• 92 years of age• Widowed 7 years ago• Mild dementia• Lives in a flat• Daughter lives locally• Unwell with pneumonia
@sheffielddoc@sheffielddoc
@sheffielddoc@sheffielddoc
@sheffielddoc@sheffielddoc
GREAT CARE IS DISCOVERED, NOT DECIDED
Key Point 1:
Great
Okay
ΔAltitude
ΔClimb rate
Know a lot
Know something
Don’t know
ΔDiscovery rate
Easier, safer work
Harder work,Poor conditions
Key Point 2:
Problem solvingis key to
Discovering Greatness
@sheffielddoc
Great
Okay
ΔAltitude
ΔClimb rate
Know a lot
Know something
Don’t know
ΔDiscovery rate
See ✗
Solve ✓Spread ✓ ✓✓
See ✗
Solve ✓Spread ✓ ✓✓
See ✗
Solve ✓Spread ✓ ✓✓
Learnerleader
@sheffielddoc
@sheffielddoc@sheffielddoc
@sheffielddoc
@sheffielddoc
The Big Room (Oobeya)
@sheffielddoc@sheffielddoc
Big Room
@sheffielddoc
We have all designed our own complex system
@sheffielddoc
@sheffielddoc@sheffielddoc
Frailty Unit
Outcome measure: 34% increase in discharge within 1 day
Frailty Unit
opens
@sheffielddoc
Length of stay for frailty unit patients reduced by more than 4
days
Frailty Unit
opens
@sheffielddoc
In-hospital mortality dropped by over 13%
Frailty Unit
opens
@sheffielddoc@sheffielddoc
Discharge to Assess (D2A)
@sheffielddoc
Time waiting per patient
D2A starts
@sheffielddoc
D2A starts
@sheffielddoc
D2A starts
@sheffielddoc
@sheffielddoc
What is your capability and capacity to discover?
@sheffielddoc
• Modern healthcare is complex• Design by front line staff running iterative tests• Measure• Involve patients• Timely specialist care is cheaper and safer• Not a project• Mrs R is in her own home