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Your facilitator today is:-
Liz Twelves
Academy Programme Lead
www.aquanw.nhs.uk
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What is AQuA?
Advancing Quality Alliance • North West quality improvement organisation
• Established 2010
• Membership: 70 organisations - Acute, Primary care, Community, Mental health and Ambulance trusts across North West England
• Core team of around 30 staff plus Associates and Affiliates
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Expectations? What motivated you to come to this session? What issues have you experienced with trying to implement change
Learning Objectives for the Session
By the end of the session you should be able to:
Understand the reasons why introducing change is so difficult
Have some strategies to improve your chances of success
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What happens to change efforts in reality?
In order of frequency:
1. The effort effectively “runs out of energy” and simply fades away
2. The change hits a plateau at some level and no longer attracts new supporters
3. The change becomes reasonably well established; several levels across the system have changed to accommodate or support it in a sustainable way.
Source: Leading Large Scale Change:
a practical guide, NHS Institute
Change is situational: new site, new boss, new team roles, new policy.
Transition is the psychological process people go through to come to terms with new situations
William Bridges
Change is different from transition
Change can be instant, transition takes time.
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Readiness for Change – Influencing
Source: NHS III
• Identify who might be for, or against your project and proposed changes.
• You can then plan necessary influencing activities.
Name In Favour Neutral Opposed
Ward Manager
HCA AJ
Catering Manager
WIIFM?
Key people or
group
What’s In It For Me (WIFM)?
What could they do to support or prevent the
improvement initiative?
What could/should we do to reduce non-compliance
activities or support compliant
ones?
+ Impact
- Risk
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Key people or
group
What’s In It For Me (WIFM)?
What could they do to support or prevent the
improvement initiative?
What could/should we do to reduce non-compliance
activities or support compliant
ones?
+ Impact
- Risk
Catering
Team
*Reduces phone calls received/ disruptions *Reduce food waste
*Change to current working practice – takes up time *Will be reliant on ward staff completing forms correctly
*Could ignore the menu cards or refuse to consider them. *Could encourage use of menu cards if can see benefits
Explain benefits and acknowledge risks
Repeated use of the PDSA cycle
Testing and
refining ideas
Implementing new procedures & systems - sustaining change
Bright
idea!
Why People Engage
• Regulatory mandate
• Risk management issue
• “If you knew, or should have known, and don’t act…”
• Evidence • Data • Logic • Business case—
Return on Investment
• Stories—recent, local, real • Videos? Bring a
patient along? • “How many people will
be affected?” Source: Reinertsen
The most successful projects:
• Clearly defined purpose & Aim statement
• Visible ownership and support from senior mangers
• Clear and relevant measures to demonstrate progress
• Part of Strategic Focus
• Strong stakeholder involvement (Service Users)
• Good data management
• Good team & internal/external communications
• Planned handover (project planning to operational)