tom downes

Discovering great care

Tom Downes13th May 2015 @sheffielddoc

@sheffielddoc@sheffielddoc

Mrs R

• 92 years of age• Widowed 7 years ago• Mild dementia• Lives in a flat• Daughter lives locally• Unwell with pneumonia

@sheffielddoc@sheffielddoc

@sheffielddoc@sheffielddoc

@sheffielddoc@sheffielddoc

GREAT CARE IS DISCOVERED, NOT DECIDED

Key Point 1:

Great

Okay

ΔAltitude

ΔClimb rate

Know a lot

Know something

Don’t know

ΔDiscovery rate

Easier, safer work

Harder work,Poor conditions

Key Point 2:

Problem solvingis key to

Discovering Greatness

@sheffielddoc

Great

Okay

ΔAltitude

ΔClimb rate

Know a lot

Know something

Don’t know

ΔDiscovery rate

See ✗

Solve ✓Spread ✓ ✓✓

See ✗

Solve ✓Spread ✓ ✓✓

See ✗

Solve ✓Spread ✓ ✓✓

Learnerleader

@sheffielddoc

@sheffielddoc@sheffielddoc

@sheffielddoc

@sheffielddoc

The Big Room (Oobeya)

@sheffielddoc@sheffielddoc

Big Room

@sheffielddoc

We have all designed our own complex system

@sheffielddoc

@sheffielddoc@sheffielddoc

Frailty Unit

Outcome measure: 34% increase in discharge within 1 day

Frailty Unit

opens

@sheffielddoc

Length of stay for frailty unit patients reduced by more than 4

days

Frailty Unit

opens

@sheffielddoc

In-hospital mortality dropped by over 13%

Frailty Unit

opens

@sheffielddoc@sheffielddoc

Discharge to Assess (D2A)

@sheffielddoc

Time waiting per patient

D2A starts

@sheffielddoc

D2A starts

@sheffielddoc

D2A starts

@sheffielddoc

@sheffielddoc

What is your capability and capacity to discover?

@sheffielddoc

• Modern healthcare is complex• Design by front line staff running iterative tests• Measure• Involve patients• Timely specialist care is cheaper and safer• Not a project• Mrs R is in her own home

CONCLUSION

@sheffielddoc

@sheffielddoc

www.sheffieldmca.org.uk

@sheffielddoc@sheffielddoc

Thank youTom.Downes@sth.nhs.u

k