Seasons Greetings

Season’s Greetings as we move into the second year of Quality Improvement in CNWL

In November we celebrated one year of QI and we have not slowed down since then. The amount of active, improving or completed QI projects continues to grow. More staff (and service users) have undertaken intensive QI training (more on this below), and following the annual visit from the Institute for Healthcare Improvement (IHI), our QI partners, plans for the next year are falling into place.

Wherever you are on CNWL’s QI journey there are opportunities to become more involved. For those of you just starting out, why not register for Bitesize QI, a half-day training session outlining the key components of the Model for Improvement? Details of the training are available here.  Alternatively, for those happy to go it alone, the IHI modules QI101-QI105 of the excellent online training  will give you what you need to get started.

Growth in IHI Open School and Life QI users  

Here’s an update on numbers of live projects on Life QI . 
 

• We now have 292 active projects on Life QI
• 866 staff have now registered on Life QI 
• 12 QI projects have been completed on Life QI  

  You can see here that more of you have continued to join our Life QI community online
 

Review of recent events

Improvement Science in Action (ISIA) Wave 2 

From 28 to 30 November, 90 delegates from across the Trust came together for ISIA Wave 2. Wave 2 delegates had already met together during virtual ‘Webex’ sessions hosted by our QI partners IHI, and our own QI colleagues. 

It was clear from the first day that many of the delegates had already acquired considerable QI experience either as a result of completing the online training or through having had some involvement in QI projects. This provided real impetus to the three days of training and arguably contributed to the excellent feedback from both our delegates and our IHI partners.  

IHI Annual Visit

IHI colleagues Pedro Delgado, Andy Longmate, Dave Williams and Dorian Burks came for their annual visit to CNWL on 26 and 27 November to support us in reviewing the progress of QI implementation in CNWL over the past year and help us to plan for the year ahead.

On 26 November they joined CNWL staff to visit QI project teams in Psychiatric Liaison (Northwick Park Hospital), Community Independence Service (CIS) and Sexual Health Services.

On 27 November IHI met with CNWL staff to feedback on the above visits, and to plan with the CNWL QI programme team for the year ahead. 

Improvement Coach Professional Development Programme

In December, 30 trainee Improvement Coaches came together for the second series of three-day workshops for the Improvement Coach Professional Development Programme. 

During the workshops delegates fed-back on progress of the QI projects they are currently coaching. Among other things, they also collectively wrestled with control charts, learned how to develop change ideas, and worked on how to assess the readiness of ideas for rapid expansion and spread.

At the end of the final day of this intensive but enjoyable programme, delegates were presented with certificates to the accompaniment of a song of their choosing. 

Carers Conference QI session

On 30 November 2018, CNWL held a Carers Conference where over 100 people attended from across the Trust. During a plenary session, Janet Seale, carer and member of the Carers Council and Lucy Palmer, Head of Patient and Carer Involvement at CNWL gave an introduction to QI, explaining how important QI is to CNWL and encouraged carers to get involved. Carers were invited to add suggestions for improvement to the ‘wall of hope’ at the event so these can be shared. Carers were also given information about how to get directly involved in QI projects, something many people were keen to do. Feedback on the session was very positive.

South of England Collaborative

Representatives from CNWL took part in and contributed poster displays to two days of workshops held in Bristol at the end of November. Among the highlights of the collaborative was a presentation and Q&A from Jonny Benjamin (MBE) and Neil Laybourn, whose chance meeting on Waterloo Bridge was the catalyst for Jonny’s journey from despair to hope, and was the subject of the acclaimed Channel 4 documentary ‘Stranger on the Bridge’

Quality Improvement Project reduces wait times in Harrow Memory Service

In a film published this month to mark one year of quality improvement at CNWL, Dr Chris Wilson, a lead clinical psychologist for older people in Harrow and Emily Kinyanjui, a community psychiatric nurse, talk about a local initiative to reduce the amount of time it takes to be seen at the Harrow Memory Service.

Dr Wilson said: “We’re using a quality improvement framework, and working hard as a whole team to reduce waiting lists to about five weeks. It was a project that everyone got behind and we were thrilled to meet the needs of our community; the right care at the right time.”

Emily Kinyanjui, a community psychiatric nurse said: “One thing we did was give people a reminder call a week or day before to reduce the number of people not attending appointments. This helped a lot. 

Camden Rapid Access Service QI project to reduce discharge summary turnaround time

The Camden Rapid Access Service QI project, led by Thomas Dowle (Clinical and Operational Lead) will reduce the time taken to send a discharge summary to a patients GP following their discharge from the service. This will improve communication and make sure the GP has an up to date picture of their patient’s needs. The team has set a target of sending 95% of summaries within 48 hours of patient discharge.  

Historically the turnaround time in the team has often exceeded the 48 hour target, sometimes taking more than seven days. A QI team of therapists, nurses and administrators got together to establish the reasons for the lengthy turnaround time. The team developed and tested a number of change ideas, including a re-design of the form (with input from local GPs), in-house training on completing the new form, a new standard operating procedure, and the deployment of weekend admin staff.  

The wider team has subsequently become involved in the change process, and the re-designed form is in its sixth iteration and has excellent uptake.  The team are achieving the provisional target they set themselves of 75% of discharge summaries to be sent within 48 hours by January 2019. They have now set a more ambitious target of 95% of summaries sent within 24 hours.  Examples of feedback from the team are “this new form is so much better” and “so much quicker and easier, brilliant”.

Vacancy Diggory Division Clinical QI Lead

Congratulations to Simon Edwards, Trustwide Clinical QI Programme Lead and QI Clinical lead for Diggory Division, who has been appointed Medical Director for Diggory Division (starting January 2019). This appointment has created a vacancy for the Diggory QI Clinical Lead post. If you are interested in applying for this exciting post please keep an eye out for further communications in January 2019.

Life QI Tip of the month : New interface

Life QI users would’ve seen a change to the system in recent weeks with an introduction of a new interface. Old users of the system will be glad to see the tabs are back! The new features are designed to improve the users experience and streamline your journey of running a QI project.

If you’re still finding your way around the new interface our key tip is look on the actions menu for more options on each page.
Don’t forget there’s a lot of helpful information on the Life QI help centre :  https://help.lifeqisystem.com/

This monthly newsletter is brought to you each month by the Improvement Support Team.

Happy Christmas everyone!