The YH Academic Health Science Networks What we do Dawn Lawson - - PowerPoint PPT Presentation

The YH Academic Health Science Networks What we do Dawn Lawson November 2015

15 AHSNs

Academic Health Science Networks

What we do:

• 1. Improve health
• 2. Generate economic growth

How we do it:

• Connect academics, NHS, researchers and industry to accelerate the process of

innovation

• Facilitate the adoption and spread of innovative ideas and technologies across

large populations

AHSN 2015/16 Plan

Health & Wellbeing Digital Health LTC Preventing early death

Workplace Wellness Digital Health Record testbed Healthy Ageing Collab. Physical health in SMI Improving Diabetes Care E-health Ecosystem Memory Support Workers Mortality Reduction Improving data quality Improving Air Quality

Current Future Efficiency & Productivity Safety & Quality

Improving Diagnostic p/way Genomics Medical Centre

MH Care Pathways & Packages

Reducing Falls Medicines Optimisation Transforming Primary Care Improving Patient Flow Patient Safety Collaborative Urgent & Emergency Care Capacity building QI

Working with Industry New Innovation Spread at pace and scale Overseas Markets

Regional inward investment Open Innovation Innovation Scouts

International Inward Investment

Investing in Innovation

Connecting HEI, NHS & Business

Innovation Accelerator Exporting UK Excellence Engaging Industry

Population Health Improving Healthcare Economic Growth

Improvement Acade ademy y Aims: s:

‘A team of improvement scientists, patient safety experts and clinicians who are committed to working with frontline services, patients and the public to deliver real and lasting change for the region.’

Y& Y&H C CCG’s, Y YAS & & Acute, M Men ental Hea Health th a and C Community ty P Providers working together to identify safety priorities, develop solutions, implement interventions

• Falls
• Pressure ulcers
• Deteriorating Patients
• Sepsis
• Medicines Optimisation
• Seclusion
• Physical health in mental health
• Medicines Optimisation (including antipsychotic prescribing)
• Patient Flow in Hospitals
• Safer Surgery WHO Checklist
• Acute Kidney Injury

Quality Improvement Training Communities of Improvement Patient Safety Collaborative Gold

Human Factors CoP Masterclasses Patient Voice

Bronze Silver

Seclusion Falls Case note review Urgent Care Patient Flow Team Safety Huddles Dementia Air Quality Healthy Ageing Culture Roundtables Behaviour Change

eFI

Transformation systems and patient flow

Behaviour change CARS

Medicine Safety Pressure Ulcers AKI Safety Observatory

Foundations

• Building foundations since 2013
• Gaining intelligence from frontline teams –

‘Bottom up from the top’, building on what is already happening, underpinned by evidence

• Generating capacity
• 150 Yorkshire & Humber

Fellows (10 Q)

• Funding to build on this
• Resources to support
• Share learning and scale up
• Innovate, Implement, and spread improvement
• Compliment what already doing wards, organisations

Core Ar Areas o

• f Work:

Patient Safety

Mobilising and inspiring frontline teams to reduce patient harm, involving everyone from cleaners to consultants, in hospitals and community settings.

Projects

Patient Safety Collaborative

• Medicines safety
• Preventing Falls
• HUSH
• Avoidable hospital mortality
• Safety measurement framework
• Human Factors (ABC)
• Investigating Patient safety

Culture S Sur urvey y – Key ey Infor

• rmation

Key Questions:

• In this clinical area, it is difficult to

speak up if I perceive a problem with patient care

• The doctors and nurses here work

together as a well-coordinated team

• I know the first and last names of all

the personnel I worked with during my last shift

• The levels of staffing in this clinical

area are sufficient to handle the number of patients

• I would feel safe being treated here

as a patient

• The culture in this clinical area makes

is easy to learn from the errors of

• thers
• In this clinical area, it is difficult to

discuss errors

Introduction to to w why b behaviour c change i e is important for staff

http://www.improvementacademy.org/patient-safety/behaviour-change-for-patient-safety.html

Mortality Review Context

• All hospitals in England are under pressure to review

deaths, safety and quality of care

• In the NHS reviews have tended to use ad hoc methods so

that results are not comparable

• In Yorkshire and the Humber the Improvement Academy is

supporting Trusts through the establishment of a shared evidence-based review method called Structured Judgement Review

What is purpose of this new approach?

• It is not just about counting numbers
• Nor about name, blame and train
• It is about gathering quantitative and qualitative

information about what goes well, or not so well, in a care system

• The review system can be used for individual cases

[‘M&M’] and for groups of cases

• The information allows units or organisations to ask ‘why’

questions about things that happen, to enable learning and action

What is special about this review method?

• Examines both interventions and holistic care.
• Looking for the nuances as well as the ‘obvious’.
• Reviewers give overall care and phase of care scores.
• All scores are accompanied by written explicit judgements
• n care. which the scores are
• Results show good care as well as poor care (and good care

is much more frequent).

• Internal review based on 1 reviewer

Examples of work with CCG’s

Safety Huddles:

• GP Dr Adnan Jabbar has been commissioned

for 1 PA and is participating twice a week with Spenborough's Community team's Safety Huddles addressing Pressure Ulcers.

• Working with community teams in Leeds, SLIC,

Kirklees, started planning in Calderdale.

Mini celebration (with a carefully designed cake) to mark the launch of the first.

Safety Huddles i in Nursing H Homes

• The Glen (EMI) home in Baildon – Commenced huddles , focussing on

reducing falls

• Troutbeck in Ilkley – Planning work commenced
• Oak Tree Lodge in LS9 - Working with geriatrician based in SJTH,

focussing on falls

• Orchard care home - Planning work commenced
• West Leeds Care Home Group - Planning work commenced

New systems of primary and community

care for people with frailty

The Healthy Ageing Collaborative is implementing the electronic Frailty Index (eFI) tool to help identify older people with frailty in primary care using routinely collected information within a patient’s electronic health record. This will enable health care professionals to diagnose frailty and better address the complex needs for this vulnerable group through individually targeted evidence-based pathways of care for people with frailty

The eFI Al Algori rith thm

• Activity limitation
• Anaemia & haematinic deficiency
• Arthritis
• Atrial fibrillation
• Cerebrovascular disease
• Chronic kidney disease
• Diabetes
• Dizziness
• Dyspnoea
• Falls
• Foot problems
• Fragility fracture
• Hearing impairment
• Heart failure
• Heart valve disease
• Housebound
• Hypertension
• Hypotension/syncope
• Ischaemic heart disease
• Memory & cognitive problems
• Mobility and transfer problems
• Osteoporosis
• Parkinsonism & tremor
• Peptic ulcer
• Peripheral vascular disease
• Polypharmacy
• Requirement for care
• Respiratory disease
• Skin ulcer
• Sleep disturbance
• Social vulnerability
• Thyroid disease
• Urinary incontinence
• Urinary system disease
• Visual impairment
• Weight loss & anorexia

3 6 deficits contained in the eFI

Regional Case Studies

1) NHS Leeds North CCG – Use of eFI to identify patients for medication reviews by Practice Pharmacists NHS Leeds North CCG Practice Pharmacists are identifying people with frailty using the eFI to then offer medication reviews and flag medications that are potentially inappropriate so that they can be adjusted or stopped. 2) NHS Leeds West CCG – Improving Care to the over 75s by enhancing pro-active case management using primary care based Clinical Care Coordinators. Leeds West CCG has implemented the role of a Primary Care Clinical Care Coordinator in a Proactive Care Service the service is informed by the eFI and improvement methodology. 3) NHS Leeds South & East – Proactive Falls Prevention in Primary Care Older people presenting with one of the frailty syndromes (such as falls or immobility) may well already have established frailty. NHS Leeds South & East CCG is exploring the role of primary care in falls prevention and in reducing hip fracture incidence by using the eFI to identify people with moderate frailty and offer proactive falls screening, medication review and health promotion.

Suite of Educational Materials

• Effectiveness Matters: Recognising and

Managing Frailty in Primary Care

• Considering a further Effectiveness Matters:

Enhanced Health for Care Home Residents

• Practical Guide to Healthy Ageing: being used

to developing a supported self-management intervention for people with mild frailty in partnership with 3 GP Practices

• Living with Frailty: A Guide for Primary Care

written as a supplement for British Journal of Primary Care Nursing

Training

• Planning some case note review training for CCG’s as requested by

Leeds West CCG

• Bronze QI e learning now available

http://qitraining.improvementacademy.org/

• Silver – 1 day face to face session (individuals or teams)
• Gold – 2 days

Forthcoming I Improvement A Academy y Events

Being Planned for 2016

• January – Human

Factors

• February – Sepsis
• March – Safer Surgery

Bronze on line QI training now live!

• Thank you
• dawn.Lawson@yhahsn508 098778

Thank you

dawn.Lawson@yhahsn.com 01924 664712 07508 098778