Service Redesign
A Team Effort !
CPPC Study Day
September 2009
Irene Pullar
The Team ?
or
The Continence Team
(In no particular order!)
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Continence Nurses/advisors
Continence Physiotherapists
GP’s
Urologists
Urogynaecologists
District Nurses
Midwives
Colorectal Surgeons
Physiologists
Carers
Any appropriately trained health care professional
Managers/Budget holders
And last but not least ››››››
The patient !
Service Redesign
• Service Design is the activity of planning
and organizing people, infrastructure,
communication and material components
of a service , in order to improve its
quality, the interaction between the NHS
as service provider and patients and the
patient's experience
Service Redesign
• How do we know our service need
changed?
• Think and ask anyone in the ‘Team’
and remember to include Yourself!
Why does it need
changed?
• New guidelines -Local or National
• Departmental changes
• Patient choices
• You
Why does it need
changed?
• Waiting lists
• DNA rates
• National Government ‘Drives’ -18 weeks
pathway
What needs changed?
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Clinic times ?
Patient information ?
Waiting times?
DNA rates?
Staffing ?
Training ?
Attitudes ?
Have the same changes
been done elsewhere?
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Ask other areas
Google it
iCSP
Clinical Governance Dept
Modernisation team
• Don’t reinvent the wheel
How do we change it?
• Ask the ‘Team’
• Get evidence – Local /National Guidelines
• Get help – Colleagues ,Clinical Interest
groups
• Modernisation Team
• Audit department
• Clinical Governance (local or national)
Clinical Governance
http://www.clinicalgovernance.scot.nhs.uk
PDSA Cycle
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Plan
Do
Study
Act
Small pilot
Review
Any further changes
Then implement
Review ……
PDSA Improvement Model
What are we trying to accomplish?
How will we know that a change is an improvement?
What changes can we make that will result in an improvement?
Cycle 1
Cycle 2
Cycle 3
Does it need funding?
• Small changes may not need funding
• Local NHS Intranet – source local or
national initiatives. Fit your project to their
project
• Modernisation Teams
Funding?
• Drug companies.
• Local University/Medical school-lists of
bursaries/awards.
• ACPWH/CSP- Lists of bursaries/awards
• Local charities
How do we know that our
change is an
improvement?
• Audit it but Get Help and use your trust’s
audit/clinical governance department.
Simple patient/Staff questionnaire
QOL scores
Validated outcome tools.
Touch screen waiting room
Questionnaires
Go for it!
• Think positive
• Jot down ideas
• Go for small projects first
• Try to fit your ideas to any ‘directives’
Go for it
• If you don’t ask you don’t get!
• Don’t give up at the first hurdle.
• Persevere , if you don’t succeed try again or
somewhere else
• Use the NHS Clinical governance/audit
departments
Useful websites
• http://member.goodpractice.net/ContinuousImprovementToolkit/reso
urces/core-improvement-tools/overview-to-core-improvementtools.gp
• www.scottishcf.org/grantsforwomen
• http://www.show.scot.nhs.uk/CSO/index.htm)
• Your NHS Intranet
• http://www.nice.org.uk/usingguidance/commissioningguides/uiwome
n/UrinaryContinenceService.jsp
• http://www.institute.nhs.uk/index.php?option=com_quality_and_servi
ce_improvement_tools&Itemid=551.html
Useful websites
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http://www.ihi.org/IHI/Topics/Improvement/ImprovementMethods/Tools/Plan
-Do-Study-Act+(PDSA)+Worksheet.htm
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http://www.csp.org.uk/director/members/research.cfm
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http://www.18weeks.nhs.uk
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http://www.clinicalgovernance.scot.nhs.uk/section2/pdsa.asp
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http://www.healthdesign.org/
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http://www.google.com
Any Questions?
Or
Have I confused you enough!