Building Capacity & Building Capacity & Capability for Innovation & Capability for Innovation &

Improvement Improvement

Carrie MarrDirector

Tayside Centre for Organisational Effectiveness

Building Capacity & Building Capacity & Capability for Innovation & Capability for Innovation &

Improvement Improvement

Carrie MarrDirector

Tayside Centre for Organisational Effectiveness

Our Journey So Far…..Our Journey So Far…..

Source: System thinking and spreading knowledge, Bojestic M., Henriks, G., Provost L. IHI European Forum, Prague 2006

Awareness•Safer Patient Initiative•Change & Innovation Plan

Education•Learning from Qulturum and IHI•Patient Safety Officer training•Improvement experts and practitioners training •Board Effectiveness Development Programme

Process Thinking•Lean and Rapid Improvement work•Real time data and measurement for improvement

Redesign•Improvement as a Systems Property•Steps to Better Healthcare•Triple Aim

Movement•Triple Aim •System Infrastructure - TCOE•Creating Breakthrough and Leverage

Scaling Up•Public Service•Working with Communities•Mobilising and deploying shared resources

2006 2007 2008 2009 2010 2011 Beyond

Creating the ConditionsCreating the Conditions

Build Infrastructure

& Capacity

Formal programmes of QI education Embed QI into all development work e.g. leadership and management development

Enabling people to lead improvement in their daily work processes •Tools, techniques, support

“Data is our vision - we must learn from it”•Realtime measurement and Information systems

Shaping the Culture:• Will and commitment• Quality reinforced at

every level by behaviour, action and communication.

• The patient and the family are the focus of attention at all times

Ref: Staines 2009

Building Local Capacity & Building Local Capacity & CapabilityCapability

Building Capacity

& Capability

Improvement AcademyeLearning PortalTools and Techniques

Clearing the way!!Experiences of care, compassion and respect

Mobilising & deploying expert support “through the line” – 2 step challenge

• Real time information and measurement systems

• Sharing evidence of improvement

• Staff engagement

• Data for discussion not judgement

Shaping the Culture• Permission and space• Evidence based approach• Facing the Future – shared

ethical responsibility• Board Effectiveness

Programme• User and community voice

Leadership and Management DevelopmentVirtual learning environment

Experts Senior

Leaders& Boards

ChangeAgents

(Middle Managers,

project leads)

Everyone

Staff

Teams

Continuum of PI Knowledge and Skills

Deep Knowledge

Many People Few People

What Skills Do We Need?

Source: Kaiser Permanente, 2008

SharedKnowledge

What data do we need?What data do we need?

Board

ET

EMT

Directorate / CHP

Ward / Team Level

Patient / Practitioner Level

ASSURANCE

Validated Data for 6 domains: Access, Efficiency, Infection & Prevention, Quality & Patient Experience, Patient Safety and Data Quality

PERFORMANCE

Validated and un-validated data across 6 domains:Clinical Excellence, Finance & Activity, Valuing Staff, Capacity & Activity Planning, Patient Experience and

Patient Safety

Imp

rov

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t

“focusing on information and data to provide assurance on improvement and quality to deliver better services”.

Pe

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nc

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ura

nc

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Da

ta a

nd

Me

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me

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for

IMPROVEMENT

Un-validated data provided in real time through Unified Patient Tracking, Clinical Portal and operational

dashboard with metrics covering Patient Flow, Inpatient Activity, Out Patients, Waiting Times, Patient Safety,

Infection Control, Clinical Outcomes

What Knowledge Do We Need?What Knowledge Do We Need?The Shift to “All Learn : All Teach” as a MovementThe Shift to “All Learn : All Teach” as a Movement

Developing local

improvement stories

Widening our improvement conversations and networks

ProfoundKnowledge

&Evidence of Standards

Adopt & Adapt Improvement Tools and Technology

Harvest andshare and

enable new ideas

Sharing experiences and embedding the improvement

cultureMeasuring the effectiveness

of improvement activities

Individual Microsystemfrontline

MesosystemMiddle mgrs

Macrosystem Policy

Real time tests of change

Improvement Evidence

• Workplace VLE• Communities of Practice

Developing a culture of

improvement

Steps to Better Care

Mental Health

OlderPeople

Planned Care

Workforce Integrated care

communities

Child health

Optimisation of Health Facilities across Tayside

Prescribing and

Medicines

Finance Support

Workforce Support

Scenario Planning, Financial Baselines, Benefits Tracking, Business Cases

Workforce Modelling, Engagement & Communications with staff

Comms SupportCommunications with public and staff

Other

OE SupportImprovement & Development Support

Labs

Maternity

Develop an innovative education and training resource to build further out capacity and capability in improvement science.

Tayside Centre for Organisational Effectiveness

Real time information and measurement resources to support quality improvement of clinical services.

Enhance spread and share of good practice through use of technology e.g. Clinical Portal, Clinical Dashboards.

Mobilisation of trained experts in quality improvement organisational development and leadership to support improvement work.The focus of this expertise will be mobilised to support front line staff and clinicians to build capability in improvement methodology and support key improvement programmes

A dynamic approach to knowledge transfer which supports our “All teach: All learn” philosophy in support of quality improvement.

Knowledge Management

Improvement Academy

Improvement &

DevelopmentSupport

Technology Enabling

Health

Research & Developmen

t

Table Top DiscussionTable Top Discussion

Where should our focus be to create the necessary capacity and capability required to

support our improvement and innovation ambitions?