April 2018 - Shared Learning

Summertime!

Welcome back sunshine (we know the sun’s hiding behind the clouds somewhere!) Summer coincides with a surge in growth of our QI community. There is real cause for celebration, now we have reached a total of 100 active projects on Life QI www.lifeqisystem.com . Our congratulations go out to the following project team:

Goodall: Speech and Language Therapy: Improving the care of adults who are eating and drinking with acknowledged risk of aspiration. This is the hundredth QI project to be registered on Life QI. Members of the project team will be awarded with a certificate to mark this achievement. 

170 staff members have registered with IHI Open School www.qi.cnwl.nhs.uk/training-and-events/online-qi-training for the online training, and 240 IHI Open School courses have now been completed. If you haven’t registered for the training, what’s stopping you? It’s really good!

Learning event

On Monday 16 April, we had our first QI learning event; for CNWL staff, service users and carers to spend a whole day in a learning environment; over 70 attended. 

Following an introduction by Dr Con Kelly, plenary speakers gave three introductory presentations on the Institute for Healthcare Improvement’s (IHI) Model for Improvement, the role of the Service User in QI and a discussion on the subject of science improvement.  This was followed by a series of ten practical masterclasses on tools and techniques. 

The day was complimented by a ‘World Café’ of seven poster presentations of current QI projects registered on Life QI (CNWL’s chosen platform for developing QI project work). 

At the close we celebrated QI projects that had attained the status of significant or sustained improvement. Our Chief Executive, Claire Murdoch, was impressed by, and awarded certificates on behalf of the project teams to:

Feedback was extremely positive, especially about the masterclasses and the learning gained by those that took part.  The next learning event is in early planning for a September date.

QI education prospectus – watch this space!

We are in the process of developing a QI education prospectus to support staff on their QI learning journey. The prospectus will have useful content whether you are thinking about getting involved in a QI project, or whether you are actively involved in a QI project and looking for further tools, information and support. Watch this space for further details.

QI update from the Psychological Medicine Clinical Network

The Psychological Medicine Clinical Network uses QI methodology to focus on the mental health and addiction care of people receiving medical treatment. Over the last year we have been working on improving care for people who attend emergency departments frequently and have mental health needs. This has involved collaborations between the five emergency departments served by CNWL, community mental health services and our subspecialist liaison psychiatry departments.

The Quality Improvement Programme

We’re now halfway through a two year QI programme. Over the last year we’ve:

• Identified cohorts of people who attended the Emergency Department (ED) more than 10 times in 2016/17
• Developed person-centred preventative care plans, written in the first person
• Set up systems to identify new frequent attenders and develop care plans.

By improving preventative care and improving communication between acute hospitals and community services, this has resulted in a reduction in ED attendances of over 20% in 2017-18. This programme is aligned with the Trust’s quality improvement strategy and can be viewed on Life QI by searching “Liaison Psychiatry”.

What works?

Last week representatives of CNWL’s five project teams met to share experiences and discuss what has worked well and what hasn’t. You may be surprised that most teams fed back that the use of care plans in a crisis has not been the most important element. What’s been more important is use of care planning meetings to support engagement with community services, promote collaboration between services and emphasise preventative care.

Other elements which have worked well have been:

• Ensuring that people who need 24/7 support are living in the right setting
• Integrating both hospital and community addiction and mental healthcare
• Ambulance crews calling the Single Point of Access for advice before conveying people to ED

Measurement for Improvement

We’ve been using the information we collect to test out the effects of our changes and provide regular feedback. Data we’ve gathered illustrates that after we met service users to write care plans and started regularly communicating ED attendances to the community mental health teams, there was a downward shift in the number of ED attendances.

What’s next

Over the next year CNWL’s mental health services will continue to develop links between community services and acute hospital liaison psychiatry departments. Following the success of last year’s programme we are going to identify larger cohorts of 25-30 people per hospital. We are linking in with work being done by the patient safety team to deliver structured suicide response training to mental health staff based on the ‘Connecting with People’ model. We are also working with the High Intensity Network to introduce serenity integrated mentoring; an approach to helping people with mental health needs which brings together emergency and mental health services.

Life QI tip of the month  

(adapted from the Life QI Learning Centre: https://www.lifeqisystem.com/learning-centre/)

Did you know you can run reports on your projects using the report templates on Life QI?

Each project has two report templates available :

• Detailed Project Report - this report extracts almost every field on your project into a formatted A4 portrait report, giving you a full breakdown of your project, from the general information right through to every chart on the project.
• Overview Project Report - if you are looking for a short summary of what the project is about (General information and Driver Diagram) and the current status, this is the report for you.

You can find and run the reports available to you by following these simple steps:

• Navigate to your project and open the ‘General’ page.
• Click the ‘Reports +’ button near the top right corner of the page.
• Click the ‘Run’ button next to the name of the report you want to run.
• A pop-up form will appear displaying the report with the project fields pre-populated and any data entry fields ready for you to complete.
• Fill out any data entry fields which appear as grey text boxes. Click the ‘Create report’ button at the bottom of the form. This will create the report and save it into the 'Reports' area, which is accessible from the main menu. It will also be listed on your project's General page for ease of access.​

How can Tim Wood help you identify potential QI projects?

We’ll be answering this question in next month’s newsletter.