Steve Jamieson Head of Nursing Department Geraldine Cunningham Head of Learning & Development

1. Steve Jamieson Head of Nursing Department Geraldine Cunningham Head of Learning & Development Royal College of Nursing

2. Leadership, Innovation and Quality: An example from practice Dr Michael Brown, Chair, Learning Disability Forum

3. The context • Harnessing the knowledge, skills and commitment of the RCN membership to effect change • Clear RCN strategic framework to guide and support activity to produce effective outcomes • The RCN as a dynamic force to challenge and provide leadership

4. Death by Indifference • Significant failures in safeguarding • Serious service and system failures • Avoidable deaths • Poor practice & care • Failure to adhere to legislation • In short, indifference

5. The RCN in Action • RCN Congress Resolution 2010 – Liaison Nurses in every general hospital • Evidence of the changing demographics of the learning disabled population • A differing health profile of people with a learning disability • People with learning disabilities are high and frequent users of general hospital services. • Different uptake and pattern of general hospital usage • Clear legislative and policy frameworks which require equal access to public services, including healthcare, • Legal duty for all Public services required to make ‘reasonable adjustments’ to care to comply with DDA legislation • To impact on improving patient experience and health outcomes.

6. A model of Liaison Nursing Practice • Learning Disability Liaison Nursing (LDLN) Services have been recommended in policy and are being developed across the United Kingdom. • First Mixed Methods research study published in 2010 focussing on outcomes from 4 Liaison Nursing Models. • The first study to examine LDLN Services from a range of stakeholder perspective and demonstrates evidence of the impact and outcomes. • The LDLN role is complex and multi-dimensional and impacts on (i) clinical care, (ii) education and practice development and (iii) strategic developments.

7. Taking action to effect change • Congress Fringe event – issues identified for members - Education, workforce & leadership in learning disability nursing • RCN hosted a UK – wide learning disability summit • Key leaders and stakeholders involved • Identification of key actions and outcomes • Effective use of RCN resources and facilities to take forward the issues

8. The Frontline Outcomes • The RCN as a dynamic force to challenge and provide leadership that can effect change to improve patient care • The RCN is a dynamic force that can influence the effective use of the nursing resource • The RCN membership has the collective knowledge & skills to effect change • The RCN has a sound strategic framework to guide and support activity to produce effective outcomes

9. ProductivityWhat Nursing Has to Offer Using Lean as part of everyday practice Bolton Improving Health System Maria Sinfield Deputy Director of Nursing

10. Designed and led by Nurses & Midwives Exemplar WardsUsing BICS in daily work Exemplar Wards demonstrate our commitment to provide a clean, safe and efficient environment of care, underpinned by Patient Safety. Uses the BICS principles of standard work, removing variation, removal of waste, improving quality and reducing cost. • 14 wards validated • 12 In progress • 1 waiting for decision • 1 ready for validation • 3 wards working towards Model • ward status Patient Outcome Target Measures • HSMR reduction i.e. MINAP <85% • Defects 50% reduction p.a. • Increase patient experience 85% good / 'excellent' on comment cards • 10% reduction in cardiac arrests • 2% reduction in pressure sore incidence • 10% reduction in patient falls

11. The Validation Process • Awarding of the Exemplar ward status is not a given • Structured and Strict process • Some wards awarded but with conditions that are then performance monitored • time provided to get to 100% appraisal for wards in Q1 • Unannounced checks for decontamination assurance • Formal Presentation of successful wards to Board of Directors

12. What has to be achieved

13. No avoidable deaths or harm HII/Infection control No Defects % of key quality indicators QFAT Highest Morale Good people management Valuing Staff No Waste Stock levels Ward budgets attendance

14. Improving Flow and Productivity on Respiratory Wards – D3 and D4 New way of Working Commenced Source: LE2.2

15. Has it made a difference? BEFORE DURING AFTER

16. Celebrating Our Success!!

17. Innovation Geraldine Cunningham Head of RCN Learning and Development Institute

18. 5 Principles of Innovation • Innovation starts when people convert problems to ideas • Innovation needs a system • Passion is the fuel, and pain is the hidden ingredient • Co – locating drives effective change • Differences should be leveraged Creative Leadership Centre

19. Finding space for innovation “Men of genius work best when they work least.” -Leonardo da Vinci (1452-1519)