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

Given the challenge of cross-organisational working to improve outpatient services is not unique to any one organisation or region, there is a risk of ‘reinventing the wheel’, duplicating efforts and best-practice not being adhered to due to a lack of resource and/or knowledge. Clinical teams want to lead change, however many fall at the first hurdle, not knowing what they can try and how to start.

UHS has been utilising a 100-day methodology to implement outpatient pathway redesign in outpatient areas, working with local partner organisations. The trust also has a capability-building programme. This proposal would bring these two areas of focus together into one programme, producing a delivery pack concurrently with delivering another 100-day programme across a new pathway. This would enable other organisations to take the methodology and training materials and apply them to their own pathways.

What does your project aim to achieve?

We aim to deliver: 1) A cross organisational improvement collaborative, 2) An adapted version of the NHSE 100 day elective care development collaborative methodology that we have undertaken and proven to work, 3) Focused intervention on pathways that have high patient benefits, identified through stakeholder involvement e.g. improved patient treatment times and patient experience, 4) Optimised patient care through focus on non-face to face interventions, 5) Build sense of capability and agency to lead pathway improvements in clinical teams, 6) Improved working with organisation partners.

The previous 100-day programme delivered: 1) Reduced time from referral to decision for, patients routinely and urgently referred with soft tissue lumps, from 28 days to 13 days. 2) Reduction in routine referral pathway in radiology from 93 days to <30 days 3) Virtual screening for sarcoma patients with 47% being downgraded to a routine pathway 4) 80% had an outcome decision made 13 days earlier.

How will the project be delivered?

Using data and stakeholder engagement across the region high-priority pathways will be identified.

Clinical teams along the selected pathway will:

1) Liaise with patient groups, commissioners and partner organisations to identify priority pathways, 2) Start 100 day structured programme, which will incorporate capability building (training and coaching) for all team members. This will enable appropriate emphasis on aspects such as problem analysis, aim definition, patient co-design, measurement, and sustainability at an early stage, 3) Conduct stakeholder involvement in evaluating risks to delivery or as a result of delivery (Quality Impact Assessment) at regular intervals, 4) Evaluate the impact and sustainability needs of the project

Clinical teams will be facilitated by an experienced transformation team from UHS who have expert improvement knowledge, coaching skills and access to analytical support. The methodology will be evaluated and adjusted as needed during and after the project.

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

The end result will be a proven methodology that can be used in other organisations, to have an impact on their chosen service. This will be available in a facilitation / delivery ‘pack’. Training will utilise some QSIR materials and therefore accredited QSIR organisations will be able to reuse our training materials. We will produce a learning report providing tips and lessons the UHS team have learned from rolling out this methodology. External support and coaching to other organisations may also be possible.

We will use the Q forum and twitter to keep Qs and other groups informed of our progress.