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The journey -

The purpose of the programme is to improve patient flows, making emergency pathways more efficient and reducing length of stay and number of beds whilst also making care safe, effective and a good experience for patients and staff. By better matching capacity to demand the trust aimed to make sure that patients who didn’t need to be admitted to the hospital could be managed on an ambulatory pathway or a short stay pathway; and that inpatients were swiftly signposted to the right specialty with a clinical management plan and pathway of care that would facilitate an appropriate length of stay.

Outcomes

Key achievements of the Programme include: Rapid Assessment in place in A&E where feasible; average length of stay reduced by 0.6 days; a 28 per cent decrease in length of stay over 14 days; 5 pathways embedded in ambulatory and short stay with another 7 at various stages of roll out; 45 patients case managed at home through a ‘virtual ward’ at any one time; a 3 per cent increase in discharges taking place before 2pm; and monthly levels of patients being seen and treated within four hours at 97 per cent.

Patient setting

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

Clinical area

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

Information, tools and techniques used

Several change management tools and models have been used, most notably some principles of PRINCE2 methodology and a Sarah Fraser model for sustainability.  Lean methodology has also informed the programme and a performance dashboard was developed according to IST specifications. The Emergency Care Programme has also benefited from clear communication strategies within divisions and large-scale direct engagement with staff.

 

Geography

This programme took place in the three main acute sites of East Kent Hospitals University NHS Foundation Trust: Kent and Canterbury Hospital (Canterbury); William Harvey Hospital (Ashford); and the Queen Elizabeth the Queen Mother Hospital (Margate).  

Timescale

The programme started in June 2010.  For the first 18 months, the programme focused primarily on developing the right systems and processes, identifying clinical leaders to facilitate the change and engaging staff.  It is now being refreshed to recognise current achievements and look ahead at the challenges that remain. With systems and processes in place, greater focus is being placed on the cultural aspects of embedding change in the organisation.  

Contact details and further information

Karen Miles, Associate Director of Operations, East Kent Hospitals University Hospitals NHS Foundation Trust: kmiles1@nhs.net [post_title] => Emergency Care Quality Improvement Programme [post_excerpt] => [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => emergency-care-quality-improvement-programme [to_ping] => [pinged] => [post_modified] => 2015-03-24 13:27:32 [post_modified_gmt] => 2015-03-24 13:27:32 [post_content_filtered] => [post_parent] => 0 [guid] => http://clients.electricstudio.co.uk/tvhiec/wpcms/?post_type=improvement-science&p=3430 [menu_order] => 0 [post_type] => improvement-science [post_mime_type] => [comment_count] => 0 [filter] => raw ) [1] => WP_Post Object ( [ID] => 3419 [post_author] => 8 [post_date] => 2013-01-16 15:51:58 [post_date_gmt] => 2013-01-16 15:51:58 [post_content] =>

The journey -

This programme’s purpose was to replace a hospital’s complex and inconsistent system for outpatient bookings with a call centre, usinga single telephone number for all outpatient bookings. A review found that bookings were being made by over 300 staff with over 70 phone numbers in use across the trust. In some departments, it was only possible to book an appointment between certain times and on occasion there was nobody was available to cover bookings during annual leave. The lack of consistency across the trust meant that the patient experience was confusing and navigating between specialties was difficult. The team worked with stakeholders to interpret the review findings and to co-design a more streamlined booking system.  A new bookings process was then introduced alongside call centre technology and, after a trial period, all booking staff moved into one building.  The service has since been gradually refined to enable staff to work across specialities.

Outcomes

Outpatient bookings are now handled by 30 full time employees.  Patient experience is much improved and savings of £1.2 million have been achieved.

Patient setting

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

Clinical area

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

Information, tools and techniques used

The creation of a Patient Access Centre was a Process Redesign in Administrative and Managerial services project (PRAM).  The project team drew on principles from a number of change tools, using a lean systems approach and being guided by principles from the DEMAIC (Define, Enthuse, Measure, Analyse, Improve, Control) model of change. To govern the overall project management, the team drew on principles from PRINCE 2. To embed the change, the team drew on Kurt Lewin’s ‘unfreeze, change and refreeze’ thinking.  The principles of Kubler Ross’ change curve were also instrumental in the team’s approach.  

Geography

The change took place within one acute hospital in Torbay, Devon.

Timescale

The project started in January 2010 and took approximately 18 months to complete.

Contact details and further information

Nick Debney, Torbay Hospital. Email: nick.debney@nhs.net   [post_title] => Patient Access Centre [post_excerpt] => [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => patient-access-centre [to_ping] => [pinged] => [post_modified] => 2015-03-24 13:27:32 [post_modified_gmt] => 2015-03-24 13:27:32 [post_content_filtered] => [post_parent] => 0 [guid] => http://clients.electricstudio.co.uk/tvhiec/wpcms/?post_type=improvement-science&p=3419 [menu_order] => 0 [post_type] => improvement-science [post_mime_type] => [comment_count] => 0 [filter] => raw ) [2] => WP_Post Object ( [ID] => 3417 [post_author] => 8 [post_date] => 2013-01-16 15:42:36 [post_date_gmt] => 2013-01-16 15:42:36 [post_content] =>

The journey -

The Healthy Futures Programme was developed as an umbrella programme through which system-wide and transformational change initiatives could be coordinated regionally. Its vision is “to achieve a financially sustainable health system which prevents illness, maintains independence and streamlines pathways.” It has particularly focused on pathology and head and neck services. Initially the programme was strongly driven by quality and safety, but financial sustainability has increasing taken centre stage. It oversees both clinical change programmes, which focus on the redesign of clinical services and pathways, and enabling programmes, which focus on the coordination of support functions in line with new service models.  

Outcomes

The programme’s key achievement is that it has created a platform for whole system change where previously there was a fragmented structure. To date, a number of major approvals for service reconfigurations have been gained and good progress made in several areas. For example, services in the two acute trusts in Bristol have been consolidated and reconfigured.  

Patient setting

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

Clinical area

Staying healthy

Maternity and newborn

Children and young people

Acute care   X

Planned care   X

Mental health

Long-term conditions

End of life

 

Information, tools and techniques used

The Healthy Futures Programme grew out of the Bristol Health Services Plan (BHSP), which was established to transform, modernise and improve health facilities and services throughout BNSSG. It was informed by the Darzi white paper, which established the need for local authorities to establish health and wellbeing boards, as well as other policy drivers. To help implement programmes, the Healthy Futures team has created a set of local templates and tools based on the principles of models such as MSP and PRINCE2.  

Geography

Bristol, North Somerset and South Gloucestershire (BNSSG).  

Timescale

The programme was initiated in March 2010 and is still ongoing.  

Contact details and further information

Richard Smale richard.smale@bristol.nhs.uk is programme director of the Healthy Futures Programme.

Further information can be found at http://www.avon.nhs.uk/healthyfutures/

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The journey -

The purpose of the programme is to improve patient flows, making emergency pathways more efficient and reducing length of stay and number of beds whilst also making care safe, effective and a good experience for patients and staff. By better matching capacity to demand the trust aimed to make sure that patients who didn’t need to be admitted to the hospital could be managed on an ambulatory pathway or a short stay pathway; and that inpatients were swiftly signposted to the right specialty with a clinical management plan and pathway of care that would facilitate an appropriate length of stay.

Outcomes

Key achievements of the Programme include: Rapid Assessment in place in A&E where feasible; average length of stay reduced by 0.6 days; a 28 per cent decrease in length of stay over 14 days; 5 pathways embedded in ambulatory and short stay with another 7 at various stages of roll out; 45 patients case managed at home through a ‘virtual ward’ at any one time; a 3 per cent increase in discharges taking place before 2pm; and monthly levels of patients being seen and treated within four hours at 97 per cent.

Patient setting

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

Clinical area

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

Information, tools and techniques used

Several change management tools and models have been used, most notably some principles of PRINCE2 methodology and a Sarah Fraser model for sustainability.  Lean methodology has also informed the programme and a performance dashboard was developed according to IST specifications. The Emergency Care Programme has also benefited from clear communication strategies within divisions and large-scale direct engagement with staff.

 

Geography

This programme took place in the three main acute sites of East Kent Hospitals University NHS Foundation Trust: Kent and Canterbury Hospital (Canterbury); William Harvey Hospital (Ashford); and the Queen Elizabeth the Queen Mother Hospital (Margate).  

Timescale

The programme started in June 2010.  For the first 18 months, the programme focused primarily on developing the right systems and processes, identifying clinical leaders to facilitate the change and engaging staff.  It is now being refreshed to recognise current achievements and look ahead at the challenges that remain. With systems and processes in place, greater focus is being placed on the cultural aspects of embedding change in the organisation.  

Contact details and further information

Karen Miles, Associate Director of Operations, East Kent Hospitals University Hospitals NHS Foundation Trust: kmiles1@nhs.net [post_title] => Emergency Care Quality Improvement Programme [post_excerpt] => [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => emergency-care-quality-improvement-programme [to_ping] => [pinged] => [post_modified] => 2015-03-24 13:27:32 [post_modified_gmt] => 2015-03-24 13:27:32 [post_content_filtered] => [post_parent] => 0 [guid] => http://clients.electricstudio.co.uk/tvhiec/wpcms/?post_type=improvement-science&p=3430 [menu_order] => 0 [post_type] => improvement-science [post_mime_type] => [comment_count] => 0 [filter] => raw ) [comment_count] => 0 [current_comment] => -1 [found_posts] => 3 [max_num_pages] => 1 [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] => 34ea4ad8ae50efee485087b7b1515d10 [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 )

Tag: Prince2

Emergency Care Quality Improvement Programme

The journey – The purpose of the programme is to improve patient flows, making emergency pathways more efficient and reducing length of stay and number of beds whilst also making care safe, effective and a good experience for patients and staff. By better matching capacity to demand the trust aimed to make sure that patients […]

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

Patient Access Centre

The journey – This programme’s purpose was to replace a hospital’s complex and inconsistent system for outpatient bookings with a call centre, usinga single telephone number for all outpatient bookings. A review found that bookings were being made by over 300 staff with over 70 phone numbers in use across the trust. In some departments, […]

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

Healthy Futures Programme

The journey – The Healthy Futures Programme was developed as an umbrella programme through which system-wide and transformational change initiatives could be coordinated regionally. Its vision is “to achieve a financially sustainable health system which prevents illness, maintains independence and streamlines pathways.” It has particularly focused on pathology and head and neck services. Initially the […]

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