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What is the challenge your project is going to address and how does it connect to your chosen theme?

Our challenge is to bring clinicians and patient representatives, traditionally siloed, together at local neighbourhood level to work towards system improvement, letting local systems lead!

By improving communication and relationships locally, working without boundaries and using a Community of Practice (CoP) approach, we hope to meet the 3rd global  WHO safety challenge “Medication without harm.”  Our CoP will influence wider system improvement, beyond prescribing that will form the foundation blocks of transformational change in Northern Ireland.

This project will prove that a CoP model improves care locally, influences wider population health and can be scaled and spread across Northern Ireland supported by the Integrated Care Partnership Networks already in place.  The CoP will connect individuals across Primary, Secondary Care and the Third Sector facilitating the sharing of power, listening, learning and creating new knowledge in a collaborative environment.

What does your project aim to achieve?

  • Build on year one’s success, providing a shared space for clinicians and patients to come together to discuss what matters.
  • To facilitate members share knowledge, learn together creating new knowledge in a collaborative environment.
  • Provide opportunity to develop and apply QI knowledge and skills.
  • Utilise trust and communication built between members in in year one to improve patient safety outcomes.
  • Innovate and deliver small step improvements (ideas include screening and management of hypertension within community pharmacy, increased awareness of opioid prescribing and promotion of wellbeing through sign posting and social prescribing).

Evaluation will include capture of a range of data including quantitative and qualitative measures taking account of process, balancing and outcome measures. Patient and staff experience will be captured using a both survey and focus group approaches. Data collection validity and reliability will be overseen by the Trust Quality Improvement Team.

How will the project be delivered?

Dr Philip Lusty started this project prior to Q Exchange 2018 and though not shortlisted proceeded with plans to form a Community of Practice and continued to engage local Trust colleagues and primary care colleagues to pursue how we might develop.  There has been support of HSCB (commissioner) through the local Integrated Care Partnership.

Dr Lusty partnered with Trust QI lead (Jacqueline), a local community pharmacist (Raymond) and a practice based pharmacist (Helena) together forming the core co-leadership team of this Community.

The community has met 6 times 2018/2019 and on 18th June 2019 celebrated their first birthday with a party inviting senior commissioners and Trust Directors to reflect on our achievements made to date.

This project fits with the wider strategy in Northern Ireland to form neighbourhoods of health care providers that will support their ICPs.

We are excited to be ahead of the curve in Portadown and hope to build on momentum and trust and show regional leadership.

 

What and how is your project going to share learning throughout?

The members of the community are actively involved engaging our key stakeholders  including patients, clinicians and voluntary sector as well as commissioners who identify key learning opportunities to inform and stimulate our thinking.  Learning partners have included MOIC, PACT, HSCB and Trust Promoting Health and Wellbeing Team.

We have actively shared “new knowledge” at

  • Southern Trust Annual QI Event November 2018
  • 40 regional GP Practices SHARE Event February 2019
  • ICP Leads Meeting
  • NI Confederation for Health and Social Care May 2019
  • Department of Health WHO Challenge “Medication without Harm” Event May 2019
  • Philip and Jacqueline participating in Health Foundation Community of Practice Leadership Programme 2018 – 2019.
  • HSCQI Sharing The Learning Event September 2019
  • This sharing the learning approach will be continued through the lifecycle of the project.
  • We have established links with other Trusts and ICP’s who are watching our journey with interest and providing a critical friend function.

How you can contribute

  • We want to learn with Q Members actively involved in CoP’s on “what work well” and “even better if.”
  • We are particularly interested in learning from patients who are currently involved in a CoP or QI.
  • We are keen to hear from Commissioners to listen to where we can add value
  • We appreciate the on going support of colleagues taking part in the Community of Practice Leadership programme and we will continue to actively contribute to supporting fellow members leading their CoP.
  • We are excited to hear how to grow the "coalition of the willing" in year two based on the main outcome of our 25/10 Crowd Sourcing, part of our birthday celebration.
  • We desire to grow as a community and identify improvement projects to collaborate on with key stakeholders, especially engaging with priority areas for ICPs as well as inform ICP "what matters most" to the community.
  • We will continue to liaise with colleagues both regionally and nationally with an interest in developing Communities of Practice.

Plan timeline

18 Jun 2018 Do we want to work together? Forming a COP?
18 Sep 2018 What's your business? In your shoes...
13 Nov 2018 Hearing other success stories? Motivation to collaborate...
5 Feb 2019 Who do we need to help us?
30 Apr 2019 Welcome Trust colleague...How can we work together?
18 Jun 2019 It's a party 1 yr old...reflection...What about year 2?
24 Sep 2019 Year 2 - What's our first project?
26 Nov 2019 2nd meeting year 2...Building Spec to our project!
25 Feb 2020 3rd Meeting year 2...Directed by the Community
28 Apr 2020 4th meeting year 2...Directed by the community
30 Jun 2020 5th meeting year 2...celebrate achievements of another year.
29 Sep 2020 Continue our plan to meet 5x per year, each year

Comments

  1. It’s lovely to see how this idea has grown and the value it is already bringing by connecting people in the local community. What learning do you envisage there will be for the wider Q community?

    Good luck

    best wishes

    Anna

    1. Anna thanks for commenting.  It is exciting times for anyone aware of CoPs in Northern Ireland or anyone with experience of being part of a collaborative Primary, Secondary, Community and Voluntary group.

      As regards the learning for the wider Q community the value will become known not just through the experience of this CoP but through the wider collective experience shared by all the fellow members who are part of the first Community of Practice Leadership Programme at present.  I am so thankful to have been given an opportunity to be part of this UK wide training programme along with 2 fellow colleagues and friends from Northern Ireland.  In many ways the members partaking on the UK training programme have formed a CoP themselves, benefitting from sharing and supporting each other as we are all involved in a CoP within the areas we each work and I have come to recognise that the impact of our actions locally can reach far beyond our own shores, especially with the involvement of this UK wide training and support network through Q.   We continue to be an encouraging support to each other.

      On 18th September the HSCQI (the Northern Ireland representative body of Q) in collaboration with the Health Improvement Network are hosting an event "Communities of Practice:  Future and Foresight" locally to my home, which no doubt members of our CoP Portadown including myself will play an active part.

      In January 2020 as we conclude our leadership training through Q there are plans for those participating in the Q leadership programme to celebrate and no doubt showcase the benefits of us having gone through the COP leadership programme 2019.  From January 2019 we have met alternate months face to face in London and in between times follow up discussion via Zoom technology.  We also have a Slack group which I still have to get used to.  Speaking for myself I have enhanced some skills and attitudes I already had and I am learning new skills and gaining confidence in QI methodology further (e.g. Liberating structures recent introduction).  I am then getting a chance to gain some confidence by putting learning into practice by co leading our group.   Most importantly as with a CoP most of the answers and wisdom tends to be within the group and I have hopefully contributed to support colleagues and I have gained from others input, encouragement and mentorship.  Collective leadership at its best!!

      Today at a Integrated Care Partnership monthly leaders meeting I was able to invite fellow members of the ICP leaders group to the Q event on 18th September as the invite is extended to those outside of Q.  I would be fairly evangelical about Q when speaking to fellow GPs and other professionals in primary care. There is keen interest in CoPs or "Neighbourhoods of practice" at these ICP leadership meetings with new ways of operating being planned in Northern Ireland, IPTs submitted etc.  Today I was sharing m experience of the importance of not starting these new groups with a pre formed agenda, concept of leaving hat at door and meeting as equals.  Some of the senior members of the ICP leadership group joined our own COP Portadown birthday party have applauded our efforts at getting through the forming stage as I am encouraging fellow leaders not to rush into outcomes, but let these appear naturally, with our focus initially on planting and nurturing these groups at this very early stage before maturation and getting the fruit!! Again now my focus has to be as year two growing and producing some fruit so our own group can celebrate our own success beyond the positive relationships now in place.

  2. Well done Philip for your group's significant progress with this CoP. It demonstrates that progress can still be achieved at a time when everyone is working so hard that they feel that they can't take on something new. The opportunity for a range of health professionals and patients to work together and understand each other better is bound to improve patient care. You  were a great encouragement to the GP practices who attended the SHARE programme ( introducing QI to GP teams using ECHO learning model).

    1. Thank you Louise as always for support and letting us share part of our journey at your "Share Programme" QI Celebration afternoon for the 40 GP practices who took part.

      I really hope that these CoPs could be places to facilitate QI confidence and capability within primary care (put our learning into action) and I will be glad of all support from colleagues who have experience within our system already.  Door always open to work together and support General Practice, Primary Care and off course significantly improve the Primary and Secondary Care Interface.  If we continue to progress at current rate we could remove the "interface" altogether.

      Ps check out the you tube video we now have attached to this application from today.  We put it together over the last few days with the help of friends in Southern Trust.

      Hope you and fellow NIMDTA and RCGP colleagues have seen the invitation to the "Communities of Practice: Future and Foresight" event on 18th September in the Templeton Hotel?

  3. Brilliant to see this CoP maturing and developing Jacqueline and Philip.  Really supportive of this proposal and interested to see what others in HSCNI can learn from your example.  Happy to help in any way.

    1. Gill thanks for your feedback and encouragement. We are keen to capture meaningful measures that will capture not just QI projects that we collaborate on but some of the "softer stuff" such as improved communication, connectedness and decision making between professionals which we hope will improve patient safety and experience.

      We would appreciate your thoughts?

  4. This project has already proved its value of connecting healthcare professionals round patient centred care. It is a great model for other primary care providers.

    1. Ruth the COP model has so much to offer in healthcare. Our initial journey focused on a QI project however the unintended consequences have been so more powerful. Relationships built and strengthened, barriers broken down and communication opened. We are so excited to see what the autumn will bring as we have just welcomed our first service users.

      Your thoughts would be appreciated as you are our Q Exchange pioneer!

  5. Guest

    Barbara Campbell 2 months, 2 weeks ago

    I love the progress the community of practice has made in Portadown - it is great to share power within the community and come up with new ideas and group solutions  - hopefully this work will spread across Northern Ireland soon!

    1. Barbara when we reflected on our achievements in the last 12 months we were so pleased with the outcomes. Silos being broken down and relationships being built upon and developed. Its a really exciting time and it all can make a real difference to patient care, safety and experience. Appreciate any thoughts and ideas.

    2. Barbara it really has been a pleasure. Though group had formed and even stormed a bit, the foundations are in place we’re still very much at early phase of our journey. For me collective leadership within the community has been key. Couldn’t have got this far without the positive influences within our Q community in Northern Ireland and beyond.

  6. Philip and Jaqueline, you have both done so well in supporting your community of practice and encouraging others to join you on your journey. As you know I am a real fan of this approach. Getting together with peers to share knowledge, learn together and create new knowledge in such a collaborative environment is good, both for the individuals who take part and for our health and care systems as a whole - if we are going to “do things differently” and get the transformational change we all seek, then this is the kind of space we need to nurture. Keep going!! We are all watching with interest and wishing you the best of luck 😀

    1. Cleo

      You'll have to check out our video as part of this application now.  You'll recognise some voices and certainly a few faces...

      Jacqueline tells a great story.

      Look forward to connecting again in September in Northern Ireland and back in London.

      Philip

    2. Cleo you have been such an inspiration to both Philip and I. Thank you for sharing the learning and keeping us focused on the goal. We have really benefitted from being part of the COP Leadership Programme.

      We are working on our measures and would appreciate any words of wisdom.

    3. Thank you Cleo for support and encouragement. It has been a fantastic opportunity to be part of the first COP leadership programme, benefit from your experience as well as Sam’s and the many other folk who have came to share and inspire us as part of the programme. Timely too with the transformational change we are all part off.

  7. Sounds like you have a great platform to build upon Philip. I'd be interested to see what sorts of projects in addition to Hypertension and Opiod management emerge in the conversations.

    1. Paul thank you for your comments. We used Liberating Structures at our birthday celebration to capture ideas and gain consensus on our next steps. We had overwhelming  feedback that we need to encourage and inspire other members of our GP and Pharmacy community to get involved hence the application. Exciting times ahead.

    2. Thanks Paul. That’s just few potential ideas circling that have been discussed. Through the closer links created this year we have got involved in a Frailty project with Trust colleagues seeing our 75 year old plus patients and we added value in primary care by making that contact count and linking in our clinical staff to perform medication reviews and target any other quality indicators, outstanding bloods needed etc. Uptake of new pre diabetes service increasing through Trust partnering with our COP and sharing new service with our COP. We’ve also started to push the social prescribing and support through link with Trust, promoting the direct dial number for the service directly to the door of our pharmacies and Practices. Engaging this year as well with the park run UK and starting to promote this going forward in our community

  8. This is excellent Philip - I love the idea of building a community of healthcare together - especially involving the patient representatives so that their voice is heard!

    1. Richard thank you for your comments really appreciate everyone's positivity. Over the last year Philip, Raymond and Helena have been fabulous champions for our COP and their energy and tenacity has enabled involvement of a wide range of professional, and commissioning representatives. We are really excited to see the impact of service user involvement in our community where everyone is warmly welcomed in the spirit of sharing, learning and creating together.

    2. Thanks Richard for your encouraging comments.  We just welcomed 2 enthusiastic patient representatives to our 1st year birthday celebration 18th June with strong links to the community voluntary sector in our area.  I am excited with the change in dynamic they brought to our group as we begin focus our attention September onwards to the service improvement and delivery part of our meetings.  Hopefully by forging relationships and supporting programmes outside of health we might be able to test new modes of non clinical support to patients and attract other means of funding to support our potential projects, building a sustainable 3rd sector at same time.

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