An Associated University Hospital of

Brighton and Sussex Medical School

Roll out plan refresh - summary

January 2018 v1.3

Context / purpose It has been agreed by TGB that each trust should undertake a refresh of their roll out plan and to describe the

alignment with the organisation’s strategy and goals

This:

• addresses a key outcome for every trust of the recent visits

• is an important point in time for all trusts to take stock of progress and future plans and priorities at the 2 year

stage

• will inform business planning ahead of 18/19, including any changes requested by trusts to the contract

profiling with VMI

• will allow trusts to share plans with each other and identify opportunities for support and learn from each other

• allows common themes and challenges across the trusts to be discussed at January TGB

Next steps

Trusts to:

• work with their VMI sensei to begin a draft for discussion at December TGTs

• provide a draft summary of their plans in the template provided by 12th January to feed into TGB on 19th

January

• discuss in January TGTs, utilising the ‘in person’ time of the Executive Sensei

• discuss their plans in report out at January TGB (VMI to also lead a thematic discussion)

Aligning strategy to roll out plan

Overview

• Our aim is to pursue perfection, putting our patients at the

forefront of everything we do, improving safety and quality

by reducing variation and waste in every process. Our

SASH+ work supports an accelerated transformation in

quality by providing us with a structured approach to

continue our improvement journey taking us from a good to

an outstanding organisation.

• Our kaizen promotion office (KPO) team lead the

transformation programme; they provide the structure,

methods and rigour behind the successful implementation

of the SASH+ improvement methodology, alongside

training and developing others to lead using the new

methods.

Through integration and partnership we aim to become both a provider and employer of choice

Annual priorities

Reduce avoidable

harm

Improve discharge planning

Staff health, wellbeing and working lives

Create best environment for patients

Improve efficiency of elective care

Values

Safety & quality One team

Dignity & respect Compassion

Vision We will pursue perfection in the

delivery of safe, high quality healthcare which puts the people of

our community first

Patient

Organisational goals

Strategic objectives

safe effective well-led caring responsive

KPO Team objectives

Support and deliver

management of diarrhoea value

stream

Support and deliver

cardiology inpatient flow value stream

Support and deliver L4L and ALT offering 130 places per year

Develop and deliver taster and

introduction sessions focussed on 5S and waste

Support and deliver

outpatient value stream

Planned improvement activity 2018 Planned dates RPIW# Certification Value stream Sensei visit

wc 29.01.18 13 SC – VMI Cardiology No

wc 19.03.18 14 SC & ZP – VMI Diarrhoea No

wc 23.04.18 15 ZP & PT – VMI Outpatients No

wc 21.05.18 16 PT – VMI Cardiology No

19.06.18 N/A - Launch of VS#4 No

wc 25.06.18 17 SR – SASH Diarrhoea No

wc 06.08.17 18 SR – SASH Outpatients No

wc 10.09.18 19 BP - SASH Cardiology Yes

wc 01.10.18 20 BP - SASH VS4 No

wc 05.11.18 21 - Diarrhoea No

wc 03.12.18 22 - Outpatients Yes

Planned improvement activity 2018 and beyond

• Frequency of RPIWs move from 7 weekly to monthly in August 2018

• To increase number of RPIWs and kaizen events during 2019 from 12

to 16 – 20

• To launch VS#4 in June 2018 and VS#5 in 2019

• Value stream launch for VS#4 planned for 19 June 2018

• In partnership with VMI, agree and test format for 1, 2 and 3 day kaizen

events in 2018 with support from VMI. First kaizen day for sepsis care

planned for 16 March 2018

• Quarterly sensei weeks also planned for 5 – 9 March 2018 and 4 – 8

June 2018

• Ensure continued link with other trust focus areas for improvement

including sepsis, falls, staff health and well being and theatre

productivity

Education and training – roll out plan

Planned for 17/18 Planned for

18/19

Planned for

19/20

Induction All new starters (1101) All new starters

(1100 anticipated)

All new starters

(1100 anticipated)

5S and waste taster

sessions – for all new

and current band 1 – 4s

6 sessions per year - bi

monthly

20 – 30 staff per

session

6 sessions per year

- bi monthly

20 – 30 staff per

session

6 sessions per year -

bi monthly

20 – 30 staff per

session

One day introduction –

for all new starters,

junior doctors and staff

on FTC > band 4

6 sessions per year - bi

monthly

20 – 30 staff per

session

6 sessions per year

- bi monthly

20 – 30 staff per

session

6 sessions per year -

bi monthly

20 – 30 staff per

session

Mistake proofing 1 session planned for

25 staff in March 18

To review continuing for

L4L once complete

TBC TBC

Promoting innovation 1 session planned for

31 staff in January 18

To review continuing for

L4L once complete

TBC TBC

Education and training – roll out plan

Planned for

17/18

Planned for

18/19

Planned for

19/20

L4L 4 cohorts of 30 staff

planned to commence

each year

4 cohorts of 30

staff planned to

commence each

year

4 cohorts of 30 staff

planned to

commence each

year

0%

5%

10%

15%

20%

25%

30%

35%

0

10

20

30

40

50

60

70

80

Cohorts 1 & 2Jun 16 to Jun

17

Cohorts 3 & 4Feb 17 to Mar

18

Cohorts 5 & 6Sep 17 to Oct

18

Cohorts 7 & 8Jan 18 to Dec

18

Cohorts 9 &10

Jul 17 to May19

Commenced

Graduated

Cumulative L4L total

Cohort target

Attrition

Education and training – roll out plan

Planned for

17/18

Planned for

18/19

Planned for

19/20

ALT 2 cohorts of 10 staff

planned to commence

1 cohorts of 5 staff

planned to

commence each

year

1 cohorts of 5 staff

planned to

commence each

year

0

2

4

6

8

10

12

ALT originalcontract

SJ, AH, HG,KM

ALT cohort 1ZP, SC, PT,

SR

ALT cohort 2Feb 18 toMay 18

ALT cohort 3Jun 18 toSep 18

ALT cohort 42019

ALT cohort 52020

Commenced

Certified

Target

RPIW cert

Cumulative RPIW cert

VMI support - 2018

VMI support 2019/20

Proposal for VMI future support • Move quarterly sensei visits to an annual sensei visit for 1 week

• Use contract money released from reducing frequency of sensei visits

to consider support from VMI in:

- 3Ps (production, preparation, process) development. This is about

creating a future state vision and process for new and evolving

services in advance of the development of them.

- The format for kaizen events and when to use them

- Supporting L4L in the 12 – 18 months following their completion of

the programme

- NED engagement and development

- Wider board development

KPO infrastructure

Current structure

KPO Director VSM 1.0wte

KPO Specialist Band 8C 2.2wte (1.0 on phased

return and 0.6 still on long term

sick)

KPO facilitator Band 7/8A 1.8wte

Temp KPO facilitator Band 7 0.6wte

Temp KPO administrator Band 2 0.4wte

Proposed structure 2018

KPO Director VSM 1.0wte

Deputy KPO Director/Senior KPO

specialist

Band 8C 1.6wte

KPO specialists Band 7/8A 3.0wte

KPO administrator Band 4 1.0wte

Up to 5 certified ALT staff to support at

least 1 RPIW per year and /or teaching.

Max 16 days per year

Sarah Rafferty

Paula Tucker

Allana Hansell