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

In working across an integrated care system a wide range of people, staff and patients, from multiple different disciplines and professional backgrounds are going to be coming together and need to build relationships and a common language in order to improve the safety and quality of care that we provide.  Safety as a key part of care provision crosses all boundaries of the health and care system and as such can provide a sound starting point for conversations.

The Kings Fund report “A year of integrated care systems”, Sept 2018, recognises the need importance of “investing in collaborative relationships” and need to “draw on skills and leadership of front-line staff”. IHI white paper on “Safe Reliable, and Effective Care” 2017, also recognises importance of “developing shared understanding” and “genuine agreement on matters of importance to team” as parts of “teamwork and communication” and “negotiation”  within the culture required to support a learning organisation.

What does your project aim to achieve?

The aim of the project is to bring health and social-care teams together, and to involve patients to develop a common language and purpose around safety. Our intention is that this will provide a basis of moving forwards to understand how we can work together to improve safety and quality of care in  pathways and working across historical boundaries.

We recognise that the evolution of a new organisation and integrated care system represents a significant opportunity, alongside the challenge of changes in teams and relationships.  We would like to use the safety conversations to stimulate ideas for quality improvement for care of patients across the integrated care system.

Measures of success;

1. Use an evaluation of Safety Culture Conversations which we will develop alongside our colleagues from NHS Education Scotland, whose cards we would use

2. Use quarterly staff pulse survey to sense check staff perception

3. Triangulate with a question included in patient face to face questionnaire

How will the project be delivered?

Having already linked with colleagues from NHS Education Scotland, we plan to use the Safety Culture Conversation cards that they have already developed.  We will liaise with those experienced in use of cards to enable us to develop a model for delivery of the  to  both within and across health, acute and community, and social care in North Cumbria. Safety Culture Cards have been used by NHS Scotland to initiate conversations.

If funding supports, we would recruit to a seconded role for leading delivery and identify “champions” for conversations, initially from our local Q community, clinicians and staff with an express interest in patient safety with a view to spreading the initiative and encouraging staff to utilise these conversations at any team meetings, and as part meetings where groups from different parts of the Integrated Health Care System are coming together to work.

Our patient experience team will help us to ensure that patients are also involved as the project evolves

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

North Cumbria is privileged to be one of the new Integrated Health Care Systems. This project has the opportunity to look at ways of bringing together health and social care teams to work not just across, but without, organisational boundaries.

We are proud to have support from colleagues in NHS Education Scotland to add breadth to the project, and facilitate a wider evaluation of the benefits and limitations of the Safety Culture Conversation Cards beyond Cumbria.

We will share learning across our Integrated Care System, with the Q community. This can be via regular updates initially on progress of implementation and numbers of teams/meetings at which these conversations are used, recognising need for formal evaluation in addition. As the first year of implementation, and assessment, are completed we would share learning by postera or presentation regionally at our AHSN or national meeting.

An increase in cross-boundary QI projects registered will be an indirect measure of success.