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Developing and testing a digital improvement system on inpatient wards

Using digital technology to support quality management and flow in an acute hospital setting - digitalising our improvement system and supporting ward accreditation

Read comments 4
  • Proposal
  • 2022

Meet the team

Also:

  • Robert Ham, Unplanned Care Project Manager
  • Anna Perkins, Unplanned Care Programme Manager
  • Sarah Shade, Deputy Chief Nurse

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

Along with every other acute hospital, we are tackling a range of different and complex challenges linked to flow and quality of care.  We have initiatives targeting improving patient flow, engaging staff in improvement, supporting staff wellbeing and monitoring the quality and safety of care.  With continued pressure on our services, the bandwidth for staff to engage with these improvement initiatives is increasingly limited and yet the scope seems bigger than ever before.

Whilst all these initiatives are undoubtedly the right thing to do, there is no reliable system to deliver insight about current performance directly to those delivering the care.  Similarly, monitoring compliance with standards often relies on manual checks and audits, all of which further add to the workload burden.  This inevitably constrains the benefit that can be achieved from implementing QMS/improvement systems and can limit their sustainability.

What does your project aim to achieve?

We want to use digital technology to help align and enable these improvement initiatives on our inpatient wards.  We plan to test QMS software to support us to embed an improvement culture, support flow and reduce the burden of quality assurance and control.  This will build on our existing improvement system deployment at KHFT, replacing paper-based and manual processes with a digital application.

By combining this with developing a ward accreditation scheme, we will support staff to deliver outstanding care in their area and acknowledge their achievements.  Teams will have clear standards to aim for, real-time visual feedback on key metrics and will be able to align their improvement efforts to common goals.

The system will also help with communication and coordination of support to the ward team.  Operational leaders will have a real-time overview and teams will be able to effectively escalate problems and report on improvements.

How will the project be delivered?

We want to identify a digital solution to test and evaluate a digital quality management system (QMS).  We have begun researching possible applications and scheduling demonstrations with internal stakeholders.  Our initial research suggests that both bespoke digital solutions and off-the-shelf products could meet our requirements.

This work will be embedded within our existing Flow programme and will be tested across 2 wards where there will be an existing culture of improvement, including the practice of improvement huddles and the use of visual management.  This work is already scheduled for May 2022.

The project will be supported by our UEC programme team, QI and IT teams.  They will work closely with the nursing leadership team to develop the pilot deployment.

An existing set of KPIs linked to quality and patient flow will be used alongside an our in-house improvement culture maturity assessment to develop and evaluate the system.

How is your project going to share learning?

This project will test and evaluate the use of digital technology to support the development of a ward-based quality management or improvement system.  The deployment will include iterative cycles of development  and learning as well as a summative evaluation at the end of the award period.

There will be two main areas of learning:

– How to adapt core elements of an improvement system to work with a digital system: e.g. improvement huddles, visual management, process confirmation and problem solving

– Case studies of how this system has been used to generate measurable improvements in the quality of care on the wards and flow through the inpatient pathway

In addition to the opportunity to share with the Q Network, we anticipate sharing the learning with ECIS and NHS Futures forum, Beneficial Changes Network and the Improvement Directors Network.  We also anticipate there will be interest from the NHSEI Ward Accreditation Network.

How you can contribute

  • We are looking for promoters, critical friends and potential collaborators to get this idea off the ground

Plan timeline

22 Mar 2022 Initial engagement with internal stakeholders
29 Apr 2022 Early demos from potential digital partners
31 May 2022 Commence deployment of improvement system on 2 wards
15 Jun 2022 Specification for digital solution agreed
31 Jul 2022 Complete definition of standards and KPIs
31 Aug 2022 Commission digital partner / product
30 Sep 2022 Baseline assessment of improvement maturity
1 Oct 2022 Commence iterative deployment on 2 wards
31 Mar 2023 Summative evaluation complete

Comments

  1. This sounds like a great idea Jonathan! Do you envisage this system being used / adapted for areas other than ward as well as next phase work?

    I look forward to hearing more details

    1. Thanks Theresa!  That's a really good question.  There are a number of digital solutions already out there that we could potentially use and many of them are adaptable for other settings.  If we can demonstrate that this makes our improvement system more effective, then we would certainly want to incorporate it as a core part of the roll-out across other services. It will be particularly useful in any areas where conventional visual management (e.g. whiteboard, poster boards) are less practical and digital solution would work better.

  2. would really like to understand this project more - looking forwards to the details being uploaded!

    1. Thanks Rachel - we're beginning to flesh out the proposal now.  It's generating some interesting discussions about quality assurance, improvement and flow and how we can better align our efforts across these areas.

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