Exploring the Benefits of the Service Improvement Project

1. Exploring the Benefits of the Service Improvement Project • Lynne Harrison, School of Health

2. Advanced Work Based Practice Project:Setting the Context • Design and Construction • Structured proposal 3000 words • Learning contract and story board: Project planning competencies • Delivery and Implementation • Conference poster presentation, including an oral defence • Learning contract and storyboard: Critical reflection of implementation learning journey • Evaluation • Evaluation report 7000 words, including process and outcome evaluation • Learning contract and storyboard: QIPP , SWOT analysis

3. Project Core Conditions. The project must: • Based in clinical practice and have some benefit for patients, other practitioners and the organisation. • Patients as the central focus. • Based on an area of weakness (identified or assumed/perceived). • Be desired by the organisation. • Fit with the mission, values, of the organisation • Commensurate with business planning policies

4. Project Core Conditions. The project must: • Be based on evidence of need (base line on data). • Problem or challenge needs to be surfaced and analysed to ascertain the root cause. • Baseline data required. • Approved by the line manager. • Confirms the need and support in terms of business planning • Acts as a filter and conduit with university.

5. Project Core Conditions. The project must: • Conform to trust policies and regulations. • As an employee and as a registered practitioner • Protection of the public • Collection and dissemination/use of data. • Adopt evidence-based approaches to care and service delivery. • Critical appraisal of evidence base for innovation

6. Project Core Conditions. The project must: • Be resourced (if required) by the practice setting/organisation. • Potential for income generation, increased turn –over/throughput, cost savings, workforce re-engineering. • Be agreed by the module leader/project supervisor as meeting the academic requirements of the module. • Requirement of an academic programme • Tripartite relationship and work based learning model

7. Model for Improvement and PDSA Cycle. Tenant that students must work with right from day 1. Check that you are doing things right – process evaluation 2. Check that you are doing the right thing - outcome evaluation. Have the changes resulted in any improvement?

8. Evaluation: What is it? • A systematic assessment of the implementation and impact of a project, programme or initiative. • Judges the value of something by gathering information • Data gathering mechanisms and data analysis processes must be robust.

9. Metrics that have been used: Some examples • Improved access across services • Allergy testing service • Quality care when the patient needs it. • Paramedic community pathway for COPD • Reduced waiting times. • Cardioversion clinic.

10. Metrics that have been used: Some examples • Income generation. • Post op cardiac surgery clinic • Workload redistribution and expansion of services. • Cardio version clinic • Patient satisfaction • Involvement in own assessment of risk

11. Metrics that have been used: Some examples • Reduction in length of stay. • Passport to emergency cardiac surgery • Improve documentation and compliance with guidelines. • UCC minor injuries assessment proforma • Increase time spent therapeutically with patients. • Mental health in-patient observation documentation and strategy.

12. Comments from students “……..I embarked on this journey with very little experience in this field.  However, guidance and structure during the contact university days, equipped me with the skills to bring the innovation to fruition.  It has been extremely beneficial to my practice and the skills I have learned will be transferable to many situations, not just in terms of project development, but leading my team of clinicians through change.  I feel a significant learning experience has been the concept of continual evaluation and engaging with the ‘plan do study act’ cycle from the outset.  As the project developed, so did my knowledge and competence and I was seeing where improvements could be made and it was important these were incorporated.  ……..”

13. “The work-based practice project has certainly been challenging but at the same time rewarding. It has provided the tools and experience in their utilisation to facilitate the service improvement role expected within my post as an Advanced Nurse Practitioner, and instilled confidence in myself as someone who can change practice for the benefit of both our patients and Trust.”

14. External Examiner Feedback “The framework utilised within the proposals facilitates structure and focus for the students and this is strength. There was evidence of well thought through and articulated practice innovation initiatives and this is clearly the aim of the module (and wider programme) – I’m sure there are many delighted service managers!”

15. Over to our ‘delighted’ Service Managers! • With reference to the project current students are undertaking. Identify the: • Focus/aim of the project. • The drivers/need. • The innovation to be introduced. • The potential benefits/evaluation markers