Welcome to the zoo
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Innovation & Improvement in the
NHS & learning from you
Orlando Hampton
Innovation Development Manager
Health Education East Midlands
orlando_hampton
orlando.hampton@nhs.net
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Aims
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Brush up on service improvement in the NHS
Share our experiences in small groups
Feedback to the room
Learn at least one new thing
Squeeze that all into 35 minutes
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Definitions:
• Innovation: The process by which an idea or invention is
implemented in practice, resulting in a change or
improvement.
• Quality: Refers to the inherent or distinctive
characteristics of properties of an object, process or
other thing which may set apart a person or thing from
other persons or things, or may denote some degree of
achievement or excellence. In terms of quality
improvement in healthcare, quality is about learning
what you are doing and doing it better.
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Definitions cont.
• Lean: A management philosophy centred on
preserving value with less work, by reducing
waste to improve overall customer satisfaction.
• Plan-Do-Study-Act (PDSA) Cycle: Another
name for a cycle designed to test a change. The
PDSA cycle includes four phases: Plan, Do, Study
and Act. PDSA Cycles are small scale, reflective
tests used to try out ideas for improvement.
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Basics of Lean
The term Lean is used to describe a set of
principles and tools used to support organisations
to pursue continuous improvement of their
systems and processes. Lean focuses on adding
value and eliminating waste and, importantly,
always striving to improve.
This focus can be on a process or a system.
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The origins of Lean
• Originates from research in the late 1980s in Toyota
• High quality products at a lower cost by focussing
on some key principles.
• How the workplace was organised and managed.
• Based on management thinkers of 20th century ie
Edward Deming “Plan-do-study-act”.
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The origins of Lean cont.
• improve services for the customer
• supporting a positive work environment for staff
• running an effective, high performing organisation
• adopted and adapted by healthcare organisations
to support continuous improvement
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What do we mean by “add value”
Value:
Noun – The regard that something
is held to deserve, the importance
or preciousness of something:
“your support is of great value”.
Verb – Estimate the monetry worth
of (something): “her house is worth
£100,000”.
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Innovation in the NHS
The Productive Series
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The Productive Ward:
Releasing time to care
NHS Change model
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Balancing Lean in the NHS: 2013
NHS Scotland QI Hub, 2013, 2011
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2011
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Reduce variation
Better metrics and information
Systematic delivery mechanisms
Incentives and investments
Procurement for quality & value
Develop our people
Leadership in innovation
Mandate the adoption
How will this happen?
Derby Hospitals
Prototype,
testing and
manufacture
with
commercial
provider
DH Flyer
BBC article
Expo (London)
IHW, 2011
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The
Improvement
Network
Barriers to innovation in the NHS
IHW, 2011
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What makes “diffusion” happen?
IHW, 2011
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Models as a timeline
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Models as a timeline
Brainstorming
Top down
Six hats
Horizontal
Fresh eyes
Bottom up
Innovate
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Adopt
Diffuse
Models as a timeline
Brainstorming
Top down
Six hats
Horizontal
Fresh eyes
Bottom up
Innovate
Adopt
Diffuse
LEAN: Add value and eliminate waste
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IMPACT: Any outcome to service or participants
Table exercise 1
1. Nominate a scribe
2. Nominate a time keeper
3. In one minute describe one service improvement
cycle you have done/been part of / witnessed
4. Scribe notes it in one sentence
5. Choose one, answer questions on next slide
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Table exercise 2: Choosing one
example, answer:
1. Did it add value?
2. Did it eliminate waste?
3. Identify barriers encountered and if/ how they
were overcome.
4. How was it shared?
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Table exercise 3
• Group share back with the room
• All examples will be written up and shared with
permission
• Would you like to put your email to your one
liner?
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Feedback
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Name
Animal Type
Improvement project in a sentence
Add value?
Eliminate waste?
Barriers?
Shared?
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Zoo Review
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Resources and references
• NHS Scotland Quality Improvement Hub: www.qihub.scot.nhs.uk
• The Lean Enterprise Academy: www.leanuk.org/health
• The (former) Institute:
http://www.institute.nhs.uk/innovation/innovation/introduction.html
• “It’s a zoo around here” Nigel Risner, 2005
• The Improvement Network (for now):
http://www.tin.nhs.uk/innovation-nhs-east-midlands
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‘Heavier than air flying machines
are impossible’
Lord Kelvin, president, Royal Society,
1895
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The Zoo – Workshop Resources
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Lion
Single-minded
Visionary
Straight forward
Purposeful
Persevering
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Elephant
Cautious
Meticulous
Deliberate
Sceptical
Formal
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Monkey
Playful
Energetic
Extrovert
Lively
Persuasive
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Dolphin
Caring
Nurturing
Supportive
Patient
Relaxed
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