Letting Go of Families

Steve Kingsbury and Ann York

Letting Go of Families Part of the ELFTends to be one of the Habits we find hardest

Helps with

E: Extend capacity

F: Flow management

Habit

Handle Demand

Extend capacity.

Let go of families.

Process map and redesign.

Flow management.

Use Care Bundles.

Look after staff.

Average

43%

40%

30%

30%

38%

8%

68%

Data from 100 teams in 2005 Average total score 38% (42/111)

VariationNatural variation

Users are differentWe are different

Artificial variationHow we do things (structures and processes)

Research shows that artificialvariation affects services most!

Let go of familiesEvery contact with a family / young person involves a

Choice ofAnother appointment orNot…

How do we decide which is which?

L and Artificial variation in CAMHSWe tend to have well thought through standard

processes to get into the serviceBut how do you get out?DNA?

Letting go exercise IGet into small groupsThink about the reasons that make it hard to let goChoose what you think are the most important 3

and write them on post it notes…

Working towards endingWhat is your prevailing team value

system?Long term support of vulnerable

families to promote developmentQuick crisis resolution and close

What is yours?

Letting go exercise IIGet into small groupsThink about the reasons that make it hard to let goThen think of things you or our service could do to

make it easierChoose what you think are the most important 3

and write them on post it notes…

Solutions…Closing tends to be easier when End point is clear e.g.

menstruation returns in anorexia nervosaPsychosis resolves

You are leaving!End point is clear- you won’t be there! Families don’t want

to start again Limited session models

Endpoint is clear- used up the sessionsBut the work may not be done

The family / young person have made the changes they wanted (CHOICE!)

And……You have time to close

Admin/liaison time in job planReview times with familiesMultidisciplinary discussion and supervision

Recap:Always work towards endingEnsure it is in your literatureRemind users at all stagesRemind referrers!Remind yourself!

Have standard processes to help you