The Advancing Quality
Alliance (AQuA) is encouraging members to enter the iNetwork’s Innovation Awards,
by nominating their projects or services for the dedicated Health Award.
Celebrating the best in
public sector innovation, the awards are seeking entries that have designed or
delivered exceptional projects or services to patients and service users.
Helen Kilgannon, Head of
System Transformation, said:
“Working with our members, we see first-hand some of the brilliant
improvements and innovations made by staff on a daily basis across teams,
projects and services.
“As the North West partner for iNetwork, we
want see as many AQuA members as possible to celebrate their efforts by
nominating themselves for the awards.
“With this year’s awards boasting a brand new
category for Health, this is a great recognition of their success and
achievements in improving outcomes and services for patients.”
Other categories open to
members include:
·Outstanding
Contribution Award
·Innovative
Access to Public Services (IAPS)
·Effective
Service Redesign and Reform
·Excellence
in Information Sharing and Security
·Connected
Procurement
·iStandUK
(electronic data standards)
·Supplier
Excellence
iNetwork help support public
sector organisations to improve local services, by encouraging collaboration
and sharing best practise. Members can access their events and training for
free through AQuA membership.
Entries for nominations close
on Tuesday 27 September before being
put out to a public vote on 30 September.
Nominations with the most
votes will then be reviewed by a judging panel and announced in October, with
finalists invited to attend the awards ceremony and dinner at iNetwork’s winter
conference on 16 November in Manchester.
Entries will be judged on
their evidence of making an impact, innovative nature of the work, and potential
to be adopted by others.
This blog is about intentionality. We intend to improve integrated care for local people – and improvement can be anywhere on the spectrum of small local change, to radical new models of care to transform population health outcomes – and we intend to invest time, energy and resources in doing this.
But just how intentional are we about equipping our combined health and care workforce with the knowledge and skills to lead and implement transformational change? Our experience at the Advancing Quality Alliance (AQuA) is that intentionality varies across the UK, and global delegates at this year’s International Congress for Integrated Care in Barcelona had a similar view.
AQuA's Change Model for Complex Systems
In Constructive Comfort The Health Foundation emphasise the importance of investment in workforce skills including leadership, change management and quality improvement in order to accelerate and build the system-wide capability to sustain large scale change. In recent years inspirational stories have illustrated intentional skill-building as part of transformation plans in NHS Highland, South Central Foundation in Alaska, Kaiser Permanente, USA and the Canterbury system in New Zealand to name just a few. So the big question is…how do you get started?
Intentionality: getting started
If you’ve asked yourself how intentional your approach is to equipping the local workforce with the capability to drive change, and the answer is ‘not very’ or ‘there’s scope to improve’, I offer five questions to help frame your discussion:
What skills and knowledge do you require to implement integrated care at scale?
At what scale is the skill and knowledge needed and how can this be achieved locally?
What change models and improvement methods are suitable for your complex environment?
What resources are available to support implementation of the changes in the local strategic plan? This includes the role of local leadership, improvement and innovation agencies.
How can multiple simultaneous priority work streams be co-ordinated and the learning spread?
Ideas on how to intentionally build workforce capability to underpin integration
AQuA recently shared its intentional approach to large-scale workforce capability building in Leading in Complex Systems: 10 learning points for developing multi-agency leadership teams. We advocate a change model (see diagram) that blends approaches to make best use of staff time and resources, and underpin this with a facilitated peer learning community and team coaching.
We condensed learning from our work with local health and care systems across the UK into ten points with the aim of helping others design programmes for system leaders:
Design and Planning
Blend theory and methodology
Intentionally design system leadership support into transformation programmes
Model collaboration in the provision of system leadership support delivery
Teams learn to lead together
Develop distributed system leadership capability
Sustain support to leaders
Tailor support for senior and executive leaders
Skills in the wider workforce
Support relationship development at all levels
Embed improvement expertise in leadership teams
Enablers
Think measurement – what is feasible?
We’d really like to hear your thoughts on this topic, and invite you to share examples of how you are intentionally developing integrated workforce capability via Twitter @IFICinfo or #ICIC16.
This blog was originally published on by the International Foundation for Integrated Care IFIC. To find out more about the Foundation, please visit their website.
Elizabeth Bradbury is a Director at AQuA and Board member for IFIC from 2014-16.
Over the next three months we’re asking members to share their views on the Advancing Quality (AQ) programme; AQuAs flagship reliability of care offer.
After almost a decade of successful collaboration with North West healthcare organisations, AQ has delivered demonstrable improvements in the quality, reliability and outcomes of clinical care.
To ensure members continue to gain the most value from an effective reliability offer we would like members to help shape our 2017-18 priorities for AQ by taking part in our online survey, a short phonecall or face-to-face meeting.
Nadine Boczkowski, AQuA Programme Director for AQ & Analytics said: “Your valuable input into the listening exercise will help us to shape services and develop new offers tailored to your needs, offering support in the right areas to drive up the quality and safety of care and deliver consistently high standards.”
The Listening Exercise is open to staff across all members currently participating in AQ, as well as those who have previously taken part in the programme (please note AQuA and AQ membership are separate).
The short survey should only take approximately 10 minutes to complete, and you can take part by following the link below.
Alternatively, if you would like to arrange a short meeting or telephone interview then please email: advancing.quality@nhs.net to arrange.
For more information about the Listening Exercise, you can download the flyer. If you would like to find out more about Advancing Quality, please visit the website.
Please note the online survey will close for feedback on Friday 30th September.
We are currently seeking expressions of interest from members to participate in a new mini collaborative programme, as part of our ongoing Shared Decision Making and Self-Management Support offers.
We will be holding an initial half-day sharing and learning event on Wednesday 9 November at our offices in Sale, and will encourage teams to continue working together throughout the programme. Applications are open to all clinical teams from across our member organisations.
Increasing collaboration between patients and practitioners forms a crucial element of the NHS Five Year Forward View, and both Shared Decision Making and Self-Management Support feature prominently in the NHS Operating Framework. This programme will provide support over a six month period to enable teams to embed these practices in their services.
Fully involving patients in the decisions about their own care and treatment has also been shown to improve outcomes, increase patient satisfaction, and make more effective use of NHS resources.
After a fantastic final event last month for the close of The Health Foundation funded REsTRAIN YOURSELF project, I felt it was a great opportunity to share with you some of my thoughts from working on programme.
The aim of REsTRAIN YOURSELF was to reduce physical restraint in mental health inpatient settings through an evidence-based approach.
Despite only meant as a ‘last resort’, physical restraint is a coercive intervention that is commonly used in mental health services. There have been increasing serious concerns over a number of years about its overuse and significant adverse effects on patients.
Over the course of this two-year programme, I’ve had the chance to work closely with a number of teams in ward environments across the North West, to offer training and support the implementation of the restraint reduction approach.
Members who have participated in the programme include:
5 Boroughs Partnership NHS Foundation Trust
Cheshire and Wirral Partnership NHS Foundation Trust
Cumbria Partnership NHS Foundation Trust
Lancashire Care NHS Foundation Trust
Manchester Mental Health and Social Care NHS Trust
Mersey Care NHS Foundation Trust
Pennine Care Foundation Trust
Having the opportunity to work alongside staff has been such a positive fulfilling experience. Having spent a number of years as a mental health nurse myself, it wasn’t easy for me to stand back and observe things on extremely busy acute mental health wards; especially when the nurse in me wants to help and get involve
From this work over the past two years we now have a strong body of evidence on restraint reductions, and here are some of my findings:
Teams
The teams faced many challenges to enable change to occur: from juggling with staffing levels, high levels of acutely unwell patients, and always struggling to find a bed. Both staff and patients have really engaged with the project and implemented a range of approaches to dealing with violence on the wards.
Staff focus on trauma-informed care has shifted from a task-orientated ‘them and us’ dynamic, to more reflective, person-centred approach to patient care.
Having been based on wards on a weekly basis, engaging with staff during those moments of violence and aggression, and trying to help them approach situations differently has been a real challenge.
Often, the adrenaline has kicked in and it is hard for staff to pull back from rushing to restrain rather than de-escalate.
However, one of the biggest efforts by teams has been their work to improve care around self-harm, and working with patients, rather than trying to control them with restraint.
This is a very sensitive area of practice in mental health which staff do struggle with. But coaching has allowed them to be more open and stand back, take their time, and work with the patient, to see better outcomes for patients and their team.
This approach has also seen better communication in shift handovers, more formal staff and patient debriefs, more meaningful activities for patients, and the development of sensory rooms.
Patients
Working with patients directly we also aimed to develop individual safety plans; a self-management tool that helps both staff and patients focus on what triggers violence, and strategies to help calm and de-escalate. After testing these through the Plan, Do, Study, Act (PDSA) process, these plans have been a huge positive for both parties.
To help improve communication between staff and patients, we also developed weather symbols to use in patient community meetings. This helped them to talk about violent incidents and the general mood of the ward in a safe managed environment, using language that all can connect with (Sunny, cloudy and stormy days).
Patients now comment upon their discharge about how they enjoyed the sunny days on the ward; reinforcing to the teams the importance of focusing on working with patients to make sure there are many sunny days on the ward.
A consistent theme for staff is how they now focus more on the potential impact of restraint on patients, rather than the technique, and how this can avoid trauma to both patients and their colleagues. For me, this is a big cultural shift, which I believe over time will improve team cohesiveness and ultimately lead to safer patient care.
Throughout the two years, all the wards we have worked with have made great progress
and have seen noticeable reductions in restraint. With The Health Foundation-funded programme now at an end, we hope to continue to build on this learning as we commence the AQuA Restraint Reduction programme throughout 2016/17.
I’m really looking forward to working with many of the Trusts who participated in REsTRAIN YOURSELF, and it’s great to also welcome Greater Manchester West NHS Foundation Trust on board for our new programme.
In October we’ll also be sharing the final evaluation report for REsTRAIN YOURSELF will be published by The Health Foundation, which will be available on our website and other communications.
Paul Greenwood is AQuA’s Improvement Advisor for Mental Health. You can contact him on paul.greenwood@srft.nhs.uk, or follow him on Twitter @PaulG_AQuA.
Advancing Quality Alliance (AQuA) members in Salford have received the national 2016 Excellence in Public Health and Wellbeing award, in recognition of their work in combating malnutrition in older people.
Representatives from Salford Malnutrition Taskforce, which includes staff from NHS Salford Clinical Commissioning Group, Salford Royal NHS Foundation Trust and Greater Manchester West NHS Foundation Trust, received the award at a ceremony in the House of Commons earlier this month.
From left: Jean Rowlnison, Age UK, Barbara Keeley MP,
David Haynes, Age UK, Kirstine Farrer, Salford CCG
On winning the award, Kirstine Farrer, Head of Innovation and Research at Salford Clinical Commissioning Group and Consultant Dietician at Salford Royal, said:
“We are thrilled to receive this accolade from Public Health England and wish to thank Barbara Keeley MP for nominating us. We remain passionate about working in partnership to address malnutrition across the city.
“Whilst developing the Salford Together PaperWeight Armband, I never thought for one moment it would receive such an overwhelmingly positive reception nationally. Having the opportunity to work with Age UK Salford and the integrated care programme in the city just demonstrates what can be achieved when you align health care and third sector.”
Julia Wood, AQuA Affiliate for the Salford Malnutrition Taskforce, added:
“The Salford Malnutrition Taskforce is made up of representatives from numerous organisations around the city. At first individuals in the Taskforce didn’t know each other but everyone around the table was very committed to reducing the level of malnutrition in Salford. Through the determination and dedication of the Taskforce incredible achievements have been made. From a personal perspective the Salford Malnutrition Taskforce was a truly fantastic team to work with and I feel proud to have been part of the team.”
Excellence in public health and
wellbeing 2016 certificate, awarded by Jane Ellison MP
The work of the team has led to the development of a number of tools to fight malnutrition across the city, including the nationally-recognised Paperweight Armband. This simple paper armband is slipped around a patient’s upper arm, and was designed as a quick, low-cost, and non-intrusive tool for identifying malnutrition.
Salford was one of five pilot sites launched by the national Malnutrition Taskforce in 2012, and has received national recognition, including a presentation to Members of Parliament earlier this year.
Notes to Editors:
For further information or to request an interview please contact, Matthew Baxter, Communications & Marketing Officer on matthew.baxter@srft.nhs.uk or 0161 206 8025.
