from average to excellent - nhs providers...your hospitals, your health, our priority from average...
TRANSCRIPT
your hospitals, your health, our priority
From Average to Excellent Through
Staff Engagement and Quality Improvement
Alison Balson, Director of Workforce
22nd April 2016
your hospitals, your health, our priority
The caring face of the NHS
your hospitals, your health, our priority
QUALITY
IMPROVEMENT
your hospitals, your health, our priority
Our journey to a culture of Quality
your hospitals, your health, our priority
The WWL Wheel
your hospitals, your health, our priority
Consistent Quality values
• Quality equal to performance and finance
• Nothing is more important than safety
• Speak up if you see harm or risk
• Science of healthcare improvement
• We measure what we do
your hospitals, your health, our priority
Over 8 years
2007-08 2014-15 % change HSMR (not rebased) 126 57 -55% Deaths in Hospital
1,561 1,142 -27%
MRSA 39 1 -97% C Diff
373 25 -93% Pressure Ulcers (<grade 2) 26 4 -85% Serious falls 58 11 -81% TOTAL HARMS 516 73 -86%
your hospitals, your health, our priority
Should be a joined up
strategy
your hospitals, your health, our priority
But we’re not as good as we want to be
• SAFE – Eight Never Events in 2 years • EFFECTIVE - HSMR is 91 we want <83 • CARING – we have a number of harrowing
failures, incidents and complaints • And…
- Band 3 CQC risk rating – Non-compliance with checklists
your hospitals, your health, our priority
Weekly deaths report
your hospitals, your health, our priority
We are still harming patients
• Aspiration pneumonia • GI Haemorrhage • Intestinal obstruction • High risk medications • Patients put NBM/Nutrition • Drug omissions • Rare but dangerous medications • Hospital overload • Patients in wrong ward for main condition • Patient identification • Escalation of deteriorating patient
your hospitals, your health, our priority
Where next ? Quality Champions
The 288 Quality Champions
Ian Aspinall Karen Atkinson Emma Baggaley Anita Baker Andrew Beddeson Chris Birchall Lorraine Bremner Leanne Brooks Dan Buck Terry Cawley Helen Champion Amanda Cheesman Tahir Chohan Kath Collins Nicola Compton Jones Cheryl Dagnall Yvonne Dunn Lucy Farnworth Andrew Foster Kathryn France Ruth Gregory Amy Halliwell Manzarul Haque Phil Harris Susan Heighway Elaine Hibbs Carol Howard Jackie Hylton Ahmed Ismail Chris Jackson Margaret Jolley Alison Jones Pauline Jones Vineeta Joshi Dawn Joyce Maria Katsarou Shams Khan Pauline Law Diane Lawrenson Vicki Loftus Nisar Mahmood Philip Makin Tricia McDonnell Ursula McMahon Carrie McManus Linda Morton Rob Nelson Sieu Ming NG Jackie Ogden Marius Paraoan Hitesh Patel Clare Thomas Deborah Travis Andrew Twist Deborah Waywell Kim Whiteside Vicky McKinnell Syed Mehdi Jayne Moakes Dawn Morris Michelle Murray Ravi Natesan Sandra Newton Helen Nicholson Graham North Neelam Patel Louise Piscina Jean Prescott Debbie Preston Boby Raja Jean Ramsdale Baskaran Ranganathan Gill Rowlands Alison Russell Helen Salvini Andy Savage Lynn Schofield Catherine Sefton Anne Sheen Sarah Short Alison Simm Nathan Sinclair Sandra Slater Booth Martyn Smith Nicola Smith Arshad Sofi Chris Swann Jan Sweetingham Donna Talbot Gail Taylor Sandra Thurogood John Turner Roland Turner Joanne Unsworth Alex Vincent Emma Wade Kay Webster Sue Whalley Judith Whelan Gemma White Ruth Wiggins Helen Wilding Tracey Williams Suzanne Wilson Joanne Wright Sheena Wright Donna Yates Nigel Grass Pam Green Susan Green Joanne Grimes Karen Hall Gail Halliwell Helen Hand Carla Harris Caroline Harrison Janet Harter Mark Heaton Chris Heaven Kathryn Heffernan Christie Hermiston Elizabeth Hesketh Susan Higgins Graeme Hodgson Yvonne Holden Suzanne Holt Emma Howarth Zoe Howarth Mruthunjaya Hulgur Tarek Ibrahim Alam Imran Nasir Iqbal Karen Jackson Jane James Neil Jarvis Alison Jones Nicola Jones Evonn Kennah Siobhan Kerrigan Zahida Khan Jamie King Laurence King Katherine Knowlesmith Nadia Koriba Fares Koussa Nyuk Cho Lee Sarah Litherland Sadasivam Loganathan Fai Lomas Sheila Lowton Gill Lyon Claire Magrath Deborah Makinson Marie Malone Jacki Mansfield Simone McCracken Alison McKenzie Turaev Akmal Victoria Allen David Arrowsmith Karen Ashcroft Dawn Aspey Imran Aziz Ravi Badge Aaron Barker Christina Barton Kim Barton Nick Bastow Angela Bibby Sue Binns Julie Bolt Vicky Bolton Cath Bridge Gill Brook Tara Broughton Siobhan Buckley Terry Butler Tracey Butler Christianne Butterworth Cath Cameron Jane Caton Alex Chialton Anne Clayton Debra Clegg Geoff Conway Emma Cooke Alison Corner Vic Cowley Carol Crook Angela Cross Lesley Cunliffe Jane Davies Anne Edwards Farag El-Habishi Chris Ellison David Evans Pam Farren Janice Fellows Rachel Fitzsimmons Mary Fleming Rob Forster Ellen Gandy Victoria Gaskell Denise Glassbrook Catherine Baker Lynsey BarberWharmby Natalie Baxter Joanne Birch David Byrne Debra Cain Sunanda Carruthers Chenshya Chanda Carol Davies Gillian De Souza Janet Derricott Jamie Dolan Xan Gallagher Nichola Halpin Tracy Jackson Daniel Kannappan Sarah McDonald Fiona Murphy Pat Obrien Gail Parker Jodie Paterson Dawn Phillips Kirsty Ratchford Paul Robey Mark Robinson Suzi Speakman Cathy Stanford Gaynor Whalley Alison Whitehead Sharon Williams Kate Witkiss Kerry Entwistle
Bronze: 237 Silver: 42
Sanjay Arya Diraviyam Balasubramanian Lynda Barkess-Jones Michelle Cooper Marie Corfield Joanne Heggerty Jawad Husain Trish Little Diane Swindlehurst Wendy Tasker Andy Thompson Andrea Arkwright Shaun Dainty Helen Flowers Janet Duffy Ram Sundar Marion Ashworth Angela Winterton Sean Jackson Lucy Lyon Andrea Rostron Kathryn Ashton Sharon Lythgoe Mark Keegan Helen Titu Carolyn Dereszkiewicz Laura Pickering Steve Izzat Gill Davenport Jenny Spicer Paula Madden Nicola Collier Nicola Hardman Luke Kennedy Alison Unsworth Abdul Ashish Sarah Simm Janice Cavadino Amanda Ahmed Fiona Hindley Caroline Greenhalgh Caroline Parry
Gold: 9 Ayaz Abbasi
Martin Farrier Diane Lee
Linda Smyth Christos Zipitis
Lindsey Bullough Diane Wilkinson
Sean Burns Stephen Gulliford
61 Quality Champion Projects 2012-14
Improving the complaints process Addressing non-productive inpatient stay for stroke patients Preparation of patient bed spaces Timely & effective use of discharge lounge Prevent perioperative hypothermia Improving the patient pathway in audiology Reducing medication omissions in patients who are nil by mouth Improving the patient experience Sustaining the safer surgery checklist Avoiding readmissions in oncology Harm from post-operative delirium Cataract patients’ pathway Preventing respiratory admissions Back to basics – time to care Privacy and dignity in theatre Nurse-led discharge in surgery Preventing falls Rapid discharge at end of life Increasing patient satisfaction with the use of Whiteboards
Improving hydration Reducing length of stay in #NOF Reducing medication omissions Reducing pressure ulcers Pain management in A&E majors Timely transportation of blood samples MDT intervention and stroke patients’ dependence Supporting carers of patients with dementia Musculoskeletal checklist Anaesthesia outside of OD ACST Handover Improving Discharge Efficiency of bone bank service Customer care focus in estates Frenulotomy clinic for babies Breast feeding of premature babies 12–16 year olds in A&E safeguarding Moving & handling induction Intentional cooling of newborns Quality champions knowledge management
Immobile patients with possible DVT Dehydration in nursing homes Ambulatory assessment discharge Reducing falls in hospital Training in dysphagia screening Discharge of vulnerable adults Communication on Rainbow Ward Nutritional supplements in #NOF Speedy transfer to side rooms Patient weights Harm from urinary catheters Improving appointment letters Reducing deaths from sepsis Shared Decision Making in maternity Preventing readmissions (Urology) Improving experience on Ward 5 Infections in new born babies Improving patient information in ENT Improving experience in audiology Improving hourly rounding Improving the birth environment
your hospitals, your health, our priority
STAFF
ENGAGEMENT
your hospitals, your health, our priority
Hard wired into our strategy
your hospitals, your health, our priority
2012 - Time for a change of gear
• Poor 2011 Staff Survey Results
• Decided that 2012 would be the year of
Staff Engagement
your hospitals, your health, our priority
Staff… 2012 2013
feel happy working in their area/team/department 54% 76%
feel involved in changes that affect their work area 33% 59%
feel senior managers encourage staff to suggest new ideas
32% 64%
feel day-to-day frustrations are quickly resolved 17% 51%
feel we communicate clearly about what we try to achieve
31% 64%
believe we provide the very best services to patients 40% 69%
are satisfied with how much the Trust values their work
20% 55%
feel proud to work in their area/team/department 61% 79%
understand the link between their role and the wider vision
47% 73%
feel communication from management is effective 22% 57%
The results – Before and after
your hospitals, your health, our priority
Temporary Spend April 2012 – September 2013
The results – HR metrics
your hospitals, your health, our priority
• 5th out of 50 in NHS North Quality Dashboard
• 5th out of 50 in NHS North Performance Table
• 1st out of 23 in NHS NW A&E Performance Table
• Achieved Financial budget £4.1m surplus and
FRR 4 for third year in a row
The results – Organisational success
your hospitals, your health, our priority
But that was only the start
• A great outcome but………..
• How do we get from good to great?
• Need to understand ‘cause and effect’
• How can we tailor a specific approach to
the needs of an individual department?
9 WWL Enablers of Engagement
Influence
Clarity
Work Relationships
Perceived Fairness
Recognition
Personal Development
Mindset
Resources
Trust
Staff Feel Engaged
Energy
Focus
Dedication
Staff Behave Engaged
Advocacy
Persistence
Discretionary Effort
Adaptability
Direct and Indirect Impacts on Patient
Care
In-role/extra-role performance
Turnover
Departmental/Divisional performance
Safety
Staff health and well-being
Absenteeism
Patient Satisfaction
How it works
A typical department
Wonderful Ward 5 24/06/2014 28/01/2015
• Big improvement • Some results doubled • Improved staff morale • Excellent team work • No complaints in 7 months • Positive comments from patients
“there is the feeling that caring for patients is always the priority and any concerns of staff are always listened to”
“excellent team work which has engaged the ward”
“I have had amazing support, not only from management but also everyone else involved”
What do you think of this approach?
your hospitals, your health, our priority
Our staff survey results
your hospitals, your health, our priority
The views of our CEO • Chief Executives have few direct powers • But they do have their hands on big levers
– Recruitment of senior staff (setting the culture)
– Choosing what to prioritise
– Speaking for the Trust
– Setting an example of management style
• Try to get staff ‘alignment’ – Quality is a unifying motivator
– Staff are very values driven
– Staff engagement releases huge discretionary effort
your hospitals, your health, our priority
Any Questions ?