the masterclass strategy ◦ what is it? ◦ influencing ◦ ahp strategy standard clinical...

Strategy◦ What is it?◦ Influencing◦ AHP strategy standard

Clinical Governance◦ Elements of CG◦ Risk management◦ Evaluation and action

planning Audit Patient and Public

involvement

Staffing and new roles Use of Time Process Mapping Business Case

Development Marketing Introduction to AHP

Management Quality matrix

A plan of action designed to achieve a particular goal ◦National◦Regional/Local◦Service specific

Your role

Influence others to get results Are you trying to influence one person or a group?

What is your hierarchical relationship with them?

How capable/knowledgeable are they?

How well do you know each other? What are their priorities?

ME

Physio OT Social Work Pharmacy

DGM

CEO

AH Network

National AH Group

Family

Elderly care working group

Community care strategy group

Draw an organogram Who do you influence? How do you influence them? Who influences you? What influence do you have? What could work better?

1. Common vision2. Awareness of others3. Awareness of key people4. Data and information use5. Making others feel valued6. Presentation impact7. Negotiating/bargaining

Each table to develop ideas of how to use each influencing strategy in your work

Write on a flip chart to stick up

The service has a documented strategy which is reviewed and updated annually.

1.1 Does your organisation have a strategy?

1.2 Have you an up - to - date strategy for your service?

1.3 Is there a ‘value statement’ that is shared by staff in your service?

1.4 Service mission statement/vision; is this agreed and documented?

1.5 Is your strategy linked to: National, Regional Local?

1.6 Service portfolio – the range of services you provide is this documented?

1.7 Major goals/objectives for your service; are these documented?

1.8 Do you have service strategies 1.9 Is the overall contribution of your service (from the patients’ perspective) documented?

1.10 Do you undertake an annual service review, and document findings?

1.11 Do you have organisational charts?

1.12 Do you produce a service annual report?

Work with a partner from the same service or on your own

Use the evaluation matrix Evaluate the components Summary and actions to go on

post –its to be stuck on the wall when completed

Clinical governance is  the system through which NHS organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care, by creating an environment in which clinical excellence will flourish

(Department of Health1998)

1. Clinical effectiveness2. Risk management3. Patient experience4. Communication5. Resource effectiveness6. Strategic effectiveness7. Learning effectiveness 

Systems awarenessTeamworkCommunicationOwnershipLeadershipManagement

Risk is the combination of the likelihood of an event and its consequences

Risks may have benefits as well as threats to an organisation's business

Risk Management is a continuous process by which risks are recognised and managed

Do you have a risk register?

What is Clinical audit? Who has done it? Who gets support? Have you used audit? What do you do with the results? How do you feed it back into practice?

Have you identified training needs? What have your services done?

Make a list of audits for your service. Prioritise:◦Organisational requirement◦Professional requirement◦Service development◦Service review◦Personal development

Make a list of audits for your service. Prioritise:◦Organisational requirement◦Professional requirement◦Service development◦Service review◦Personal development

Do you include patients/service users in service development and evaluation?

Do you have a service lead for this?

What have you tried? Was it useful?

Each table work together to complete the task set for you on one of the Clinical Governance strands.

Fill in one flip chart sheet and stick it on the wall

45 minutes

In an average 54 hour week what percentage of time does a leader spend on work planning reflecting and thinking?

◦A) 7.5%

◦B) 13%

◦C) 18.5%

◦D) 28%Source NHI 2007

In an average 54 hour week how many hours does a leader spend in meetings?◦A) 12

◦B) 27

◦C) 38

◦D) 45

Source NHI 2007

In this time the leader attended 26 meetings, how many started on time?

◦A) 4

◦B) 7

◦C)11

◦D) 16Source NHI 2007

What percentage of people actively contributed/participated in the meeting◦A) 65%

◦B) 52%

◦C) 42%

◦D) 36%Source NHI 2007

INPATIENTS TEAM EASTBOURNE

46.06%

5.11%

0.91%

0.65%

3.02%

3.94%

13.33%

4.89%

0.22%

2.61%

0.94%

5.52%

1.73%

0.80%

1.32%

0.33%

0.11%

3.90%

3.06%

1.56%

FACE CONTACT IND

FACE TO FACE GRP

TEL CONTACTS

WARD ROUNDS

CASE CONFERENCE

STUDY LEAVE

LIAISON

ADMIN

MANAGEMENT

HOME VISITS

TRAVEL

CLINICS

MTGS

IN SERVICE TRNG

TEACHING PHYSIOS

TEACHING STUDENTS

TEACHING HEALTH PROF

TEACHING PUBLIC

CLIN. SUPERVISION

OTHER

How you and your staff spend their time?

8A 7 6 5 3

OTHER

CLIN. SUPERVISION

TEACHING PUBLIC

TEACHING HEALTH PROF

TEACHING STUDENTS

TEACHING PHYSIOS

IN SERVICE TRNG

MTGS

CLINICS

TRAVEL

HOME VISITS

MANAGEMENT

ADMIN

LIAISON

STUDY LEAVE

CASE CONFERENCE

WARD ROUNDS

TEL CONTACTS

FACE TO FACE GRP

FACE CONTACT IND

Ageing workforce More expensive workforce Changing individuals’ needs Changing educational opportunities Variety of providers Need to:

◦ retain staff◦ develop staff◦ work differently

Working at a highly specialised level within the boundary of the profession

Core Professional Practice

Working at specialist level within and beyond the boundary of their profession

Training Regulation

Core Professional Practice

Extended Practice

Write a list- what would it achieveHow would you progress this?

Write a list- what would it achieveHow would you progress this?

Puts a spotlight on waste Streamlines work processes Defines and standardises the steps and sequence

Promotes understanding Builds consensus Key ‘tool’ for work re-design

Physiotherapy Out-Patients - Management of Referral for OP appointment DRAFT ‘TO BE’ PROCESS

Sen

ior

Phy

sio

Phy

sio

Rec

eptio

n Yes

No

No

Date stamp and prioritisation stamp referral letter/card

Is this urgent appointment?

File routine requests in waiting list drawer in date

order

Referral from Esperance

Complete prioritisation stamp with type of

appointment/speciality and prioritise as urgent or routine

Referral from Consultant

Referral from Occupational

Health

Is referral from out of area?

Put in tray for Senior Physio to

check

Patient rings for appt

Pick up referrals from tray

Referral from Horder Centre

Referral from out of area

Patient rings for appt

Referral from GP

Is this a respiratory appt requested by

consultant?

Hand back to Reception staff

File referral in relevant filing

drawer

Referral from IP Physio (card in traty)

Register referral on Tiara (checking

other episodes etc)

This is an additional step, but does not change

management of referral – prioritised and letter sent as

for rest of process

YesNo

Send standard letter (from Tiara) to GP asking for reply if

they do not agree to referral

Send standard letter (from Tiara) asking

patient to make choice appointment (letter sent

within 1-2 days)

Send choice appointment letters

to calculated number of NP

assessment slots

Self-referralSelf-referral

1. Are there any wasteful handovers?2. Are there any bottlenecks?3. Could some tasks be carried out by one person

instead of several?4. Are tasks carried out for our benefit or the

patient's?5. Could some tasks that are performed in another

process be performed here?6. Are the people who work in the process allowed to

make decisions?7. Which tasks help to achieve the purpose and

which ones create waste?8. Is there any duplication of work?9. How much rework is being carried out?

Decide which service you need to review◦Are there problems?◦Do you think it could function better?◦Are there potential gains to be made?◦Are there non value steps in the service?

Invite the key people- give them sufficient notice

Don’t assume you know!

Let’s see

how far we get!

Let’s see

how far we get!

Introduction Background/context Proposed service Links to local /national priorities Predicted capacity Benefits to patients/

organisation/stakeholders Cost-benefit

Service evaluation Predicted outcomes Governance arrangements Risks of doing it or not Lead- in time Financial impact statement Summary

Use the headings in the template…..

Start a force field analysis

Use the headings in the template…..

Start a force field analysis

Source DH 2006

Patient/Public

NationalTargets/drivers

Reviewing service

provision

Deciding priorities

Designing services

Shaping the service structure

Managing demand

Referrals,Individual needs

assessment,Patient choice re treatment

Managing performance,

quality, outcomes

Seek public and

patient views

Needs assessment

Understand the ‘politics’ Get to know those who ‘buy’ your services

Make a clear business case Show how your proposal adds value Use information and data Show the likely impact

Preparation Know your service

◦SWOT analysis◦Staffing and expertise◦Current service specification

Identify your “selling” points Branding Finance

Needs analysis◦Population, users and public health

Know your competitorsWho can help you? InformationCommunicationPublicity

Name of competitorYour assessment of their Strengths and weaknesses

Areas of direct competition Impact on your service

Unique selling points

Key stakeholders internal/external

Stakeholder Interest and Influence

Interest

Low

Influence

Voluntary SectorPatientsProfessional Bodies

MedicineSurgeryWomen’s HealthGPsPurchasersComplaints

Support ServicesDept.HealthEmployersSHASocial ServicesRegulatorHuman Resources

CEOExec TeamContract DeptFinance Dept

Low High

High

Make a List

Make a List

1. Strategy 2. Activity3. Patient

experience4. Finance5. Staff resource

effectiveness6. Staff

management and development

7. Information and metrics

8. Leadership and management development

9. Clinical excellence10.Communications and

marketing11.Service improvement

and re-design12.Risk management13.Corporate

governance14.Key performance

indicators

Strategy Clinical governance New roles Process mapping Business case

development Marketing Introduction to AHP

management quality matrix

Write down the first thing you are going to improve

Write down the first thing you are going to improve

Any Questionsor further Discussion

Will be made available to you

www.jjconsulting.org.uk