West Yorkshire Modernisation and Improvement Forum - 10 High Impact Changes
Subscribe to email bulletin | Contribute material | Discussion Forum | West Yorkshire home
| The Top Ten High Impact Changes (10 HICs) represent a move towards evidence-based innovation. If all ten changes are applied systematically across the NHS, to a standard already being achieved in some places, the experience of millions of patients and staff would be transformed. A significant amount of work has already been initiated through WYMIF to support the implementation of these changes, and will provide the basis for service improvement work streams for the future. |
From the Modernisation Agency |
NHS Benchmarking Club - 'Benchmarking the Ten High Impact Changes'Work in West Yorkshire
High Impact ChangeWest Yorks Lead |
Action taken so far |
Action in progress |
|
1. Treat day surgery (rather than inpatient surgery) as the norm for elective surgery Sarah Lloyd – Day surgery champion
|
One-day event held to assess where we are and develop an action plan. The Day Surgery champion has visited each Trust. |
Work to be done on the basket of 25 cases including asking organisations to benchmark their performance (to take into account local variation). SHA performance team to benchmark each organisation compared to a national profile |
|
2. Improve patient flow across the whole NHS system by improving access to key diagnostic tests |
One-day event undertaken with wide stakeholder involvement – looked at key areas of work; radiology; endoscopy; pathology and a physiological measurement. Work to develop a West Yorks strategy arose out of this with a Director lead and support team |
W Yorks strategy which comprises three streams of work Establishing networks – looking at workforce, near patient testing, quality of care issues Spread of modernisation tool kits across West Yorkshire. Training on demand and capacity, re-profiling and better pathways. Care pathways –money will be available to employ 4 staff who will work in patches alongside the new SIMs |
|
3. Manage variation in patient discharge thereby reducing LOS Kate Mackay and team of SIMs Individual organisations |
Individual organisations have implemented this work to differing degrees |
Implementation at least in part will be through training in SPC, capacity and demand and other techniques. Also ensure that organisations benchmark |
|
4. Manage variation in patient admission process As above |
As above |
As above |
|
5. Avoid unnecessary follow -ups for patients and provide necessary follow ups in the right care setting As above |
As above |
Work by SIMs – will need to benchmark across organisations and also across different specialities |
|
6. Increase the reliability of performing therapeutic interventions through a care bundle approach As above |
Work has already been undertaken to implement these in critical care- key link Wendy Quinn The West Yorkshire group continues to meet to share best practice and develop protocols to ensure that other care bundles are consistently implemented |
Continued identification of best practice and spread and adoption of polices.
|
|
7. Apply a systematic approach to care for people with long term conditions |
Work undertaken such as implementation of Evercare and other models in different organisations and to different degrees. Benchmarking those conditions and ‘frequent flyers’ – competed via LDP submissions. Plans for emergency bed days and community matrons submitted via LDPs. |
LTC programme - to include Case management, community matrons, implementation of Ever care or similar models. Also reduction in emergency bed days target. Links to diagnostic strategy e.g. near patient testing. Work needed to establish links to older people’s work.
|
|
8. Improve patient access by reducing the number of queues All organisations and new SIMs will play a key role in the implementation of this change |
Work in individual organisations to redesign patient journey and reduce queues. The level of implementation varies from organisation to organisation and specialty to speciality |
Work of the SIMs to work with organisations and specialties to look at how queuing can be reduced. Links needed to new diagnostic Care Pathway managers and work undertaken at redesign of acute and community services. |
|
9. Optimise patient flow through service bottle necks using process templates All organisations and new SIMs will play a key role in the implementation of this change and taking on training to ensure that front line staff, clinicians and managers are aware of, and regularly use, the technique |
Some organisations in the patch have undertaken considerable work in this area e.g. those involved in collaborative. But implementation remains patchy within organisations and varies from organisation by organisation |
Work of the SIMs to work with organisations and specialties to look at how bottlenecks can be identified and then reduced through process mapping. Links needed to new diagnostic Care Pathway managers and work undertaken at redesign of acute and community services. |
|
10. Redesign and extend roles in line with efficient patient pathways to attract and retain an effective workforce All organisations with the support of the WDC. |
Benefits realisation plans for Agenda for Change (AfC) completed. Education & Training Strategy clearly identifies priorities of Assistant and Advanced Practitioner development. Assistant Practitioner developments in radiography established - evaluation currently underway. Education programmes in place and under continual development to support Assistant and Advanced Practice. Capacity building programme in role redesign techniques underway.
|
Continuation of work by WDC to support employers with role redesign and skill mix. Maintain links with national teams and national programme developments. Develop strategies for wider adoption of Assistant and Advanced Practitioner roles. Work with Faculty for Improvement and SHA team to spread good practice.
|
|
General work for the top ten |
National MA conference MA webcasts Presentations and discussions at a range of service improvements and events Baselines assessments undertaken by individual NHS organisations Work at a national levels to identify a consistent set of metrics and an approach to benchmarking All PCTs have been asked to include HIC in their LDP submission Benefits realisation work across West Yorkshire – how can the alignment of benefits of the implementation of NPfIT, Agenda for Change and the top ten HIC Working with 4 other SHAs to work with Paul Plsek to measure extra improvement gained from this way of working Launch of HICs at WYCEF – looking at ‘room for improvement’ |
Bring together a meeting of the top 10 champions Invite Helen Bevan to speak to SHA; and to general West Yorks community Continue to develop ways of measuring To ask all organisations to submit a gap analysis Benchmarking of all organisations LDPs submissions have requested information on this area – sharing good practice, benchmarking and plans for future work will arise out of this base line assessment Faculty for Improvement and the SHA team can help to spread good practice
|