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Weston Park Collaborative – Session 2
Tuesday 15 November 2016 – 9:00 to 12:15
Room 2, R Floor, RHH
09.00 – 09.05
Jim
Welcome and Agenda
Agenda
Time Topic Who
9.00 Welcome & Agenda Jim
9.05 Progress update from Outpatients Outpatients
9.15 Progress update from Inpatients Inpatients
9.25 Themes, Global aims, Specific aims and Fishbone Nick
10.25 Break
10.40 Progress update from Pharmacy Pharmacy
10.50 Progress update from Daycase Daycase
11.00 Progress update from Radiotherapy Radiotherapy
11.10 Creativity session / brainstorming Steve / Rosie
12.00 Next steps and timeline Jim
09.05 – 09.15
Progress Update from Outpatients Team
Progress Report - WPH OPD
What progress have you made since the last session?
• Completed process map for injection patient pathway – helped to
confirm thinking and measurability
• Defined Global Aim – “To improve the pathway for patients who
have injections in OPD”
• Started measuring – waiting times/journey tracker sheet –
template amended following initial usage
• To collect data for 1 month
• Survey monkey -35/70 responses
• Gathered data +++
• Datix analysis to identify themes
• Reviewed system for green referrals
What’s going well?
• Waiting times already improved
• Better understanding already of where the blocks are
• More focussed aim
• Improving timings collection tool
• Started to “auto-think” in an improvement mindset
• Microsystems information board
• Sharepoint
• Green referrals – quick win
What are your challenges?
• Involving everyone and ensuring good
communication
• Time for staff to complete actions in
between meetings
What are your plans and next steps?
• To develop a newsletter ‘a la’ pharmacy
• Translate data into something meaningful – i.e. timings,
survey results etc and use it to improve service!
• Look at “patient talks”
• E-check-in
• Quick wins
• Simplify some processes in the dept e.g. allocation,
environment, communication
OPD – Injections in OPD
Write a Theme for Improvement: _________________________________________
Global Aim Statement Create an aim statement that will help keep your focus clear and your work productive:
We aim to improve: _________________________________________________________________ (Name the process)
In: _______________________________________________________________________________ (Clinical location in which process is embedded)
The process begins with: _____________________________________________________________ (Name where the process begins)
The process ends with: _______________________________________________________________ (Name the ending point of the process)
By working on the process, we expect: __________________________________________________ (List benefits)
It is important to work on this now because: ______________________________________________ (List imperatives)
Create Flowchart
The pathway for patients that have injections in OPD WPH
Preparing the notes when the patient attends
Patient reporting back to reception
See next slide
See next slide
Category – patient experience
Improve patient experience and reduce
waiting times
Improve efficiency
More timely – better care for patients
Streamline the patient’s journey
A smoother patients experience
A quicker more structured journey for the
patient.
Patient receives their injection
Consistency of a patient’s journey
Communication
Correct follow up given to the patient
Patient informed of when to go to
pharmacy
Correctly assessed in correct clinic by
clinician
Minimize errors to improve the patient
experience
Improve the staffs role / experience increase
job satisfaction
Reduce inconsistency in the patient journey
We want to improve our service
To keep within the times of patient
appointments
Important to identify small changes that may
positively impact on the patient experience.
Reduce variation in care
Maximize clinic slot utilization
Identify correct use of environment
Need to be more efficient
By working on this process we expect It is important now because
09:15 – 09:25
Progress Update from Inpatients Team
Progress Report - Inpatient Microsystem WD2,3 and TCU
What progress have you made since
the last session?
• Weekly meetings have commenced
• 5Ps completed
• First global aim completed
• Specific aim completed - whiteboard
• Themes identified include; electronic whiteboard usage,
admissions and TTO’s.
What’s going well?
• Staff engagement
• Good MDT representation
• Using effective meeting skills
• Actions are always followed up between meetings
• All staff are being updated on the progress of the group by
a newsletter attached to the handover sheet and put up in
the staff rooms.
What are your challenges?
• Consistent attendees , different staff members attend each
week .
• The need for medical representation
• Work pressures
• Ongoing work on wards
What are your plans and next steps?
• Create a cause and effect diagram
• Start thinking about change idea
• To keep working up the improvement ladder so that we will be at
a stage where we can implement a PDSA cycle based around
effective electronic whiteboard use
• Look at admissions process
• Ask for input / representation from pharmacy and medical staff
Use of whiteboard - inpatients
Write a Theme for Improvement: _________________________________________
Global Aim Statement Create an aim statement that will help keep your focus clear and your work productive:
We aim to improve: _________________________________________________________________ (Name the process)
In: _______________________________________________________________________________ (Clinical location in which process is embedded)
The process begins with: _____________________________________________________________ (Name where the process begins)
The process ends with: _______________________________________________________________ (Name the ending point of the process)
By working on the process, we expect: __________________________________________________ (List benefits)
It is important to work on this now because: ______________________________________________ (List imperatives)
Create Flowchart
Ward 3, TCU and Ward 2
The effective use of the whiteboard
Patient admission
Discharge of the patient
More joined up working and communication
An improved discharge process
It’s a trust requirement and it helps with the discharge process
9.25 – 10.25
Nick Miller
Specific Aims and Fishbone Diagrams
Cause & Effect
The Microsystem
Improvement Ramp
Effective Meeting Skills
Global Aim
1
2
3
5 P Assessment
Theme
Global Aim
Change Ideas
Specific Aim
Measures
SDSA
P
DS
A
P
DS
A
P
DS
A
PDSA
1
3
2
Dartmouth Microsystem Improvement Curriculum
5P Assessment
Theme
Global Aim
Change Ideas
Specific Aim
Measures
Flowchart or Process Map
Global Aim
1
2
3
SDS
A
P
DS
A
P
DS
A
P
DS
A
PDSA
1
3
2
Cause & Effect
Effective Meeting Skills
Global Aim
1
2
3
5 P Assessment
Theme
Global Aim
Change Ideas
Specific Aim
Measures
SDSA
P
DS
A
P
DS
A
P
DS
A
PDSA
1
3
2
Dartmouth Microsystem Improvement Curriculum
5P Assessment
Theme
Global Aim
Change Ideas
Specific Aim
Measures
Flowchart or Process Map
Global Aim
1
2
3
SDS
A
P
DS
A
P
DS
A
P
DS
A
PDSA
1
3
2
5P Assessment
Theme
Global Aim
Change Ideas
Specific Aim
Measures
PDSA
Remember that the aim of the 5Ps is.......
To understand the system well
enough to generate your first
themes for improvement
Global Aim Statement
• Clarifies and connects the improvement theme to
your work
• The starting point
• Sets the scope
• Increasing clarity of focus
• Specific aims
• Fishbone diagrams / cause & effect
Aim of this section
• Clarify what a specific aim is
• What is a Fishbone Diagram?
• Why we use them
• How we do them
• Have a go at a specific aim & fishbone
5P Assessment
Theme
Global Aim
Change Ideas
Specific Aim
Measures
Flowchart or Process Map
Cause & Effect
The Microsystem
Improvement Ramp
Effective Meeting Skills
Global Aim
1
2
3
SDS
A
P
DS
A
P
DS
A
P
DS
A
PDSA
1
3
2
Global Aim
1
2
3
5 P Assessment
Theme
Global Aim
Change Ideas
Specific Aim
Measures
SDSA
P
DS
A
P
DS
A
P
DS
A
PDSA
1
3
2
Dartmouth Microsystem Improvement Curriculum
5Ps Assessment
Theme
Global Aim
Specific Aim
PDSA
Narrow the focus
What is a specific aim?
• At its simplest its what you want to achieve & by
when
• Allows you to make a start on comparing now
with a future improved state
• Gives you a detailed & clear focus for planning
changes
• Its measurable
Specific Aim Statement
• Want you want to achieve
• By how much?
• By when?
Principles of an Effective Specific Aim
1. State clearly & precisely
2. Use numerical goals
3. Set a specific target date
4. Avoid drift…..keep it focused
5. Something you don’t need permission for
6. Something you can work on now
Global/Specific Aim Worksheet
Write a Theme for Improvement: _________________________________________
Global Aim Statement Create an aim statement that will help keep your focus clear and your work productive:
We aim to improve: ____________________________________________________ _____________ (Name the process)
In: _______________________________________________________________________________ (Clinical location in which process is embedded)
The process begins with: _____________________________________________________________ (Name where the process begins)
The process ends with: _______________________________________________________________ (Name the ending point of the process)
By working on the process, we expect: __________________________________________________ (List benefits)
It is important to work on this now because: ______________________________________________ (List imperatives)
Create Flowchart
Specific Aim Statement We will: _ improve _ increase _ decrease
The: _ quality of _ number/amount of _ percentage of ________________________ (describe what will b e measurably different)
By: ___________________________________________________________________ (percentage)
OR
From: _________________________________________________________________ (baseline state/number/amount/percentage)
To/By: ____ _____________________________________________________________ (describe the change in quality or state the number/amount/percentage)
By: ____________________________________________________________ (date)
Example: We will decrease the amount that my dog weighs from 55 pounds to 50 pounds by August 31, 2007.
Or simply
How much?
By When?
Examples
“We aim to reduce to the number of central line
infections in the intensive care ward from 12 per
year to zero by 1st July 2013.”
Measure: The number of central line infections
recorded on the intensive care ward
IHI Collaborative Specific Aims re:
Reducing Adverse Drug Events.
Examples
“We aim to decrease the length of waiting time
from referral to first appointment
from a current maximum of 17 weeks wait
to a wait of 9 weeks or less
by December 2015”
Measure: The number of weeks wait from patient
referral to attending first appointment
.
From “Global” to “Specific” Aim
- Antenatal Clinic
“We aim to improve patient flow in the midwifery booking clinic.
The process begins when the woman books in at reception.
The process ends when the woman books out at reception.
By working on this we expect to improve patient experience,
reduce clinic waiting times, organise our resources effectively
and make the department look less chaotic.
It is important to work on this now because women are
dissatisfied with the time they spend here, they become lost in
the department and we are frustrated and embarrassed about
this”
From “Global” to “Specific” Aim
- Antenatal Clinic
“We aim to improve patient flow in the midwifery booking clinic.
The process begins when the woman books in at reception.
The process ends when the woman books out at reception.
By working on this we expect to improve patient experience,
reduce clinic waiting times, organise our resources effectively
and make the department look less chaotic.
It is important to work on this now because women are
dissatisfied with the time they spend here, they become lost in
the department and we are frustrated and embarrassed about
this”
Antenatal Clinic
“We aim to decrease patient waiting in the
midwifery booking clinic by 50% by 1st August 2015”
Measure: The time in minutes that patients wait in
the waiting room
Have a go
• 10 minutes
• In microsystem groups
• Work on a specific aim based on your global aim
• Remember measures
• How much by when
5P Assessment
Theme
Global Aim
Change Ideas
Specific Aim
Measures
Flowchart or Process Map
Cause & Effect
The Microsystem
Improvement Ramp
Effective Meeting Skills
Global Aim
1
2
3
SDS
A
P
DS
A
P
DS
A
P
DS
A
PDSA
1
3
2
Global Aim
1
2
3
5 P Assessment
Theme
Global Aim
Change Ideas
Specific Aim
Measures
SDSA
P
DS
A
P
DS
A
P
DS
A
PDSA
1
3
2
Dartmouth Microsystem Improvement Curriculum
Fishbone / Cause and Effect Diagram
Result
/effect
People
Materials Process
Equipment
What is a Fishbone / Cause & Effect Diagram
• A tool that depicts the possible causes that
contribute to a single effect
• Outcomes always have many causes and rarely
result from a single cause
• An acorn does not produce an oak tree on its own
Web of Causation – Delayed Diagnosis
Heathcare is complex
Delayed
Diagnosis
and
Treatment
Samples
batched
in lab
Prescription
needs to be
authorised
– Doctor
has left the
ward
Why do a Fishbone?
• To identify the various causes of an effect or
outcome
• To build a picture about potential causes and
effects to guide improvement work
• Start to group potential causes under the headings
• We give more thought to the problem
• Most importantly, it helps the team answer the
question of where to begin with the process of
improvement – Its fun!
Lengthy
Appointments
People Equipment
Materials Process
Clinical staff inconsistent Support staff not
trained
No one responsible for patient flow Patients arrive with more
needs than originally
stated
Providers are lateSupport staff unprepared
for patient visits
Equipment
broken
Not enough computers
Equipment missing
Inventory low
Missing exam
room supplies
Charts are missing
Information, e.g. test
results missing
No standard
registration processMA does paper flow and patient flow
Variation in rooming process
Check out
process delays
Poor communication between all
staff on patient status
Fishbone (Cause and Effect) of Lengthy Appointments
37
Your 25 min challenge:
• Confirm SPECIFIC AIM
• To create a CAUSE AND EFFECT DIAGRAM for this specific aim
‘the problem’
primary cause
secondary
causes
What?
How much?
By when?
10.25 – 10.40
Break
10.40 – 10.50
Progress Update from Pharmacy
Progress Report – Pharmacy Microsystem
What progress have you made since
the last session?
• Inpatients are on-board.
• Newsletter – good general communication
• Data collected
• Quick fix of bloods reporting (DCSU)
• Mapped the patient journey
• Purpose statement
• Love and nuts for Pharmacy, DCSU, Inpatients
What’s going well?
• Meeting regularly
• Enthusiasm
• Effective meeting skills being used
• Good representation from Pharmacy, DCSU, Inpatients
What are your challenges?
• Attendance due to workload deciding what to focus on first
• Medical representation
• Feels it is too big to solve – all interlinked
• IT in general
What are your plans and next steps?
• Coin drop for patients
• Love and nuts for patients
• Find a theme
• Patient survey
• Banner
10.50 – 11.00
Progress Update from Daycase
Progress Report – Day Case Microsystem
What progress have you made since
the last session?
• 2 tests of change with new patient counselling
• 2 weekly meetings continue
What’s going well?
• Staff engagement on the unit
• We have progressed our tests of change
What are your challenges?
• Representation at meetings from a wider range of staff
• Medical staff representation / input
• Staying on track, questioning meeting every 2 weeks
• Keeping momentum after a long time in the process
• Basic IT issues
What are your plans and next steps?
• To study what happened at our 2 tests
• To take the learning from these and re-evaluate
• Plan further tests based on our learning
11.00 – 11.10
Progress Report Update from Radiotherapy
Progress Report - R/T and R/T Physics Microsystem
What progress have you made since
the last session?
• Weekly meetings have continued
• Decision to split into R/T and R/T physics to allow focus on
global aims for each area simultaneously.
• 5Ps completed
• First global aim completed
• Lots of themes for improvement identified
What’s going well?
• Staff engagement
• Lots of ideas generated for change
• Good representation
• ‘Core group’ very committed – continuity between meetings
is good.
• Team accessing Sharepoint
• Lots of patient input so far
What are your challenges?
• Deciding at what point to start communicating to wider team
– there is a feeling that we ‘need something to show’ before
we can get full engagement.
• The need for medical representation
• Work pressures often mean difficulty in picking up actions
between meetings.
What are your plans and next steps?
• Map out process maps for themes identified for tests of
change
• Start thinking about the first change idea we are going to
explore
• Create Specific Aim for each group and continue to work up
the improvement ramp.
Breast patient pathway - Radiotherapy
Write a Theme for Improvement: _________________________________________
Global Aim Statement Create an aim statement that will help keep your focus clear and your work productive:
We aim to improve: _________________________________________________________________ (Name the process)
In: _______________________________________________________________________________ (Clinical location in which process is embedded)
The process begins with: _____________________________________________________________ (Name where the process begins)
The process ends with: _______________________________________________________________ (Name the ending point of the process)
By working on the process, we expect: __________________________________________________ (List benefits)
It is important to work on this now because: ______________________________________________ (List imperatives)
Create Flowchart
the treatment pathway and experience for breast patients in
Radiotherapy.
The receipt of the referral form for radiotherapy.
the follow up telephone call after radiotherapy has finished.
See next slide
See next slide
• To identify and additional
requirements in the information and
support needs of this group of
patients.
• To identify any stages in the
treatment process that have little or
no added value.
• To evaluate the adequacy of
appointment slots.
• DIBH has recently been introduced into
the department.
• The National Cancer Patient Experience
Survey indicates there may be some
unmet needs regarding support after RT
and information about long term effects.
• The Support4All project is about to get
underway.
• Staff indicate it may be useful to store
electron cut-outs centrally.
• The positioning of larger ladies has been
raised.
• The use of hospital gowns has been
raised as a possible area of
improvement.
By working on this process we expect It is important now because
11.10 – 12.00
Change ideas brainstorming and multivoting
Creative Thinking Agenda 11.10 – 12.00
Time Topic Leader
11.10 Creative thinking – the theory Steve
11.20 Creative thinking warm ups Rosie
11.30 Brainstorming activity Steve
11.45 Multi - voting Rosie
11.55 Summary Rosie
Steve
Creative Thinking – the theory
52
Attention…..Escape……Movement
Movement Play imaginatively with this suggestion and generate ideas from
it without judgement or criticism. Encouraging mental
movement.
“Let’s try to generate at least 10 ideas for ways to manage
patients arrivals in outpatients without a receptionist or a desk”
Attention Looking closely, observing with fresh perspective and really
noticing current rules and assumptions.
“patients who come to outpatients must first come to reception”
Escape Challenge or block an existing rule is encouraging escape from
the current mental valley.
“the Trust has made it illegal to have a receptionist and a desk in
outpatients”
Rosie
Creative thinking Warm Ups
WARM UP 1
You have 1 minute to fill in the circles with as
drawn ideas as possible (the sheet is 2 sided)
Ready Steady….
0 9 0 0 0 1 8 7 6 5 4 3 2 1 5 0 0 0 4 9 8 7 6 5 4 3 2 1 0 3 9 8 7 6 5 4 3 2 1 0 9 8 7 6 5 4 3 2 1 0 2 1 9 8 7 6 5 4 3 2 1 0 9 8 7 6 5 4 3 2 1 0 0 Hours Minutes Seconds
Circles
HOW MANY?
Did anyone do 40?
WARM UP 2
You have 2 minutes to think of as many
alternative uses of the household object on your
table
Ready Steady….
0 9 0 0 0 2 8 7 6 5 4 3 2 1 5 1 0 0 4 9 8 7 6 5 4 3 2 1 0 3 9 8 7 6 5 4 3 2 1 0 9 8 7 6 5 4 3 2 1 0 2 1 9 8 7 6 5 4 3 2 1 0 9 8 7 6 5 4 3 2 1 0 0 Hours Minutes Seconds
Alternative Uses
0 9 0 0 0 1 8 7 6 5 4 3 2 1 5 0 0 0 4 9 8 7 6 5 4 3 2 1 0 3 9 8 7 6 5 4 3 2 1 0 9 8 7 6 5 4 3 2 1 0 2 1 9 8 7 6 5 4 3 2 1 0 9 8 7 6 5 4 3 2 1 0 0 Hours Minutes Seconds
Alternative Uses
DEBRIEF • Fluency – how many uses you can come up with
• Originality – how uncommon those uses are (e.g.
“sim card tool” is more uncommon than “holding
papers together”)
• Flexibility – how many areas your answers cover (e.g.
cufflinks and earrings are both accessories, aka one
area)
• Elaboration – level of detail in responses; “keeping
headphones from getting tangled up” would be worth
more than “bookmark”
WARM UP 3
You have 4 minutes to turn the shapes you have
been given into a picture. Uncommon subject
matter, implied stories, humour, and original
perspective all earn high marks.
Ready Steady….
0 9 0 0 0 4 8 7 6 5 4 3 2 1 5 3 0 0 4 9 8 7 6 5 4 3 2 1 0 3 9 8 7 6 5 4 3 2 1 0 9 8 7 6 5 4 3 2 1 0 2 1 9 8 7 6 5 4 3 2 1 0 9 8 7 6 5 4 3 2 1 0 0 Hours Minutes Seconds
Incomplete Figure
0 9 0 0 0 3 8 7 6 5 4 3 2 1 5 2 0 0 4 9 8 7 6 5 4 3 2 1 0 3 9 8 7 6 5 4 3 2 1 0 9 8 7 6 5 4 3 2 1 0 2 1 9 8 7 6 5 4 3 2 1 0 9 8 7 6 5 4 3 2 1 0 0 Hours Minutes Seconds
Incomplete Figure
0 9 0 0 0 2 8 7 6 5 4 3 2 1 5 1 0 0 4 9 8 7 6 5 4 3 2 1 0 3 9 8 7 6 5 4 3 2 1 0 9 8 7 6 5 4 3 2 1 0 2 1 9 8 7 6 5 4 3 2 1 0 9 8 7 6 5 4 3 2 1 0 0 Hours Minutes Seconds
Incomplete Figure
0 9 0 0 0 1 8 7 6 5 4 3 2 1 5 0 0 0 4 9 8 7 6 5 4 3 2 1 0 3 9 8 7 6 5 4 3 2 1 0 9 8 7 6 5 4 3 2 1 0 2 1 9 8 7 6 5 4 3 2 1 0 9 8 7 6 5 4 3 2 1 0 0 Hours Minutes Seconds
Incomplete Figure
DEBRIEF
• Uncommon subject matter
• Implied stories
• Humour
• Original perspective
Steve
Brainstorming
BRAINSTORMING………. “Generate a wide variety of ideas from ALL participants
WITHOUT criticism or judgment.”
Brainstorming
Successful
brainstorming:
•Encourage creativity
• Involve everyone
•Generate excitement
and energy
•Levels out hierarchy
Brainstorming Steps
1. Review the topic, clarify as needed
2. Take a minute or two of SILENT thinking
3. Go around the table for each person to give
an idea.
4. After the first round, members can pass.
5. Once one member passes, let all members of
the group shout out ideas.
When ideas start to flow…let them come!
Brainstorming cont.
-Go for Quantity….NO DISCUSSION at this
stage.
-NO CRITICISM of ideas…not even a groan or a
grimace….or even ‘that’s a great idea’!
-Build on each others ideas
-Encourage wild ideas.
-One conversation at a time.
-Write ALL ideas on flipchart for all to see
Brainstorming - Practice.
In your group.
- allocate a facilitator.
- 10 minutes
Generate at least 30 different ways to
communicate the amazing improvement work
taking place at Weston Park Hospital
Rosie
Multivoting
Affinity Grouping and Multivoting
• Affinity grouping is a brainstorming method in
which participants organise their ideas and identify
common themes. In the brainstorming all ideas
need to be recorded on Post ITs and posted up
onto the flip chart.
• Multi-voting is a structured series of votes by a
team, in order to narrow down a broad set of
options to a few.
1. Clarify and remove duplicates.
2. Start by choosing two ideas.
3. Agree with the group whether they are related.
If they are related put them together.
4. At the end of the exercise there should be less
than 10 groups of post it notes.
5. Give a short descriptive header to each group.
Affinity Grouping
Multi-voting Steps
-Number each idea.
-Each person can have 1/3rd of the ideas to vote on.
eg if 21 ideas were generated, each person gets 7 votes. They can not
vote on one idea more than once.
-Tally votes.
-Eliminate ideas with few votes.
- If this identifies 3 -4 ideas to work with stop here.
Otherwise repeat with the remaining items.
Selection Criteria
Add some criteria to help the voters
Suggestions might be depending on the change -
Ideas that can be started fast
The change is reasonably low cost
The effort is small compared to the impact
The idea can be tested without getting ‘permission’
from others
Is the most creative!
Multi-voting Steps
Voting methods:
-Colored sticky dots
- Individually write choices on piece of paper
-Go to the list and indicate your choice w/marker
-A show of hands as each number is called out.
-Remember selection criteria
Have a go – multi-voting
• Remove duplicates
• Descriptive header to groups left (no more than
10)
• Number each idea and vote on 1/3rd (tick/dot)
82
Summary
• Creativity involves breaking established patterns
• Warm up exercises can help
• Brainstorming – broad idea generation
• Multi voting – narrowing down options
• Team creativity – joint problem solving helps with
team building and learning
12.00 – 12.10 Jim
Next steps and timeline
WP Collaborative Overview
Action
Meeting 1
Action
Meeting 2
Action
Meeting 3
July 2016 Sept 2016 Nov 2016 Jan 2017 Mar 2017 May 2017 July 2017
16th January 9-12:15
Cause & Effect
The Microsystem
Improvement Ramp
Effective Meeting Skills
Global Aim
1
2
3
5 P Assessment
Theme
Global Aim
Change Ideas
Specific Aim
Measures
SDSA
P
DS
A
P
DS
A
P
DS
A
PDSA
1
3
2
Dartmouth Microsystem Improvement Curriculum
5P Assessment
Theme
Global Aim
Change Ideas
Specific Aim
Measures
Flowchart or Process Map
Global Aim
1
2
3
SDS
A
P
DS
A
P
DS
A
P
DS
A
PDSA
1
3
2
Next Steps Before learning session 3
16 January 2017
1. Coaches keep coaching
2. Teams keep meeting - 5P’s, meeting skills,
refine your specific aims and fishbones
3. Change ideas
4. Think about patient involvement
5. Tell 1 other person about the collaborative
Progress Reports Progress Update Team__________________________ Date___________
What progress have you made since the last session?
What are your plans and next steps?
What’s going well?
What are your challenges?
Dates for the diary
• Please complete post it note evaluation – what went
well – what could be improved
• MCA Connect – 1 December 2016
• Outpatient Collaborative final session 28 November
2016 – MEC, NGH, 9-12.30
• Ward Collaborative update event, NGH, MEC - 2
December 2016
Thank you
Well done!