital readmissions and the cost of social care.  

Patient setting

In-patient   X Out-patient   X Community based   X
Mental health Chronic illness   X Cross-systems   X
 

Clinical area

Staying healthy Maternity and newborn Children and young people Acute care    X
Planned care Mental health Long-term conditions    X End of life   X
 

Information, tools and techniques used

The programme used Vanguard Consulting’s change methodology for systems thinking.  

Geography

The programme was first piloted in the Taunton federation and is being rolled out more widely across the county.  

Timescale

The Somerset Reablement programme started in spring 2010 with a pilot in Taunton. From January 2012 Reablement was mainstreamed in Taunton and rolled out in another large federation in Somerset.  

Contact details

Ann Anderson ann.anderson@somersetccg.nhs.uk and Sue Glanfield Susan.glanfield@somerset.nhs.uk were both members of the project team.

[post_title] => Reablement programme, Somerset [post_excerpt] => [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => reablement-programme-somerset [to_ping] => [pinged] => [post_modified] => 2013-01-16 14:47:29 [post_modified_gmt] => 2013-01-16 14:47:29 [post_content_filtered] => [post_parent] => 0 [guid] => http://clients.electricstudio.co.uk/tvhiec/wpcms/?post_type=improvement-science&p=3398 [menu_order] => 0 [post_type] => improvement-science [post_mime_type] => [comment_count] => 0 [filter] => raw ) ) [post_count] => 5 [current_post] => -1 [in_the_loop] => [post] => WP_Post Object ( [ID] => 3408 [post_author] => 8 [post_date] => 2013-01-16 15:15:37 [post_date_gmt] => 2013-01-16 15:15:37 [post_content] =>

The journey -

The Small Business Research Initiative is an innovation challenge to industry. The object of this particular SBRI was to develop technology solutions to help reduce secondary care admissions and deliver new services and products to the NHS. The solution featured here is Message Dynamics’ ‘COPD Monitor’ which uses interactive voice technology to monitor patients’ wellbeing.  It is designed to improve patients’ quality of life, improve disease management, reduce admissions and reduce costs.  

Outcomes

The COPD monitor calls patients twice a week to record their state of health. Between September 2011 and February 2012, almost 1,500 calls were completed (a response rate of 91 per cent). Of these, 13 per cent generated an alert which starts an automatic escalation process. An initial follow up call by the unit’s nurses resolved 80 per cent of issues and the remaining 20 per cent required home visits. These home visits prevented nearly forty emergency admissions (representing a saving of at least £80,000). The investment in this project by the SHA has been £48,775. However, excluding the development cost the cost of the service to deliver this service is £375 – ie 25p per call. The return on investment ratio of this pilot is in excess of 200:1. An unanticipated benefit is that patients like talking to a computer; they do not feel they are wasting people’s time and patients report feeling less isolated. Clinicians are also noting that patients are becoming better equipped to understand and manage their own conditions.  

Patient setting

In-patient   X Out-patient   X Community based   X
Mental health Chronic illness   X Cross-systems   X
 

Clinical area

Staying healthy   X Maternity and newborn Children and young people Acute care   X
Planned care Mental health Long-term conditions    X End of life
 

Information, tools and techniques used

SBRIs start with a ‘problem space’ which can be defined quite closely to respond to a specific issue.  Prince project management underpins the thinking of the programme management team and helps provide a balance between process structure and outcome focus.  

Geography

The programme covers the South Central SHA area.  

Timescale

SBRI was launched in July 2010 and companies were given six weeks to bid. Sixty-nine companies from the UK and overseas responded in September 2010 and in November, Message Dynamics was one of four companies that received funding to take their proposal to a ‘proof of concept’ (POC) by February 2011. The product was adopted in September 2011 and is now offered to all patients referred to the specialist COPD service at Heatherwood and Wexham Park Hospital.  

Contact details and further information

Duncan Goodes, Head of Innovation Promotion: Duncan.Goodes@nesc.nhs.uk [post_title] => Small Business Research Initiative [post_excerpt] => [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => small-business-research-initiative [to_ping] => [pinged] => [post_modified] => 2013-01-16 15:15:37 [post_modified_gmt] => 2013-01-16 15:15:37 [post_content_filtered] => [post_parent] => 0 [guid] => http://clients.electricstudio.co.uk/tvhiec/wpcms/?post_type=improvement-science&p=3408 [menu_order] => 0 [post_type] => improvement-science [post_mime_type] => [comment_count] => 0 [filter] => raw ) [comment_count] => 0 [current_comment] => -1 [found_posts] => 11 [max_num_pages] => 3 [max_num_comment_pages] => 0 [is_single] => [is_preview] => [is_page] => [is_archive] => 1 [is_date] => [is_year] => [is_month] => [is_day] => [is_time] => [is_author] => [is_category] => [is_tag] => [is_tax] => 1 [is_search] => [is_feed] => [is_comment_feed] => [is_trackback] => [is_home] => [is_privacy_policy] => [is_404] => [is_embed] => [is_paged] => [is_admin] => [is_attachment] => [is_singular] => [is_robots] => [is_favicon] => [is_posts_page] => [is_post_type_archive] => [query_vars_hash:WP_Query:private] => 8aa596ed529bb3489f4cb9ae13cc664b [query_vars_changed:WP_Query:private] => [thumbnails_cached] => [stopwords:WP_Query:private] => [compat_fields:WP_Query:private] => Array ( [0] => query_vars_hash [1] => query_vars_changed ) [compat_methods:WP_Query:private] => Array ( [0] => init_query_flags [1] => parse_tax_query ) ) [1] => derp )

Category: Chronic illness

Small Business Research Initiative

The journey – The Small Business Research Initiative is an innovation challenge to industry. The object of this particular SBRI was to develop technology solutions to help reduce secondary care admissions and deliver new services and products to the NHS. The solution featured here is Message Dynamics’ ‘COPD Monitor’ which uses interactive voice technology to […]

Posted on Jan 16th Cat: , , , , , , , , Tags: Comments: Comments are off for this post

Reducing spend and increasing efficiency in MSK services

The journey – This programme aimed to improve quality, reduce spend and increase efficiency inmusculoskeletal (MSK) services in East Sussex. Data on efficiency and spend in MSK services were presented to 70 participants at an event called Shaping the Future, where a number of key issues and possible solutions were identified.  These included high rates […]

Posted on Jan 16th Cat: , , , , , , , Comments: Comments are off for this post

Integration and Collaboration: Clinically-Led Initiatives in South Devon and Torbay

The journey – This programme aims to build on an already strong local history of collaboration and engagement to drive forward some ambitious integrative changes to the local healthcare system across a range of identified pathways.  It involves a long-term, systematic culture change. The programme has concentrated initially onthree care pathways (cardiology, diabetes and rheumatology) […]

Posted on Jan 16th Cat: , , , Comments: Comments are off for this post

Anticipatory care planning

The journey – The anticipatory care planning team brought together GPs, nurses and other healthcare professionals, with support from specialists where necessary. It was designed to improve the quality of patient care, reduce unnecessary admissions and thereby to reduce costs. The programme involved the public and patient involvement (PPI) forum for south and east Dorset, […]

Posted on Jan 16th Cat: , , , Comments: Comments are off for this post

Reablement programme, Somerset

The journey – The Reablement programme helps patients or their carers to be experts in their own care and maintain independence for as long as possible.  By giving tailored solutions that don’t foster dependence and supporting people to remain in their own homes, it ultimately aims to reduce health inequalities and build a cost-effective service […]

Posted on Jan 16th Cat: , , , , , , , , Comments: Comments are off for this post