Meet the team
Thomas John Rose
University of Birmingham, Institute of Applied Health Research
- England - West Midlands
- Nury Moreira, Healthcare Lead, Strategic and Partnerships, The Institute of Engineering and Technology
What is the challenge your project is going to address and how does it connect to your chosen theme?
The NICE clinical processes are only a fraction of the processes undertaken in an NHS Trust. Their UK business equivalent are referred to, by business, as product or service realisation processes. Other processes, often referred to as business processes, still need to be process managed. As they are non added value processes they are therefore costly to the organization if miss managed. There is often a fine line between what should be classed as a service realisation process and what should be classed as a business process but what is important is that they are managed. For example how should ward round or clinical handover be classified?
The Challenge is: To test the hypothesis that ‘documented standard work, process visualization and process management are fundamental quality tools in achieving the NHS Long Term Plan and will enhance the great QI activity that is already being undertaken in the NHS’.
These are all key elements of a ‘Lean’ methodology.
What does your project aim to achieve?
Business processes that are poorly defined and miss managed make a large contribution to poor outcomes particularly in terms of flow, throughput and cost. Like the service realization processes these business processes can be defined and documented by good practice and presented in a similar format to the NICE guidance.
1. Work with a number of NHS Trust to document some ‘standard work’. For a description of standard work see: https://q.health.org.uk/document/standard-work-in-the-nhs/
2. Seek out support for process management in the NHS to gain a higher profile with stakeholders.
3. Document a draft strategy for implementing standard work, process visualization and process management.
4. Document a draft methodology implementing standard work, process visualization and process management.
5. Test development ideas generated via the project.
6. Clearly show how QI activity can be made more sustainable and scalable as a result of being part of a Process Management System (PMS).
How will the project be delivered?
The term standardized work has been used in the manufacturing industries since the old days of piece work. A more up-to-date term is process management. Our day-to-day work is divided into a number of processes e.g. Ward Round and Handover.
NICE Guidance for clinical processes, is maybe an example of how standardized work, or the first stage of process management, could be presented for non-clinical processes in the NHS. The NHS guidance is presented via the internet, under multiple headings, in a flow chart format with links from the illustration to more detailed procedures and guidance. Trusts have no obligation to follow this guidance but, assuming it is an example of good practice, then why wouldn’t they?
The project delivery process will be to create some examples of standard work by collaborating with up to six Trusts. Process illustrations will be created from the standard work. Process management techniques will be used to improve the processes. All examples will be published.
What and how is your project going to share learning throughout?
In the book ‘Transforming Health Care – Virginia Mason Medical Centre’s Pursuit of the Perfect Patient Experience’, Charles Kenney talks about the difficulties the Virginia Mason Medical Centre has had with the implementation of standardized work.
The term standardized work is perhaps not the best terminology for an equivalent activity in today’s NHS. Work is the many tasks we each carry out every day whilst at work. Work in the NHS in increasingly defined by outcomes but the defined outcome gives only a brief indication of how that outcome should be achieved. Standardized work is critical to the implementation of Lean and VMPS.
This idea will document a draft strategy and methodology that will clarify the situation, outlined above, in the NHS around ‘standard work’ and ‘process management’. Learning will be shared by the publication of a series of newsletters published as Q blogs, articles in relevant journals and a final report published on the Q Community portal as the timeline shows.
How you can contribute
- Join me and be part of this project. All are welcome to play an active part in this idea.
- Comment on my idea. All comments are welcome and will be responded to.
- Name some of your key processes and help to define them.
- Work with me to document some 'standardized work' in your workplace.
- Would you like to design some examples of standard work in your Trust?
- If 'yes' please post a comment to this idea and we will be in touch.
- Let me know, via comments, if you do not understand any aspects of this idea.
- Please read the document https://q.health.org.uk/document/standard-work-in-the-nhs/
- This document explains what 'standard work' is in the NHS.
- Please comment on the above document.
- See first ‘comment’ for an explanation of acronyms used.
|31 Jul 2019||Launch of Community of Practice|
|31 Aug 2019||Publish 'Back to Basics' pamphlet re 2018 Q Exchange idea|
|30 Sep 2019||Design example standard work Trust 1|
|31 Oct 2019||Design example standard work Trust 2|
|30 Nov 2019||Design example standard work Trust 3|
|23 Dec 2019||Design example standard work Trust 4|
|31 Jan 2020||Design example standard work Trust 5|
|29 Feb 2020||Design example standard work Trust 6|
|31 Mar 2020||Test ideas and define key NHS processes|
|30 Apr 2020||Publish draft strategy - standard work and process manage|
|31 May 2020||Publish draft methodology - standard work|
|30 Jun 2020||Publish example 'standard work' documentation|
|31 Jul 2020||Publish draft methodology - process management|
|31 Aug 2020||Publish final report via Q Community|