What is the challenge your project is going to address and how does it connect to the theme of 'How can we improve across system boundaries?​

Though collaborative quality improvement (QI) efforts may deliver sustainable change they often lack the resource, capacity and skills to evaluate the components delivering best outcomes, value, and inequalities impact key to shared learning and scaling.

Disconnect of academic organisations from improvement initiatives limits their impact on local health outcomes.

Chronic Kidney Disease (CKD), a high prevalence, CVD risk factor, leads to renal failure, Black African and Caribbean heritage communities are disproportionately impacted. Novel treatments are available.

In southeast London (SEL) there are multiple primary-care CKD improvement initiatives aiming to improve CKD detection, management, and reduction of outcome inequalities, few have robust built-in evaluation.

This project makes novel connections between academic teams with community groups and in-the-field primary care improvement initiatives to co-design a novel, flexible, pragmatic evaluation methodology for CKD improvement, acceptable to our communities and addressing inequalities, that can be scaled to other improvement work and geographies.

What does your project aim to achieve?

AIM

Co-design an evaluation framework (CoEF) for a complex primary care CKD improvement landscape with a comprehensive approach that integrates

·       evidence

·       pragmatism and

·       flexibility

to support SEL CKD improvements

·       improved patient outcomes

·       reduced inequalities and

·       delivering best value

A methodology that can be scaled to other improvement efforts and geographies.

OBJECTIVES

1.      Assemble stakeholders

o   Academic – evaluation expertise (King’s College London)

o   Community groups –community needs/acceptability (To be commissioned)

o   In-the-field teams – capacity and capability (CESEL, Hidden CKD, Healthy IO, Personalised-Care CKD Project +others)

o   Data teams – accessible CKD data

2.      Stakeholders agree CKD improvement outputs/outcomes

·       Inequalities focused

·       Data informed

e.g.

o   Improved CKD detection and coding using General Practice CKD register.

3.      Co-design, test and refine CoEF, apply to each CKD initiative and assess effectiveness

4.      Spread and scale CKD interventions most likely to improve outcomes

5.      Spread and scale CoEF methodology for other disease areas, collaboratives, and geographies.

How will the project be delivered?

Collaboration of equal partners with

• agreed goals, milestones and objectives
• regular  touch points for shared learning
• clear plan for knowledge exchange within the team, region and beyond

Month 1: Establish an equitable partnership with governance, project plan, risk matrix, and communication plan. Identify stakeholders, agree project brief, commission Community Organisation Partner, share capacity, interests, and evaluation plans.

Month 2: Co-design CoEF with evidence, theory of change, and evaluation methodology. Map and share CKD improvement landscape and capacities.

Month 3: Refine CoEF in workshop with all stakeholders. Share draft, gather feedback, and align with individual initiatives/projects objectives.

Months 4-10: Test CoEF with CKD improvement initiatives/projects, share learning, and align evaluation plans. Timetable shared learning opportunities.

Month 10: Gather feedback and refine CoEF.

Month 11: Report findings on effectiveness of approach .

Month 12: Conduct knowledge exchange via stakeholder connections, newsletters, social media, workshops, academic papers, and presentations. Consider next steps and future funding.

How is your project going to share learning?

An early task is to agree a communication strategy with knowledge exchange at it’s core encompassing opportunities within and beyond the team:
Within the team and stakeholders: Use social media and targeted newsletters, organise workshops for co-production, foster shared learning contacts, collaborate with King’s College London for best practices dissemination, and maintain ongoing stakeholder communication for feedback and framework adjustments.
Within South East London (SEL):  Shared reports, encourage stakeholder connections for sharing best practices, engage in King’s Health Partners webinar series, participate in SEL Training hub events and primary care forums, and attend SEL events for example KHP and Population Health Management annual conferences.
Beyond SEL: Collaborate with Q members, produce podcast/s, publish research in respected journals, deliver presentations at conferences focused on evaluation.