Strategies in knowledge transfer workshop by Maureen Fallon, Assistant Director, Continuous Service Improvement, Cardiff and Vale University Health Board. Presented at "Using Research Evidence to Improve Health and Social Care". A NISCHR AHSC Workshop to Explore Strategies in Knowledge Transfer. 6th May 2014 – Cardiff

1. Faculty for Quality Improvement
Cardiff & Vale UHB and Cardiff University
Maureen Fallon

2. Background:
• A joint venture between
Cardiff University and the
Cardiff and Vale UHB
• Critical mass of clinical and
academic staff working
together – the most research
active site in Wales
• Bedside to Bench and Bench to
Bedside (education, training
and CPD)
• Currently ‘virtual’ and working
to a physical site in 2014/15

3. Why set up the Faculty?
• Share good practice
• Support
• Signpost
• Success

4. Faculty For Quality Improvement-
what is it?
Established in 2011 the ambition for the Faculty is:
“to play a major role in fostering a quality improvement and innovation
culture by creating a dynamic environment where excellence comes as
standard”
Key to the Faculty’s success is harnessing the tremendous potential and energy
of our staff; particularly by engaging, encouraging and empowering them.
As a result, the Faculty embraces everyone, whatever their role, on the basis
that every member’s contribution is essential to care quality.

5. Faculty aims:
1. Increase the quality, reliability and effectiveness of care
(Best Care)
2. Develop a culture of 'continuous improvement' through developing a
programme to support capacity and capability in healthcare improvement
methodology and delivery at the coal face and in the educational settings
(Best Place to Work)
3. Build and maximise collaborative relationships with partnership
organisations that seek to advance and promote innovations in promoting
and delivering health care
(Best Health)
4. Add value and improve efficiency by focussing efforts that tackle Harm,
Waste and Variation
(Best Value)
Eliminate harm,
variation and waste
Develop a culture of
continuous improvement
and capacity building
Increase quality
reliability and
effectiveness of care
Collaborative and
partnership
relationships, to
advance and
promote innovation
Best for
Patients
&
Citizens
Best
health
Best
care
Best
value
Best
place to
work
Adapted from AQuA Alliance 2010

6. Secondary DriversPrimary DriversAim & Measures
Aim
To establish a framework to
motivate and build with,
enthusiasm and drive for
delivering high quality care
across the UHB
Measures
By March 2016
Be recognised as an International centre
of excellence
Delivery of 1000 Lives+, AQF and intelligent
targets
Develop and support 100 Improvement
Advisers (IQT Silver Practitioners)
Develop and support 1000 Improvement
Practitioners (OD Programme; LQI; Yellow
Belt; RCN leadership programme
Implement real-time business intelligence to
capture quality outcomes, efficiencies and
financial savings
Best Health
Collaborative and partnership
relationships, to advance and
promote innovation
Establish strategic alliances and partnerships with Cardiff
University Health Care Related Schools and other external
influential organisations
Work with the Welsh Public Health UKCRC to tackle the
underlying determinants of poor physical and mental health
Build on the work of Magic & Expert Patient initiatives to
incorporate shared decision making as part of the UHB’s
Strategy
Establish clinical and governance dashboards
Build on the work of the Pt Experience Team to incorporate
signposting of services & capture outcomes of Exec
Walkrounds & HCS
Promotion of a culture of improvement that has the
patient/citizen at its centre e.g. Transforming Theatres,
ERAS and the Patient flow collaborative
Best Care
Increase quality reliability and
effectiveness of care
Best Place
Culture of quality
improvement:
Can Do
Establish faculty expertise across the key themes of
improvement, education & management
Delivery of core curriculum to support quality improvement
via OD/ IQT training & Breakfast club and web-ex methods
Develop positive staff engagement activities: Chairman’s
Award; competitions & ATP
Establish a business intelligence for real time information
and measurement systems
Working with the SPN collaborative develop a quality cost
matrix to pinpoint savings
Improved performance against productivity benchmarks:
CHKS, WAMI & Intelligent Targets
Best Value
Eliminate harm, variation and
waste

7. Creating the Conditions
Build
Infrastructure
& Capacity
Formal programmes of QI education
Embed QI into all development work e.g.
leadership and management development
Enabling people to lead improvement
in their daily work processes
•Tools, techniques, support
“Data is our vision - we
must learn from it”
• Real time measurement
and Information systems
Shaping the Culture:
• Will and commitment
• Quality reinforced at every
level by behaviour, action and
communication
• Patient/Family/Carer
centredness at all times

8. Creating the conditions:
•Academic
•Clinical
•Research
•Partnerships
•Networks
•Training/education
•Bench to Bedside
•Culture - 2 jobs
• Celebration
• Recognition
• Dissemination
Growth Capacity
ExpertiseCapability

9. Our Journey So Far…..
Awareness
•Safer Patient Initiative
•Change & Innovation Plan
•Faculty for Quality Improvement
Education
•Learning from 1000 Lives+, Qulturum, Tayside and the IHI
•Links to Harmonisation; C21 and HEI programmes
•Improvement experts and practitioners training – LQI/IQT
•Board Effectiveness Development Programme
CSI
• Lean and Rapid Improvement work
• Real time data and measurement for improvement
Redesign
•Improvement as a Systems Property
•Triple Aim – Excellence at a lower cost per capita
•Co-production / Prudent Healthcare
Movement
• Task force
•System Infrastructure - IQT and LIPS
•Creating Breakthrough and Leverage
Scaling Up
•Public Health
•Working with Communities
• Clinical innovation centre
2010 2012 2016 and Beyond

10. Faculty outputs – improvement and innovation in action

11. Faculty outputs in action (clinical training)
Academic NHS
Research New Instruments
Smoke remover surgical innovation
Further development of surgical skills
Advancing clinical practice
Centre of excellence
Education/ QI Post Graduate Skilled workforce
Training Spin-out opportunities New model of training
Innovation/ CSI Simulation Reduce Harm, Waste and Variation
Shared
Purpose
Medicentre – shared facility
Collision Space - Faculty
Cedar – shared facility
Collision Space - Faculty

12. Will
NCEPOD Report ‘
Caring to the End’
(2009) highlighted that
poor communication
between teams at
handover contributed
towards 13.5% of adverse
outcomes in Acute
Hospitals.

13. Innovation
Ollie
Tan
Rob

14. Delivery ~ what we Did
• 13th Aug – 15th Sept
e-learning package
• 17th Sept – 4th Nov
e-handover training
Support- HANDS ON)
• …….PDSA…….
Feedback from Junior Doctors
5th Nov……….Software updated

15. Engagement…….Enduring
E
SpRs/Jnrs
Post
Graduate
Dept
Directorate
Mgt
Team
IM&T
Clinical &
MGT Lead
Medical
Director
SNPs

16. e- Handover – screen shot

17. Sustainability
UHL UHW
0
20
40
60
80
100
120
140
1 3 5 7 9 11 13 15 17 19 21
number of
requests
requests on w/e&
BH
0
20
40
60
80
100
120
140
160
1 3 5 7 9 11 13 15 17 19 21
number of
requests
requests on
w/e& BH
Mean: 88/week; 70 at w/ends
Mean: 94/week; 68 at w/ends

18. Spread
I am moving to Surgery next month....I
can’t believe that they don’t use e-
handover………what can we do?
F2 - Catherine
Emma F1 – Medical Assessment Unit
Why can’t we use e-handover……..it
would be much safer and easier to keep
a track on patients
- Emergency Unit
- Paediatrics
- Surgery
Visit by Cwm Taf…………..

20. Standard map.
Service nodes in
blue, demand
nodes in yellow.

21. Heat map showing
demand density.
Service nodes in
blue. Demand
nodes on gradated
red (high) – green
(low) scale.

22. In closing
1928: Pencillum discovered by Fleming
1939: Chain and Florey took an interest……..Penicillin
1940’s: Heatley got involved…………..
1945: Nobel Prize for Medicine
Without Fleming, no innovation; without Chain
and Florey, no testing, without Heatley, no wide
scale use of penicillin

23. …but really, we all
know it takes more
than tools to make
real change happen!
And finally……….if you always do………..