What is the challenge your project is going to address and how does it connect to your chosen theme?
This project is a partnership between Y&H AHSN and Barnsley Hospital NHS Foundation Trust (BHNFT) to test and refine an improvement and innovation approach. An Innovation Collaborative, for short.
BHNFT have identified the challenge that could be tackled using this approach as “Accessing outpatients – different ways of carrying out clinics instead of face to face”. BHNFT are using their service data to identify the three specialities with their longest waiting times to give a focus to the work.
At Y&H AHSN we will utilise our experience and knowledge to support BHNFT to identify and address challenges by brokering introductions with industry, signposting to existing solutions, supporting the horizon scanning of new technologies and real world testing of solutions. We will also support the introduction and implementation of these innovations with a contextually appropriate and systematic QI support programme, encompassing QI methodologies, tailored on a case by case basis.
What does your project aim to achieve?
We want people to have a better experience of care by breaking the mould of the traditional out-patients model (measured through focus groups of service users and staff).
We aim to bring down the time people wait for their out-patient appointment and improve the accessibility of care (measuring waiting times and the uptake of new ways of delivering care across a range of demographics and barriers to access; such as not having English as a first language or having learning difficulty or disability)
We also aim to learn how to use the methods of continuous improvement in tandem with testing and adoption of innovation.
There are hundreds of potential digital and medtech solutions on the market (or close to market) that might help people with undiagnosed or chronic illness get the care they need from their hospital. But which one is the right one to implement for their illness, their circumstances, their environment and is within the realms of possibility for the hospital?
How will the project be delivered?
The Innovation Collaborative will broadly follow a breakthrough series collaborative structure. With a series of learning events interspersed with multiple small cycles of testing. In addition to the generation of change ideas from front-line staff and service users, Y&H AHSN will source medtech and digital companies who are willing to support the small scale testing of their innovations in the real-world. Each of these innovations will become change ideas, rapidly testing them for potential. The rapid testing allows for the risk of implementation failure to be managed.
Our team of Q members includes skills and experience of; managing collaborative programmes; coaching of front-line teams, clinical leadership, public participation, and adoption of innovation. We have a broad range of QI methods to call upon to meet the unique challenges of rapid testing of innovations.
Our wider team, from Barnsley Hospital and Y&H AHSN complement these skills with industry partnerships and teamwork.
What and how is your project going to share learning throughout?
This project is a learning journey.
BHNFT has culture of learning and celebrating the efforts of its staff (Check out Channel 5’s Casualty 24/7). Using a breakthrough series collaborative approach leaning is generated in every small testing cycle and shared at each learning event. The hospital’s Board have committed to using the leaning from this project to shape the organisations Quality Strategy which is due to be revised in 2020.
Barnsley hospital is part of South Yorkshire & Bassetlaw Integrated Care System (ICS). This ICS has developed an Innovation Hub with Y&H AHSN that will benefit from the lessons from this project and can transfer them across system which covers a population of about 1.5m people.
This will provide critical lessons for the rapid uptake of innovation, a critical element of the Long-term Plan, that can be utilised by the national AHSNnetwork and all the organisations it supports across England.
How you can contribute
- Local Q members could get involved with coaching or public participation, Pointers from people who have done Experience Based Co-Design would be much appreciated.
- We are looking for advice on Human Factors or Ergonomics and how to use this skill set to optimise every learning opportunity as we test multiple HealthTect or Digital products.
- Any bright ideas from Q members on promising HealthTect or Digital products that could be tested on a small scale.
- Any bright ideas about real-world testing of HealthTect or Digital products?
|13 Nov 2019||Identify the pathways with the longest waitinglist|
|29 Nov 2019||Staff Engagement & Recruitment|
|31 Dec 2019||Innovation Scouting Starts|
|31 Dec 2019||Public participation group 1|
|14 Feb 2020||Process mapping (work as done) - Baseline data|
|14 Feb 2020||Staff Engagement session- Familiarisation|
|28 Feb 2020||Driver diagrame production|
|31 Mar 2020||Failure Mode Effect Analysis of interventions|
|30 Apr 2020||Learning workshop 1 -staff & public|
|14 May 2020||Learning workshop 2 - Industry & staff|
|19 Jun 2020||learning workshop 3 - All participants|
|24 Jul 2020||Learning workshop 4 - Celebration Garden Party|
|31 Aug 2020||Evaluation reporting|
|30 Sep 2020||Produce Sustainability & Spread Guidance|
3 Jun 2020
Overview to date:
Our project commenced in September 2019 with a meeting of YHAHSN (QI and E&I) teams and senior management at BHNFT with the aim of exploring outpatient pathways in the form of a deep-dive. The outcome goal of the meeting was to identify and agree a specific outpatient pathway for project focus. The group also discussed how best the project would be measured in terms of metrics and how we would know that any change undertaken had made an improvement.
Following a deep-dive into the top 10 services ranked by longest appointment waiting times, dermatology was identified by the trust as the best place to target innovation adoption, this decision took into account a 12 week wait for new appointments and an 18 week wait for FU appointments, in addition to the identification of dermatology as a team committed to delivering QI/Innovation at project pace.
The Trust also hosted a clinical engagement event which was well received and highlighted ideas about which services are keen to explore the digital transformation further. Following the event BHNFT produced a driver diagram mapping dermatology transformation in addition to process mapping and logic modelling done in collaboration with YHAHSN’s QI Team. YHAHSN E&I began the innovation scouting process and in April 2020 a comprehensive list of varying digital outpatient solutions with a dermatology focused approach was submitted to BHNFT for consideration.
What have we learned so far, either from the successes we have had or from where things haven’t gone to plan?
Due to the ongoing situation with the Coronavirus pandemic, from Mid-March 2020 the project has been on a hiatus in order to allow BHNFT to focus staff resource where most needed at this unprecedented time. Naturally this has caused the project to veer away from initial plans and timescales however YHAHSN are keen to readily support BHNFT throughout the pandemic response, and following the May virtual call with the project group there is an identified opportunity to refine project focus to support the trust within the initial project outline and defined aim. This agile and adaptive way of working will likely look to use QI methodology to undergo rapid evaluation of a video consultation or AI product in dermatology and build on learnings initiated by the response to the pandemic with regards to the changing landscape of delivering safe outpatient services.
What could others learn from our experience of working with a range of stakeholders and collaborating across boundaries (geographical, professional, sector) – what is working well and any challenges we have faced?
The project has employed a wholly collaborative approach, made easier by the involvement of senior clinical leads and management at BHNFT, PPI (public & patient involvement) and senior QI & E&I Leads from YHAHSN. All parties have been involved as key decision makers at each step of the project process and will continue to support each other collaboratively through the difficult pandemic challenge, particularly with a shifting focus on priorities across the outpatient department to align with the Covid- 19 recovery period.