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Delayed Discharge of Care – Assessment and Implementation Plan – London council

Background

  • A large London borough of Hackney had major issues in delayed discharge of patients from Homerton Hospital into social care services, with the proportion being 70% of all delays. They needed to understand the root causes of the issues

Deliverable

  • Kinetik was asked to help complete a current state assessment and identify key recommendations at a steering group meeting

Activities

  • We carried out an assessment via focused interviews with key members of staff that work within the process. Together with the team we identified 10 specific recommendations

Specific Benefits

  • We identified up to 5 days of delay due to the cumbersome funding process for assessment, and we pinpointed the lack of proactive care team to manage discharge
  • As a result of the work we supported the organisation to come up with very practical and achievable recommendations that could be delivered in the short term. It also contributed to the overarching council strategy on driving end-to-end change in the whole discharge process

Business Intelligence Assessment – National Health Service Primary Care Trusts

Background

  • Primary Care Trusts were part of a drive to get patient services commissioned in a world class manner. There was a specific need for joined up thinking in the area of decision-making led by Informatics. We were asked to carry out a benchmark test of 3 PCTs in the South of England in their strategic decision support service

Deliverable

  • We submitted a full analysis to the commissioning support board, and ran a validation workshop to drive concrete next steps for action

Activities

  • We carried out an assessment of the decision making processes at each Trust, and the way in which data was used through all stages of the cycle. In addition, we reviewed technology, skills and informatics organisation design. We ran two workshops with key stakeholders across the 9 Primary Care Trust to report on our findings. This created priority in key areas of focus to enable Informatics-driven decision-making

Specific Benefits

  • Our work was seen to be of great value as part of a new commissioning hub that has been set up to co-ordinate a range of collaborative activities in the area

World Class Commissioning Strategic Assessment – National Health Service Primary Care Trust

Background

  • The client, a medium size PCT (£150M income), needed to undertake a gap analysis in tight timescales to understand more deeply the key functional and process gaps in its organisation. The assessment was part of the World Class Commissioning approach that the PCT was developing

Deliverable

  • Our analysis identified 36 specific gaps across 10 business functions and support processes (Board & Leadership, Public Health, Health Market Analysis, Clinical Leadership, Market Analysis, Pathway Design, Provider Selection and Management, Knowledge Management, Performance Management and Informatics). We identified a range of cross cutting themes around capacity, capability, behaviours and informatics across the organisation

Activities

  • We had working sessions with 17 senior managers and directors in an intensive 3 week period, using advanced workshop techniques to carry out an assessment of over 450 specific activities

Specific Benefits

  • Our gap analysis was fully accepted by the Senior Leadership Team and has given the organisation distinct purpose in improving its capability, culture and behaviours. Our analysis identified clear focus for the executive in its next step of prioritisation and implementation planning for presentation to the Strategic Health Authority

Lean Transformation – National Health Service

Background

  • The Client was a medium-size hospital trust (£100M income, over 2000 staff) and wanted to embark on a Lean Transformation to improve patient quality whilst delivering value for money as part of becoming a foundation trust

Deliverable

  • Training of the executive directors in Lean Transformation, together with practitioners who would deliver change
  • Review of X-Ray Diagnostic as part of training

Activities

  • An intensive one-day introduction to board director and senior managers using both presentation and ‘going to see’ events
  • Two Practitioner events that included playing an experiential Lean game, value stream mapping and a 5S exercise within the X-Ray department
  • Assisted the Operations Director in transformational planning

Specific Benefits

  • Our training launched a further 26 improvement projects
  • X-Ray process became a walk in service reducing 2 weeks of wait times for patients
  • Almost 700 hours of work saved per annum by a simple change in process

Using Data for Informed Improvement – National Health Service

Background

  • The client was the NHS Information Centre, and wished to deliver support to frontline trusts in improving patient pathways by better utilising data for decision making and continuous improvement across end-to-end clinical processes

Deliverable

  • Designing of 10 workshops across England for acute trust/primary care trusts to demonstrate how a better use of data could aid decision making and improve flow through the clinical pathway

Activities

  • Ran workshops to deliver the patient aim for elective surgery from GP visit to treatment within 18 weeks. Key outcomes included:
    • Understanding and deciding the measures that aided end-to-end processes improvement
    • Understanding how analysis of data process pathways and booking systems processes could reduce ‘lead time’ for patients
    • Use of time based presentation of data using statistical process techniques (SPC) to simplify decision making
    • Creation of better review processes across different stakeholders to aid quality and speed through the pathway

Specific Benefits

  • Excellent feedback received from the workshop which involved stakeholders from several primary and acute trusts, the Department of Health, the Institute of Innovation, Connecting for Health & the Information Centre
  • The workshop created 30 initiatives for improvement within pathways. Use of ‘holistic’ and ‘better use’ of data was seen as a key area in how performance excellence in end to end clinical pathways could be delivered

Bid for Hinchinbrooke Hospital

Background

  • A large support services organisation needed assistance in a bid to run the first franchised hospital in the UK

Deliverable

  • We were asked to provide a lead on part of the tender bid, specifically in relation to Lean and Continuous Improvement solutions that would reduce the length of stay for patients

Activities

  • We carried out analytical work to compare the hospital length of stay (LOS) across all Health Resource Groups (HRGs) with the national benchmark and an associated hospital in the region
  • We carried out focus interviews with key staff at both hospitals to gain an understanding of the current work to improve LOS as well as ascertain the appetite for continuous improvement
  • We defined a detailed change methodology to deliver LOS savings

Specific Benefits

  • We identified the potential of 20,000 bed days’ savings (20%) within 12 months and a further 30% saving within 24 months, with a defined method to achieve this
  • Even though the bid was not successful, the client gained a large amount of knowledge from the process. It has gone on to win other franchise awards within the NHS