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 Population Health 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 Healthcare Improving MH Care Pathways & Packages Improving Diagnostic p/way Genomics Medical Centre 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 Economic Growth Regional inward investment Open Innovation Innovation Scouts International Inward Investment Connecting HEI, NHS & Business Investing in Innovation Innovation Accelerator Exporting UK Excellence Engaging Industry
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
Transformation Behaviour systems and change patient flow Communities of Improvement Urgent Care Dementia Gold Air Quality Silver Culture Healthy Ageing Roundtables Behaviour Change Bronze Masterclasses Human Patient Voice Patient Flow Factors CoP Quality Case note Falls Improvement review Seclusion AKI Training Pressure Ulcers Medicine Safety Team Safety Huddles Safety Observatory Patient Safety Collaborative eFI CARS
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 of Work: Patient Safety Projects Patient Safety Collaborative Mobilising and inspiring frontline teams to reduce patient harm, involving everyone • Medicines safety from cleaners to consultants, in hospitals and community settings. • Preventing Falls • HUSH • Avoidable hospital mortality • Safety measurement framework • Human Factors (ABC) • Investigating Patient safety
Culture S Sur urvey y – Key ey Infor ormation 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 others • 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 on 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
N ew 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 3 6 deficits contained in the eFI • Activity limitation • Ischaemic heart disease • Anaemia & haematinic deficiency • Memory & cognitive problems • Arthritis • Mobility and transfer problems • Atrial fibrillation • Osteoporosis • Cerebrovascular disease • Parkinsonism & tremor • Chronic kidney disease • Peptic ulcer • Diabetes • Peripheral vascular disease • Dizziness • Polypharmacy • Dyspnoea • Requirement for care • Falls • Respiratory disease • Foot problems • Skin ulcer • Fragility fracture • Sleep disturbance • Hearing impairment • Social vulnerability • Heart failure • Thyroid disease • Heart valve disease • Urinary incontinence • Housebound • Urinary system disease • Hypertension • Visual impairment • Hypotension/syncope • Weight loss & anorexia
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
Recommend
More recommend
