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Pat O’Connor

Capacity and Capability Building . Pat O’Connor. Building Capacity !. CAPACITY BUILDING is…. An approach to the develop sustainable skills, organisational structures, resources and commitment for healthcare improvement Hawe et al: 1999. Which way does (should) Building Capacity flow?.

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Pat O’Connor

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  1. Capacity and Capability Building Pat O’Connor

  2. Building Capacity !

  3. CAPACITY BUILDING is… An approach to the develop sustainable skills, organisational structures, resources and commitment for healthcare improvement Hawe et al: 1999

  4. Which way does (should) Building Capacity flow? Top Down? Spread from the Middle? Bottom Up?

  5. A hospital framework

  6. Teams and Leaders: Roles • Set Aims • Build Will • Assure Resources • Remove Obstacles • Review and Reflect • Assure Spread Senior Leaders • Make Improvements • Test and Learn • Report Lessons • Make Requests Teams • Human Resources • Technical Expertise • Information Technology • Budget and Capital • System for Spread Infrastructure

  7. Framework: Leadership for Improvement 1. Set Direction: Mission, Vision and Strategy PULL Make the future attractive Make the status quo uncomfortable PUSH • 5. Execute Change • Use Model for Improvement for • Design and Redesign • Review and Guide Key Initiatives • Spread Ideas • Communicate results • Sustain improved levels of • performance • 3. Build Will • Plan for Improvement • Set Aims/Allocate Resources • Measure System Performance • Provide Encouragement • Make Financial Linkages • Learn Subject Matter • 4. Generate Ideas • Understand Organization as a System • Read and Scan Widely, Learning from other Industries & Disciplines • Benchmark to Find Ideas • Listen to Patients • Invest in Research & Development • Manage Knowledge 2. Establishthe Foundation • Reframe Operating Values • Build Improvement Capability • Build Relationships • Develop Future Leaders • Prepare Personally • Choose and Align the Senior Team Source IHI

  8. National Quality Strategy for the NHS in Scotland

  9. National Level Capacity Building 170,000 staff in NHS in Scotland 17 Territorial boards National Education Scotland Quality Improvement Scotland 300 expert 3000 improvement advisors

  10. Why? Very few healthcare staff are experienced in process change. Improving a process is more than half the battle. Fewer have experienced results review and opportunity identification

  11. May have 3 big aims Develop infrastructure Enhance improvement sustainability Foster problem solving capabilities

  12. Capacity Building Driver Diagram 5 year Plan Primary Drivers Secondary Drivers Improvement board dashboard of measures Board uses Improvement science to delivery national strategic priorities Review of outcomes at each meeting Infrastructure supports improvement and measurement Patients drive Improvement agenda International expert faculty Alliance Board NHS Tayside Board accepts Improvement as key strategic priority for effective governance Transform NHS Tayside healthcare systems though focused expertise and implementation of Improvement Science 50% of Board agenda focused on Improvement data % involvement of patients and public in redesign Improvement Boards track and support progress remove barriers Create a reliable metric system IT used to improve real time data Harmonize our metrics Develop local improvement data repository QoF driven By Improvement outcomes Ownership of agreed upon set of outcomes from Triple Aim Clear, shared measurement plans in all departments Macro Meso and Micro level Inventory of national programs and measurement Robust, evidence- based proven clinical changes % movement to real time data Improvement science expertise and application drives improvement in all services • %Achievement of all improvement local Delivery plan goals • % staff in training using improvement science within curricula • % staff using improvement science improved patient outcomes Population QI improvement goals, %Cost reduction,% pos Patient experience improvement % of staff trained in improvement science Profound and basic levels Heat target achievement Research and development drivesimprovement Academic Acceptance of pragmatic science Dundee University multidisciplinary education includes improvement science Educational infrastructure focused on capacity Building in improvement skills All staff development has elements of improvement goals Faculty expert at improvement methods and coaching Capacity Building Programme design and structure % of staff in training involved in improvement activity % staff development has elements of improvement goals

  13. Considerations The context within which the program will apply Pre-existing capacities to support change Sphere of influence to effect change Individual Team Organisation

  14. Attributes of High Performing Organizations Safest Most Effective Most Personal Source: Kaiser Permanente, 2008

  15. In your hierarchy How many people as ‘experts’ do you need?

  16. An improvement expert within Within 2 steps

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