Q Exchange

Focus on what’s strong, not what’s wrong!

Enabling patient centred collaboration through focusing on assets rather than deficits

Idea
2019

Meet the team

Vicky Ellis

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

Working across organisational boundaries is a consistent barrier to implementing sustainable models of care that have been proven to improve patient outcomes (Buurtzorg model, Esther). The traditional approach to review and tackle the so called ‘problems’ to system working with little or no success. If we are all aiming to deliver patient centred care, why are we not able to be integrated. We propose using a new approach that ensures the people we care for are the star of the show and their improved outcomes are really what matters no matter who is involved in delivering that care. Governance, finances, regulation and policy all impact on this so lets find a way to use our strengths from each sector and organisation to make this happen.

What does your project aim to achieve?

Aims

To identify the barriers and challenges faced when teams are integrated

Identify the true needs of the people we care for

Identify the strengths of the organisations and systems involved in care delivery

Measurement;

This will be linked to the Transforming Integrated Care in the Community (TICC) European social research programme to enable the development of a blueprint that will provide a guide to effective integration of services

Key Stakeholder and beneficiaries will include the people we care for, Community Health, Social care, Primary Care, Third sector and inform regulation and inspection

How will the project be delivered?

Using a solution driven method of interaction (SDMI) approach. This will include local and national workshops including utilising Q community members. We will also appropriately use liberating structures methods to uncover insights and learn together

We will also have the TICC project partners as stakeholders in this separate but essential project

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

This will be shared through the Q community but nationally and our local community.

The generation of a blueprint that will include the findings from this project will be shared widely through the already established TICC project comms. This includes newsletters, press releases. This links with our local STP and future development of PCNs to meet the NHS long term plan

Comments

Graham Martin 14 Jul 2019

Looks like an interesting proposal. You might want to have a look at the literature on learning from 'positive deviance' in healthcare (e.g. work by Rebecca Lawton and colleagues at Leeds), which has some similar ideas at its heart.
Eric Barratt 11 Jul 2019

Hi Vicky,

Great proposal. Totally in support of the idea of learning from the good over the bad - very much along the same vein as appreciative inquiry. However, it is a real challenge to draw people away from focusing on the bad - behavioural insights/science approaches may be worth exploring, if not done so already.

Also suggest linking in with KSS AHSN, as a core part of this project is on spread and adoption, for which is their core business.

Regards,

Eric
Isabel Ho 30 Jun 2019

I agree with Vicky the scope is very large and which group of patients / locality you are focusing on first? What else apart from running LS sessions to gain insight? What are the 'popular' models out there apart from Buurtzorg model? Is Safety 1 Safety 2 appropriate for your piece of work? Greatix is a good idea but how's the actual process works?
Nicola Ballingall 25 Jun 2019

Great idea, this reminded me of the GREATix concept; "while it is vital to learn from errors in healthcare having this as the sole focus results in unintended consequences that positive performance is not recognised and transfer of good practice is delayed." ofhttps://emj.bmj.com/content/33/12/901
1. Vicky Ellis 9 Jul 2019
  
  Hi Nicola
  
  Thank you for the link that is extremely interesting and helpful. We have been so focused on looking at the negative reasons why things go wrong or what the barriers are we forget to look at the really positive aspect where it does work and spread that more widely.
Nikki Davey 24 Jun 2019

Hi Vicky- is there a particular patient group you are interested in? I just ask as the scope of the project seems very large and I'm interested in how you will narrow it down? I did some work in Medway looking at just the falls pathways and this was pretty complicated - the key to us involving patients in the most meaningful way came about by working with Red Zebra. Can share more if this sounds like its useful.
1. Vicky Ellis 9 Jul 2019
  
  Hi Nikki
  
  Yes the current patient group we are looking at is adult housebound community care patients. But this is going to be expanded to other areas in time e.g. health visiting.The ideal model we are looking at is based on the Buurtzorg principles one of which is developing informal and formal networks. This includes family friends neighbours and importantly the third sector. I would welcome linking up to discuss the learning from your work further
Anna Burhouse 21 Jun 2019

Hi Vicky,

I’m really interested in the ideas you have shared here. I’m always looking for new and creative ways to Involve patients, carers and families in improvement and would love to learn from you. Can you say a little more about the solution driven method of interaction (SDMI) approach and the scope of TICC?

Best wishes

Anna
1. Vicky Ellis 9 Jul 2019
  
  Hi Anna
  
  SDMI is a model used in Holland in the Buurtzorg team meeting to enable healthy discussion and solution focused decision making as and decision the team makes need to have a consensus. This approach has also been used really effectively with training sessions and workshops. The TICC programme is specifically looking at developing a blueprint to enable best practice models of care to be implemented into other countries. We are over half way through this pan European project however the barriers that have been identified and preventing the programme being sustainable. As we move into a period of significant change and primarily integration this is the ideal opportunity to ensure the patients needs comes first, surely if we all (providers, commissioners and regulators) understand what these needs are we can all be aligned and speak the same language. The Buurtzorg model and other models such as Esther all focus on the patient needs not how many contacts they have to do, not just putting more and more bureaucracy in place because one thing has happened we do really need to stop being as risk adverse, challenge back on performance measures that are not outcome focused and let our patients have a voice