Embed Size (px)
Citation preview
ACTIVITY 2: Case for action (now- lunch @1pm)
In the frame of reference of your chosen Targets, write down
a sentence or two for each:
1. What are we changing?
2. Why are we changing it?
3. What are the consequences of not changing?
How will you address WIIFM, What does it mean to me?
? orthopod/rheumatologist
? Stream Director/ Manager
Short
Simple
Specific
No jargon
Assess
Friday 18th August 2017
Elizabeth Bryan| Implementation Manager | Agency for Clinical Innovation
Comparing your current service to the MoC
Implementation
PLAN
Identify an area of need, build a case for change and obtain sponsorship to proceed with the program of work.
Includes all aspects of project management related to implementation.
ASSESS
Identify local issues and gaps, analyse issues, develop and prioritise solutions.
Includes all aspects of the project informing implementation of the new Model.
OPERATIONALISE
Make a plan to put the solutions into practice to align with the Model.
Support changes through ongoing monitoring of change in practice, evaluation and communication.
Includes all aspects of the project related to changing current practice.
Compare current service
against MOC
Identify gaps Understand
causes
Prioritise gaps to be addressed
Assess- what?
1. Understand your current service- warts and all.
2. Finding appropriate solutions to address existing gaps.
Brainstorm solutions to
address gaps
Assess & prioritise potential solutions
Begin testing solutions
Assess: how?
Map current service
If no current service, map what options are currently available for OACCP or ORP
cohorts in your area
Compile any existing service/cohort data
Checklist: team self-assess current service against the Model of Care
Identify and validate gaps- true picture from multiple perspectives?
Analyse their root cause- why do our gaps exist?
Prioritise gaps to be addressed first. Sequence gaps (when everything is a priority)
Understand what may have been attempted previously to address gaps, and why it
didn’t work?
Involve stakeholders in determining how gaps will be addressed and what new ways of
working will look like- prepare people to work differently.
1. Understanding your Current Service
Demand/ Waitlist/ Cohort
Who are our referrers
Drop out rate/ DNAs
Process mapping your current service
Compare current service
against MOC
Identify gaps Understand
causes
Prioritise gaps to be
addressed
Self Assessment Tools
Self Assessment Tools
Purpose: identify gaps in current practice
Divided into 2 components: the assessment tool to fill in
and the supplementary information to guide your decision
making.
Uses a 4 point scale to assess the level which
CURRENT PRACTICE achieves each service
component
Who needs to contribute for a comprehensive picture?
What evidence do you have to support your decision?
Self Assessment Tools
Osteoarthritis Care delivery is based on chronic care principles
Not Met Planned Partially
Met
Met
The OACCP service is governed by a shared understanding,
clear vision and strategies supporting the delivery of chronic
care services for the management of OA
☐
☐
☐
☐
EXAMPLES OF HOW TO MEET THIS COMPONENT
Senior leaders visibly participate and show commitment (dedicate resources) to allow utilisation of chronic care principles in musculoskeletal
services
Documented local service delivery model (structure, content, locations) complying with elements of care
Formal arrangements for delivery of services (e.g. contracts for external allied health providers, VMO or GPs)
Structures are in place for clinicians to provide evidence based/guideline recommended care (e.g. professional development, quarantined
administrative support, room/clinic space)
Identify and understand gaps
Not met, partially met, planned = gaps
Why investigate gaps further?
Is there data available to quantify the gap?
Process mapping current state
Experience- patient, family and staff
Focus Groups, surveys, interviews
Root Cause Analysis: 5 Whys tool
Understand what has been attempted previously to address gaps/issues and
why it didn’t work
Compare current service
against MOC
Identify gaps Understand
causes
Prioritise gaps to be
addressed
Prioritising gaps to addressed: what should we
focus on first?
Why ‘focus’ on addressing priority gaps first? Why not
fix/address everything at once?
Foundational elements vs. good to have
Factors to consider when prioritising:
Risk/ Safety
Resources required
Ease of implementation and magnitude of change (how hard will this be?)
Local environment
Executive or service priority alignment
Major dependencies
Prioritisation Tools
Executive decision (top down)
Stakeholder decision e.g. multi voting
− Each team member is given a designated number of votes
(e.g. 3,2, 1)
− Each team member votes on their top priorities
− The solutions are then ordered by the number of votes.
Suggestion: discuss/determine a prioritisation
approach with your sponsor.
2. Finding appropriate solutions to address
existing gaps
Key stakeholders to include in idea generation activities:
Clinicians and frontline health professionals
Non-clinical staff (e.g. operational, data managers,
executive members)
Consumers (patients/carers)
Brainstorm solutions to
address gaps
Assess & prioritise potential solutions
Begin testing solutions
Brainstorming Solutions
How to address some gaps will be obvious (e.g. governance).
For others, there are many different options/approaches that might suit your
service (e.g. all participants have access to and behavioural support that
promotes exercise, weight loss, education, self-management support, pain
management and psychosocial and co-morbidity management).
Tools and encouragement for thinking outside the square:
Power of 3
What if?
What would x do?
Blitz
Starburst
https://gem.workstar.com.au
Prioritise solutions if needed
The benefits or the predicted impact (high or low) on the issue or
gap to be addressed
The magnitude of the change (including what is in scope and out
of scope)
The resources required if any, (e.g: workforce, time, technology,
infrastructure, equipment, human behavioural factors)
The timeframe until full implementation
The potential risks/challenges to implement and how to manage
them
Major dependencies.
Prioritisation Tools
ACTIVITY 3: Assessment Tool planning
1. Read the Assessment Tool for your relevant model of care.
2. Using your key role map, identify who will need to contribute
to get a complete (provider, referrer, service user,
management) picture.
3. Consider the evidence people will need to have to complete
the assessment accurately
4. Consider best option for how to complete assessment tool at
your site? - Individuals complete and then collate?
- Extended Steering Committee to complete the tool?
- Workshop?
5. Document your plan for when, how, who to complete.
Level 4, Sage Building
67 Albert Avenue, Chatswood NSW 2067
PO Box 699
Chatswood NSW 2057
T + 61 2 9464 4666
F + 61 2 9464 4728
www.aci.health.nsw.gov.au
Elizabeth Bryan Implementation Manager, ACI
9464 4695
