#hellomynameis Damian

A couple of years ago I introduced an electronic record into our assessment process so that all children presenting to our Emergency Department would receive a Pain Score. Prior to this our recognition and response to pain had been haphazard and below national standards.

I congratulated myself on its implementation as within 24 hours virtually all children received a pain scores. I overnight had become an improvement guru.

Until we re-reviewed clinical notes and found that our response (i.e type and time to analgesic) hadn't improved at all.

All that had happened is that I had a process of showing how much pain children were in and that we weren't do anything about it...

...at least before we didn't know they were in pain :(

Data is everywhere

"If you do not measure you do not improve....

... but data alone will not produce improvement"

At the turn of the century the Institute for Medicine produced their seminal work Crossing the Quality Chasm. It reframed the need for quality improvement.

Recently Mary Dixon-Woods and colleagues wrote a paper on demystifying theory in quality and safety in health care. I blogged on this paper re-mephasing the need for language that was appropriate and understood by the general clinician or nurse.

The bricks and mortar of the NHS is its staff. My ask of LIIPS was to provide a means of educating those working at the 'coalface' (I don't like that term but it does describes the situation well) on the basics of using measurement to improve the care they provided.

The aim then to produce a solid platform at the floor rather than sprinkle education from the ceiling.

My own interests in Quality Improvement had identified the multi-faceted nature of ensuring patient safety and improving quality of care.

Presenting this in a way that makes sense to health care professionals can be very challenging

My idea was to debug the information in slides like this and give staff the first rung on the ladder towards collecting their own data.

We needed something different - an event that would stand out to participants with a focused remit the would give them something to hang on to.

The first brick in this building process was The LIIPS Measurement for Improvement process.

It was great to see the session start of with a quote from Jay Banerjee

"You can't manage improvement unless you can manage people"

Jay emphasised the challenge by describing the problem

We are often more obsessed by the number of people completing the friends and family test - rather than what the results are actually showing...?

"Systems are designed to produce the results they do" - Paul Bateldon.

We encourage are staff to get high numbers of test returns. What is the consequence of that?

"Routine data doesn't exist"

So how do we collect and use data correctly.

Carl Walker discussed the role of audit and the clinical audit team in quality improvement. Not here that audit scores higher than data in scrabble (but not Quality Improvement)

Simon Sutherland used his trip to work as an example of variability in processes.

He introduced the concept of data plotting and graphs

"Given two numbers - one will always be bigger than the other"

Learning from the event:

There were comments on the need for a 'how to' not only a 'why"

Relates to initial point about really understanding the need to contextualise information for the audience and given them tools they can use.

Time keeping was an issue

Improvers like to talk - they need managing in exactly the same way as any other speaker regardless of how important their topic is to them!

The was also feedback on clearer roles and responsibilities for those involved.

There is learning for everyone in how best to share information

Social Media is not the only solution it is part of a communication strategy.

Finally the workshop is part of a PDSA cycle itself.

For more information on LIIPS

http://www2.le.ac.uk/partnership/liips

A storify of the initial event is here:
https://storify.com/Damian_Roland/liips-measurement-for-improvement-worksho...