Jul 262017
 

Kate Mackenzie (back), Senior Measurement Improvement Manager

So I went running on the weekend (“So what?!”).

I took part in a running event (“Oh you’re are one of those types!”).

I ran 104 miles.

Now I have your attention. I ran 28 miles on day 1, 39 miles on day 2 and 37 miles on the final day.

I should add for the millennials amongst you, that’s 167 km. Or Milford Haven to Cardigan for visualisers and geographers. Some of you are likely wondering why on earth I would do such a thing. You may even be thinking – I’d love to try something like this. And the compassionate ones might be concerned for the state of my feet (a bit weary, puffy ankles and medically taped up. My ice bath is calling!).

It is the same with improvement projects.

Rarely can you capture interest or support merely by saying “I am doing some improvement”. The only people whose heads will turn are other improvers. “I am doing an improvement project” might capture a few more as it sounds like something out of the ordinary. The third gets everyone’s attention. It’s the data.

Done right, the data is your common language. It immediately gives a frame of reference for your journey. And it explains the magnitude of your achievement. It provokes a response. It shouldn’t be complicated or onerous to collect or explain.

The words “data” or “measures” often raises groans of not being mathematically minded or it’s all too hard. It can feel that it is something extra to do on top of all the lovely improving that you are doing.

Measuring your improvement is inextricably linked to the change you are making. Your data is sitting all around you. You just need to look around with your project aim clearly in mind and think how do I check whether this has improved?

If you don’t know your numbers at the start (your baseline), how can you truly know that you are putting your effort into the right thing?

By monitoring your progress (regular measurement), you are aware of positive results which can be a massive morale boost to keep going. Or you know that blips are just blips or if there is something more determinedly awry.

And then when it comes broadcasting your success to your colleagues, your peers, your directorate manager or the finance director. You want them to recognise and celebrate your achievements but you need to tell them in a way that is meaningful to them as well as you.

You could think about another example – many people undertake a personal improvement project at some stage of their lives,  to lose some weight. In this instance, decisions are taken about what time of day to weigh, how often or whether to enlist the support of a local club. The key point is that no-one starts without knowing their weight to begin with and without recording their regular weigh-ins. Measurement is how you keep yourself on track, how you keep pushing forward with your project.

In short, DATA IS YOUR FRIEND.

It is how you prove to the detractors that your efforts are making a tangible difference. It will be how you convince your upper echelons to give you the support and investment.  And when you look back, it will be the thing that crystallises your success.

Happy measuring!

Jul 262017
 

Kate Mackenzie

Es i i redeg ar y penwythnos (“Beth am hynny?!”).

Cymerais ran mewn digwyddiad rhedeg (“O un o’r rhieni wyt ti!”).

Rhedais 104 o filltiroedd.

Nawr rwyf wedi llwyddo i ddal eich sylw. Rhedais 28 milltir ar ddiwrnod 1, 39 milltir ar ddiwrnod 2 a 37 milltir ar y diwrnod olaf.

Dylwn ychwanegu ar gyfer y mileniaid yn eich plith mai 167 km yw hynny. Neu o Aberdaugleddau i Aberteifi i ddelweddwyr a daearyddwyr.

Bydd rhai ohonoch siŵr o fod yn meddwl pam ar y ddaear y byddwn yn gwneud y fath beth. Efallai y byddwch hyd yn oed yn meddwl – Byddwn wrth fy modd yn rhoi cynnig ar rywbeth fel hyn. Ac efallai y bydd y rhai trugarog yn eich plith yn pryderu am gyflwr fy nhraed (braidd yn flinedig, wedi’u lapio mewn tâp meddygol gyda fferau chwyddedig. Mae’r bath iâ yn galw!) Mae’r un peth yn wir am brosiectau gwella.

Anaml y gallwch ddal diddordeb neu ennyn cefnogaeth rywun drwy ddweud “rwy’n gwneud ychydig o waith gwella”. Yr unig bobl y bydd eu pennau’n troi yw pobl eraill sy’n gwneud gwaith gwella. Efallai y bydd “Rwy’n gwneud prosiect gwella” yn ennyn diddordeb ychydig mwy o bobl gan ei fod yn swnio’n rhywbeth allan o’r cyffredin. Mae’r trydydd yn denu sylw pawb. Y data.

O’i wneud yn iawn, y data yw eich iaith gyffredin. Maent yn rhoi fframwaith cyfeirio ar gyfer eich taith ar unwaith. Ac maent yn esbonio maint eich cyflawniad. Maent yn ennyn ymateb.

Ac ni ddylent fod yn gymhleth neu’n feichus i’w casglu na’u hesbonio.

Mae’r geiriau “data” neu “mesurau” yn aml yn ysgogi cwynion nad oes gan rywun feddwl mathemategol neu bod y cyfan yn rhy anodd. Gall deimlo ei fod yn rhywbeth ychwanegol i’w wneud ar ben yr holl waith gwella hyfryd rydych chi’n ei wneud.

Mae cysylltiad annatod rhwng eich gwaith gwella a’r newid rydych chi’n ei wneud. Mae eich data o’ch amgylch chi. Y cyfan sydd angen i chi ei wneud yw edrych o amgylch gyda’ch prosiect mewn golwg a meddwl sut y gallwch wirio a yw hyn wedi gwella?

Os nad ydych yn gwybod y rhifau ar y dechrau (eich llinell sylfaen), sut y gallwch wybod i sicrwydd eich bod yn canolbwyntio eich ymdrechion ar y peth cywir?

Drwy fonitro eich cynnydd (mesur rheolaidd), rydych yn ymwybodol o ganlyniadau cadarnhaol a all fod yn hwb enfawr i forâl a’ch helpu i ddal ati. Neu sut mae gwybod mai gwyriadau yw gwyriadau ynteu a oes rhywbeth mwy difrifol yn bod.

Ac yna pan ddaw’n amser i roi gwybod i’ch cydweithwyr, eich cyfoedion, eich rheolwr cyfarwyddiaeth neu’r cyfarwyddwr cyllid am eich llwyddiant. Rydych am iddynt gydnabod a dathlu eich cyflawniadau ond rhaid i chi ddweud wrthynt mewn ffordd sy’n ystyrlon iddyn nhw yn ogystal â chi.

Gallech feddwl am enghraifft arall – mae llawer o bobl yn ymgymryd â phrosiect gwella personol ar ryw adeg yn ystod eu bywydau, er mwyn colli ychydig o bwysau. Yn yr achos hwn, gwneir penderfyniadau ynghylch pa amser o’r dydd i bwyso, pa mor aml, neu a ddylid troi at glwb lleol am gymorth. Y pwynt allweddol yw nad oes neb yn dechrau heb wybod eu pwysau cychwynnol a heb gofnodi eu cynnydd bob tro y byddan nhw’n pwyso eu hunain. Mesur yw sut rydych yn cadw eich hun ar y trywydd iawn, sut rydych yn parhau i wthio ymlaen gyda’ch prosiect.

Yn gryno, DATA YW EICH FFRIND.

Dyma sut rydych yn profi i’r difriwyr bod eich ymdrechion yn gwneud gwahaniaeth gwirioneddol.

Dyma sut y byddwch yn argyhoeddi’r rhai ar y lefelau uwch i’ch cefnogi ac i fuddsoddi.

A phan fyddwch yn edrych yn ôl, dyma fydd yn crisialu eich llwyddiant.

Mwynhewch y mesur!

Jul 072016
 

Dr Gethin Pugh, Consultant in Anaesthesia & Intensive Care Medicine, Welsh School of Anaesthesia

What is Quality Improvement?Welsh Anaesthesia Seminar

Quality Improvement (QI), or Improvement Science, uses a systematic approach to design and implement changes in healthcare.  Knowledge of the methodology of QI is essential when considering improvements to the modern complex healthcare environment.  QI is also included as part of many postgraduate training curricula.

In March 2016, the AoMRC published its report: Quality Improvement – training for better outcomes, which sets out recommendations for quality improvement education and training.  The report has drawn together a wide range of organizations to align efforts to implement quality improvement training as a core competence in modern clinical practice, from undergraduate curricula through specialist curricula and beyond into Consultant practice.

The report represents a starting point for future development and aims to provide a structured framework to embed improvement methodology as a core competence for all doctors.

It is recognized that significant barriers remain, with a lack of parity in access to QI training and resources across organizations and specialties.  For many senior doctors and other members of the multi-professional team, the concept of QI remains a new idea.

The rotational nature of medical training means that doctors in training, working within multi-professional teams, are well placed to share areas of good practice and support QI development.

QI Training in Anaesthesia and Intensive Care Medicine in Wales

The Welsh School of Anaesthesia working in partnership with 1000 Lives Improvement have developed a QI Training programme for both doctors in training and trainers, to provide high quality training in the principles of QI and access to QI training resources to support innovation and excellence in healthcare.

This programme aims to provide high quality QI Training through the use of interactive workshops for trainees and support the development of QI networks of both trainers and trainees across Wales.  Furthermore, it is hoped that as part of the programme, access to high quality QI projects will be enhanced and individuals will be well supported in developing their own projects.  The programme includes the courses outlined below:

Quality Improvement in Anaesthetics – a 2 Day Interactive Workshop for Specialty Trainees

The Welsh School of Anaesthesia working in partnership with 1000 Lives Improvement offers an interactive workshop for trainees in Anaesthesia & Intensive Care Medicine in Wales.

The course provides the opportunity to learn from experts in quality improvement, who have experience of successful QI projects, to advance your own knowledge and skills in this area.

Candidates have the opportunity to develop their own QI project as part of the workshop, working in small groups to gain valuable hands on practical guidance.  Attendance at both days of the workshop and submission of a successfully completed project results in the award of IQT Silver Level Accreditation.

Feedback from delegates who attended the last workshop in 2015/2016:

‘Credible faculty full of useful information’

‘Really enthused me to do QI work’

‘Great reframing and moving on from audit, good interactive style’

Bronze Level Accreditation was completed via an e-learning package prior to attending the 2-day workshop.

As part of this programme, a further QI Training Workshop for specialty trainees in anaesthesia will be held this autumn.  Dates will be confirmed shortly and will be published on the Welsh School of Anaesthesia website.

Quality Improvement in Anaesthesia:  Introduction for Trainers (1 Day Course)

This 1-day introductory course for trainers focuses on the principles of Quality Improvement.

The course provides the opportunity for trainers in Anaesthesia in Wales to build on their knowledge of QI and its role as part of training in Anaesthesia and Intensive Care Medicine.

The course enables trainers to gain an understanding of the methodology and framework that underpins QI and its role in improving healthcare.  Participants will also have access to contacts with experience in this area that will be able to provide further support for QI initiatives locally.

Future areas for development:

As part of the ongoing development of the educational programme to support QI Training in Wales, there will be a number of new opportunities for trainers and trainees this autumn:

  • Welsh School of Anaesthesia Educational Supervisors Study Day, October 2016

The workshop will provide some background of the present scope of QI Training and provide the opportunity for trainers in Wales to gain an understanding of the methodology and framework of this developing area of postgraduate training, as part of an interactive workshop.

Society of Anaesthetists of Wales, Autumn Meeting, October 2016 will also include a presentation on QI Training in Anaesthesia in Wales by a member of the QI development programme, Dr. Katy Beard.

  • Working in partnership with other Specialty Schools to support QI Training in Wales

At present, members of the programme development team are working with the All Wales School of Emergency Medicine to develop a QI Training programme for Specialty trainees in Emergency Medicine.  This includes supporting trainers to develop a QI training network as well as mapping QI training areas against the requirements of postgraduate curricula.

Jun 102015
 
Stephanie Morris

Stephanie Morris

Here we have a blog written by Stephanie Morris, student Adult Nurse at Bangor University about why she is proud to be part of the 1000 Lives Improvement Student and Educator Community. Have you got thoughts to add? Leave them in the comments below after reading this post.

Where it all began…

#HelloMyNameIsSteph and I am studying Adult Nursing at Bangor University. I became familiar with 1000 Lives Improvement following a teaching session at our university in one of our first modules on quality improvement. Soon after, we were lucky to attend the 1000 Lives Improvement National Learning Event at Llandudno. The day brought a wealth of knowledge on prudent healthcare and we met and listened to an inspirational talk by Dr Kate Granger. Learning about the #HelloMyNameIs campaign, I became instantly compelled to learn more about quality improvement and to take what I had learned into my practice as a student nurse. It wasn’t long before I learned about the 1000 Lives Improvement student chapters through our lecturer Angela Williams. Me and my fellow students were keen to get involved, so we re-established the chapter in 2014.

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May 132015
 
Frances Samuel

Frances Samuel

From Wednesday 22nd April to Friday 24th April I was lucky enough to attend the 20th International Forum on Quality and Safety in Healthcare at the ExCel in London, all thanks to 1000 Lives Improvement. The event is promoted as a unique opportunity to learn from, and network with key figures and organisations in the world of quality improvement. It did not disappoint! With 3,000 delegates from 80 different countries it was a very inspirational and professionally organised event. I shared my experience with three nursing students from other universities across Wales, who were all equally enthusiastic about quality and safety improvement.

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May 122015
 
Paul Gimson

Paul Gimson

It was a real privilege to be able to represent 1000 Lives Improvement and Public Health Wales at the 2015 Quality Forum this year.

I expected many things when I went along to but learning a new word was not one of them. The word was ‘Exnovate’ and it was used by Maureen Bisognano, the CEO of the Institute for Healthcare Improvement (IHI), to highlight the real need for healthcare systems across the word to do less of what isn’t important or needed. It chimed with those of us there from Wales because of its similarities with our own prudent healthcare principle of ‘Do Only What is Needed and Do no Harm.’ The issue of over diagnosis and overtreatment was a theme of many of the sessions within the conference and so it was nice to be able to feedback to Wales that the work we are doing here on prudency is not only ground breaking but it is of international significance.

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May 112015
 
Iain Roberts

Iain Roberts

This year I attended the 20th International Forum on Quality and Safety in Healthcare (#Quality2015) with colleagues from NHS Wales. It was a forum packed full of learning and here are some of my thoughts and highlights.

You find lots of wisdom and learning at the International Forum on Quality and Safety in Healthcare.  Whether you want to learn about the Ebola outbreak in West Africa, the challenges of restraint and patient safety on a mental health unit, or the process of reporting serious untoward incidents in different health systems, then there is a lot to consider on a wide range of healthcare topics, some I’ve really enjoyed about the forum each time I have been.

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May 082015
 
Claire Roche

Claire Roche

Two weeks have passed since I attended the International Forum on Quality and Safety in Healthcare (#Quality2015) with colleagues from NHS Wales. It was a Forum packed full of learning and here are some of my highlights from across the three days.

 

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Apr 292015
 
Danny Antebi

Danny Antebi

In the wake of the Francis Report in England and Trusted to Care here in Wales, getting improvement and patient safety messages across to all healthcare staff is essential.

We need to communicate these both as national priorities and within individual health organisations. But doing it is a challenge.

Exploring the role of communications in quality improvement is a new paper from colleagues who were involved in the 1000 Lives Campaign. It describes the importance of large campaigns (in this case, a national campaign) and a framework for communications to support those initiatives.

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Apr 152015
 
Jean White

Jean White

It takes just a moment for a healthcare professional to introduce themselves to a patient, yet often this simple act can be forgotten in the busyness of providing care.

However, the omission of this common courtesy can – and does – have a huge impact on a patient’s experience. It can leave them feeling less valued and isolated in an already strange and vulnerable situation.

A friendly introduction is about making a connection, beginning a patient-staff relationship and building trust.

It’s about putting the patient at the centre of the care being provided and reassuring them.

That’s why I’m delighted to see that healthcare students across Wales are pledging to introduce themselves to patients properly by supporting the ‘Hello my name is’ campaign.

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