Redesign capacity enhancement project

Improving the way the Western NSW Local Health District provides support for staff completing improvement, redesign or innovation to improve patient care outcomes.

View a poster from the Centre for Healthcare Redesign graduation December 2021.

Aim

Facilitate an integrated approach that enhances staff capacity to develop, plan and implement improvement, redesign or innovation leading to improved patient experience and outcomes, improved staff experiences and more efficient provision of care.

Benefits

• Increased number of service and system improvement initiatives that are started and completed and reduced inefficiency.
• Improved staff satisfaction
• Improved patient care, targeting the quadruple aims of efficiency, patient outcomes and patient satisfaction.

Background

The district has not fully used the Redesign school, linked with Accelerating Implementation Methodology training or provided ongoing localised redesign or project enhancement training within recent years. There is no process for succession planning, or early identification of staff within roles that would benefit from training. There are significant geographical and individual challenges associated with a rural local health district. There is an increasing need for support of project and redesign initiatives. This need is driven by changing community needs, government policy and directives and technological innovations.

There is limited knowledge and understanding of how to determine the best pathway for service improvement ideas or projects. There is no way to track completed projects and a lack of cohesion, integration and staff understanding of the existing systems has led to projects not being undertaken efficiently or effectively. Therefore scarce resources have been wasted and improvements not fully realised or sometimes even implemented at all. This results in patients not receiving the best care they could.

The lack of redesign and service or system improvement learning opportunities within the district has led to a deficit in capability within the district. The district needs to build capacity for redesign and project management support and training to enhance staff skills and facilitate effective and efficient redesign and change across the district. This will better use resources and ultimately support the quadruple aim of improved patient experiences, improved patient outcomes, improved clinician experience and efficiency.

Implementation

The changes we are implementing will result in staff having access to a suite of tools that would assist them with completing projects well. Due to the impact of COVID-19 we have not completed this work as yet, but it is in progress.

Solutions

• A flow chart for both project leads and managers, to guide staff to the ideal tools and processes to follow for a specific project.
• An intranet page that that directs staff to tools and resources that will be useful, including project management, quality improvement, research and ethics.
• Face-to-face Accelerating Implementation Methodology training locally to build networks and awareness of projects starting.

Each of these solutions for change require an increase in resourcing. The flow chart requires consensus between departments that have worked differently over many years. This will take time and each department needs to be able to see how these changes will improve the services for them.

Status

Implementation – The project is ready for implementation or is currently being implemented, piloted or tested.

Dates

• Initiation workshop 16-19 Feb 2021
• Diagnostics workshop 23-25 March 2021
• Solution workshop 18-20 May 2021
• Implementation workshop 2021 – 2022
• Evaluation and sustainability workshop 2021 - 2022
• Virtual graduation day and final presentations 10 Dec 2021
• Final implementation of project planned for May 2022

Implementation sites

This project will be been implemented across all of Western NSW Local Health District.

Partnerships

Centre for Healthcare Redesign

Evaluation

Evaluation will include:

• number of staff completed Accelerating Implementation Methodology training
• number of hits or visits to the project intranet page
• completion of the flow chart
• staff survey.

Lessons learnt

Despite all the best planning a pandemic can halt a project, but not derail it completely.

Further reading

• van Leijen-Zeelenberg JE, Elissen AMJ, Grube K, et al. The impact of redesigning care processes on quality of care: a systematic review. BMC Health Serv Res. 2016;16:19. DOI:10.1186/s12913-016-1266-0
• Bhattacharyya O, Blumenthal D, Stoddard R, et al. Redesigning care: adapting new improvement methods to achieve person-centred care BMJ Qual Saf. 2019;28(3):242-48. DOI:10.1136/bmjqs-2018-008208
• Prior SJ, Van Dam PJ, Griffin PEJ, et al. The healthcare redesign student experience: qualitative and quantitative insights of postgraduate work-integrated learning. High Educ Res Dev. 2021:1-17. DOI: 10.1080/07294360.2020.1867515
• Western NSW Local Health District. Strategic Plan 2020-2025: Healthier rural people, thriving communities [Internet]. Western NSW Local Health District; 2020. Available from: https://wnswlhd.health.nsw.gov.au/our-organisation/our-story/our-strategic-plan
• World Health Organization. 10 Facts on Patient Safety [Internet]. World Health Organization; 2019. Available from: https://www.who.int/news-room/photo-story/photo-story-detail/10-facts-on-patient-safety

Contacts