Meet the team: Improvement and Transformation
Harrogate & District NHS Foundation Trust
- England - Yorkshire and Humber
- David Plews, Deputy Director of Improvement & Transformation
- Natasha Ori-Orison, Project Support Officer - Quality Charter
Launched in 2016, the Trust’s Quality Charter comprises six elements, one of which is the “Quality of Care Champions” scheme – a program accredited by the Yorkshire & Humber Improvement Academy to provide three levels of in-house QI training. The Bronze Award is an introduction; accreditation for the Silver Award hinges upon delivery of an improvement initiative and the Gold Award is a Train the Trainer course.
Although proving very successful, the scheme was established with a modest budget and we are now keen to build upon a solid foundation and the overall impact of Silver level projects. Many proposals are ultimately geared toward cost avoidance / reduction or revenue generation and knowing that it’s possible to secure some investment will further the ambition of our Quality of Care Champions and encourage them to tackle some of the more complex aspects of service improvement.
Example projects to date include:
* Developing a Vulnerable Parent Pathway within 0-19 children’s services.
* Reducing follow-up appointment waiting lists for glaucoma patients in Ophthalmology.
* Introducing acupuncture as an alternative therapy in pregnancy.
* More than halving the length of the therapy rehabilitation pathway for certain amputee patients.
* Improving the referral and triage process, caseload management and data capture in Dietetics.
* Reducing costs and time associated with patient surveys, whilst improving response rates.
* Implementing the #EndPJParalysis campaign across our care of the elderly wards.
* Launching a series of engagement strategies to enhance awareness and support of the Trust charity.
We propose to establish a scheme through which our Silver level Quality of Care Champions can apply for funds that support their QI project. This will enable our champions to improve quality across our hospital and community services with a speed and scale that mirrors their passion and ambition.
Although our staff are excellent at delivering improvement without additional resource, the ability to provide some funding would present an opportunity to improve the quality, pace and scale of various initiatives. Applications will be reviewed by an already established “Quality of Care Champions Advisory Group” and investment agreed up to the value of £1000.
So rather than supporting a single project, we would use this funding to support up to a project per month throughout 2019-21 to the tune of one thousand pounds each, equating to a bid for £24,000.
What We Hope to Achieve
By establishing a cohesive approach to engaging the whole workforce in quality improvement activity, we have learned that the single most powerful determinant of care quality is the collective knowledge, skills and behaviours of the people providing care.
We have demonstrated that the approach can have equally powerful benefits for patients, whether project leads are in clinical or non-clinical roles; and that seniority is not a barrier to success.
The implementation of our Quality Charter has brought to life the Trust’s mission and vision statements and the first of its three strategic objectives ‘to deliver high quality care’.
Had such a funding scheme been available during the course of 2017-18, we may have been able to:
* Produce high quality marketing materials that would have enabled us to implement #EndPJParalysis campaign across more than just our care of the elderly wards
* Introduce a more efficient text messaging reminder service to further reduce DNA rates in Outpatients.
* Accommodate protected time for community staff to expand a streamlined approach toward procurement of pharmaceuticals.
* Contribute towards the purchase of a suitable Diabetes Management software package, which would greatly benefit our paediatric team.
* Improve the clinic room that is used to provide acupuncture to expectant mothers, providing a more therapeutic environment.
We work on the principle that increasing quality can be the safest way to reduce cost. Having these funds available would not only improve the outcome of many projects but also enable some projects to commence that would have otherwise been marginalised because of the need for some initial investment.
Benefits for Q
The Trust has a strong agenda to develop a culture and strategy that grows and develops quality improvement within individual teams. Accreditation for training rests upon delivery of an improvement initiative, so in that respect we would be continually:
* Generating more potential Q members and a raft of ideas that can be shared with the wider health and social care economy. Every Silver Level project is supported with full documentation.
* Taking advantage of the Q network, website, events and social media to encourage a “share and spread” approach that demonstrates to others how the investment has benefitted services.
* Share guidance and in particular, lessons learnt, with other organisations interesting in implementing similar changes to practice.
* Offering to make a limited number of presentations on the implementation and evaluation of the Quality of Care Champions scheme to other interested Trusts.
How you can contribute
- It may be that other members of Q have similar schemes within their organisations and can suggest the criteria against which applications are considered.
- Propose quality improvements that deliver significant benefits for a comparatively small investment. We can then share this with our Quality of Care Champions to inspire their innovative practice with examples from across the health and social care system.
Example Silver Level QI Project (PDF, 311KB)