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NHS Improvement Vascular Ultrasound Applying the learning from Diagnostics

Work Programme for 2009/10. 18 sites have been testing improvements across 5 areas: Adult

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NHS Improvement Vascular Ultrasound Applying the learning from Diagnostics

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    2. Work Programme for 2009/10 18 sites have been testing improvements across 5 areas: Adult – age related hearing loss Children’s hearing pathways transition Balance adults children Tinnitus Complex hearing services

    3. Geographical coverage, varied settings (acute, community etc.) Partnerships with local authorities.Geographical coverage, varied settings (acute, community etc.) Partnerships with local authorities.

    4. Key Principles from Early Work The emerging key principles which will be explored further are: Access to services in the community – saving on secondary care overheads, adding quality to patient experience through ease of access Direct access to audiology services as the default pathway – streamlining the pathway, reducing waiting times and saving on appointments in ENT Implementing One-stop pathways as default – encouraging adoption of the assess and fit , MDT working – saving on multiple appointments and making best use of available resources Developing standardised protocols and pathways for those identified with complex hearing problems –providing early diagnosis and making best use of specialist resources, saving on ad hoc visits / follow ups

    5. Improving the Patient Experience Shaping services around what our patients tell us and embedding their views and feedback into redesigning services. Graph shows improved QET score in that domain. Note Patient experience is the lowest score, so though we are seeing improvement we’ve still got a lot of work to do. ALSO – Improving patient outcomes by measuring clinical outcomes to demonstrate improved quality.Shaping services around what our patients tell us and embedding their views and feedback into redesigning services. Graph shows improved QET score in that domain. Note Patient experience is the lowest score, so though we are seeing improvement we’ve still got a lot of work to do. ALSO – Improving patient outcomes by measuring clinical outcomes to demonstrate improved quality.

    7. Audiology Improvement Programme for 2010/11 Prototype Phase Working with 6 prototype sites to take forward to the next phase. significant potential to demonstrate QIPP outcomes have potential for spread across Audiology and into Physiological Measurement and be aligned to the wider agenda of the diagnostics Direct access models – 3 sites, different models / professionals, scientist led services Patients with complex needs – improving quality through clinical networks (small volume, individualised care) Community based models for service delivery – supporting care closer to home One stop services – reducing the number of visits Robust testing with larger numbers to test “what really works”. Using a whole pathway approach to make sure that changes in one part of the pathway don’t have detrimental effects elswhere. Sharing innovation between sites, to test models in different clinical settings (DGH, Teaching Hospital, Community setting)Robust testing with larger numbers to test “what really works”. Using a whole pathway approach to make sure that changes in one part of the pathway don’t have detrimental effects elswhere. Sharing innovation between sites, to test models in different clinical settings (DGH, Teaching Hospital, Community setting)

    8. Whole Process Approach Clarity over the process to be tested Look at potential benefits compared to the old process (QIPPS) - Quantify Ensure the new process is as ‘Lean’ as possible – reduce waste, delays etc. Ensure ‘Lean tools’ have been utilised and applied – standardised working, reduced defects, customer focus (VSM) Test the new pathway with larger numbers (Is it robust? – staff skills, referral(GP’s) )

    11. So what about Vascular Ultrasound pathways?

    12. Princess Alexandra in Harlow Princess Alexandra in Harlow

    13. Carotid Duplex

    14. Carotid Duplex

    15. Peripheral Pathway

    16. The Opportunities A process approach will have opportunities for Physiological Measurement services Which principles apply to which specialty? - some with community opportunities Direct access – often challenging to some staff groups Straight to test ? – could different models apply (hub & spoke) Complex needs – could a specialist network approach work

    17. Over to you? Are we looking at the right pathways? Which services allow for community delivery? How can we use direct access models to save O/P slots ? Scientist / sonographer led Are there opportunities for One - stop clinics? Who has innovative models to share?

    19. More details Website www.improvement.nhs.uk – link to Improvement System Audiology www.improvement.nhs.uk/audiology Diagnostics www.improvement.nhs.uk/diagnostics Mention E-Bulletin – details of how to subscribe on our website. We will be launching our toolkit for Audiology improvement via our website towards the end of July – Service improvement tools and techniques with examples and models taken form audiology sites that we have worked with.Mention E-Bulletin – details of how to subscribe on our website. We will be launching our toolkit for Audiology improvement via our website towards the end of July – Service improvement tools and techniques with examples and models taken form audiology sites that we have worked with.

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