It’s day 10 of Celebrating Haelo and today, we’re looking back at the Practices Improving Processes programme, led by Stuart Clough.
Practices Improving Processes in Salford (PIPS) was a unique programme which Haelo supported in Primary Care, and I was fortunate enough to be the lead of this programme. The programme was a Breakthrough Series (BTS) focussed on efficiencies in General Practices from across Salford. In total, 8 Practices took part in this 12-month programme which ran from April 2017. In order to do this, Haelo provided a learning environment for the Practices, which focussed on Quality Improvement methods to support them in making efficiencies, no matter how small. General Practice is a pretty busy place to be, so to maximise time and effectiveness, this programme was perfect!
Alongside making the gains, Haelo were able to provide improvement capability to the teams who took part, allowing them to take things further, beyond the programme, making sure that they could continuously improve and provide patients with the best care possible! We saw some really good, innovative ways of maximising efficiencies and I am really proud of what all the participating Practices achieved!
If you’d like to find out more, feel free to drop me a line as I’d be happy chat about the programme, or tweet me, @StuCloughNHS.
There is growing pressure for general practices to continue to deliver high quality care, while meeting increasing levels of demand and diverse expectations. At the same time financial resources are being reduced, requiring practices to stretch their resources to maximum capacity.
Therefore, NHS Salford CCG wanted to offer GP practices an opportunity to participate in a 12-month long programme which would provide practice teams with suitable QI training and onsite support to redesign processes that impact on patient outcomes, patient and carer experience, staff experience and value and efficiency. The intention of the programme was to support GP practices in Salford to identify opportunities to improve how they work, use data to drive improvement, reduce waste and inefficiencies and reduce costs. By doing this, it would help the GP Practices to plan ahead and maximise the time they have.
The eight Salford GP practices included:
The fundamental QI methodologies used to enable GP practices to deliver quick win efficiencies over the programme life span were Lean, in conjunction with the Model for Improvement. These methods were selected so that the GP practices could become very specific about what they wanted to achieve, in addition to utilising their data to demonstrate their progress. Using tools which helped them to firstly, diagnose an issue and secondly, apply tools to test changes. The GP practices were then skilled to assess whether they had seen any improvement in the changes that they had been testing.
Haelo launched the PIPS programme on the 12 July 2017, and using the structure of a BTS Collaborative, GP practices came together for three learning sessions, followed by a celebration event. Each learning session was 60 days apart and in the interim periods, each GP practice would have tailored improvement coaching support to help them enable their changes.
Within the learning sessions, participating GP practices received training in the key components of Lean methodology. Underpinning the PIPS programme was the Model for Improvement; GP practices used the Plan, Do, Study, Act cycle to test their change ideas on how to improve their current problem. Lean and the Model for Improvement have synergy between them, therefore, this was a suitable balance of QI to provide the GP practices with as they strived to make changes to their current processes. The learning sessions also provided valuable space for the GP practices to work as a collaborative, share learning, experiences and initiatives to apply them to another setting where appropriate.
The GP practices decided to work upon a number of different topic areas, selected through what they felt to be issues which required change. These were:
Prior to the first learning session, the practices had an opportunity to think about which of the above areas were providing them with difficulties and what waste they could eliminate in order to make their processes more efficient. This issue was then brought with them to the first learning session where they explored which tools to use and how to apply them to their issue area(s).
Haelo provided expertise in a handful of QI tools over the PIPS programme. The following tools were selected for their simplicity and their ease of application to real-life situations:
The GP practices were supported by Haelo team during the design of the initiative they wanted to test a change on and also supported the GP practices when they put the tools into action.
For more information on the specific initiatives, please see the below case studies;
At the end of the PIPS programme, the GP practices came together to showcase their work and share reflections on their initiatives, with the aim to share and learn from each other’s experiences. The PIPS programme has helped the participating GP practices to see a series of improvements and has been positively received by their staff.
Going forward, the GP practices are keen to continue to develop their QI skills and apply what they have learnt to other areas within their processes and procedures. In addition to this, they are now looking to sustain their improvements and share them across Salford to other GP practices. The GP practices are now more reliant on their data, which has helped them to convey the message about QI but also, how they can use this to demonstrate what efficiencies they have seen.
A selection of the GP practices initiatives over the PIPS programme can be found here: