12 September 2019

Quality Improvement projects delivering improvement in Tower Hamlets Community Learning Disability Service!

Great news from Tower Hamlets Community Learning Disability Services, with two Quality Improvement projects recently achieving improvement

One project is focusing on increasing access to genetic testing, which is important so people can find out why they have a learning disability, and if they need help with other health problems that be associated with their learning disability. The other is working to reduce waiting times within the service between referral and completion of the single assessment process.

Results and successful change ideas

Both teams recently presented to the Tower Hamlets Adult Mental Health QI Forum to share fantastic progress with their projects:

The genetic testing project has achieved a 66% increase in the number of people accessing genetic testing. Change ideas have included developing accessible written materials and consent form, developing education sessions for staff, changing the way in which this is discussed in weekly team meetings and developing the communication strategy with GP surgeries.

The LD access project has achieved a 34% reduction in waiting time from 9.82 weeks to 6.46 weeks. Change ideas have included changing to a daily referrals meeting and developing a referral form.

The importance of service user and carer involvement

The genetic testing project team shared how the involvement of Farah Akhtar, a carer, as a core member of the project team was critical to the development of the change ideas and the progress of the project. Dr Ian Hall, commented “the biggest learning point for us has been just how important it has been to have a carer on the team. She has helped us to communicate about this issue, making it understandable and less overwhelming for our service users and carers” . Dr Soe Win added, “she has also helped to engage other members of staff in the project, by communicating from her perspective why this is important to work on. It’s been amazing”.

Farah Akhtar commented: “As a carer, it’s been brilliant to be able to feedback to the project my personal views and experiences and to be part of the project from its early stages. The team members have kept me informed and involved me as the project developed. I think my experiences, as a mother of a person with learning disabilities who has been through genetic testing, are unique, and when I contribute to these discussions (planning sessions and staff training), I feel like a really important part of the team”. She added, “it’s not often that carers can be valued in this way for their unique experiences”. The team are now looking at trying to identify a service user to join the team alongside Farah and the other members. The Access project has also been inspired to find a service user or carer to join their team as well.

Multidisciplinary project teams

A key enabler for both teams has also been the strong multidisciplinary approach to the projects, with nurses, psychologists, psychiatrists, social workers, administrators, speech and language therapists, occupational therapists and physiotherapists being involved in one or both projects. The Access project has also strengthened its work by engaging trainee psychologists to undertake ​interviews with service users and carers about their experience of the initial assessment by CLDS. These are being undertaken by two trainee clinical psychologists as service related research projects, which is part of their doctoral training requirements. The team working to reduce waiting times has also been using QI tools effectively to undertake a simple post-it exercise to seek feedback from staff, service users and carers about their experiences of the single assessment process.

Post- It exercise

Figure 1

Implementation planning to hold the gains!

Both teams will now be focusing on ensuring they hold the gains they’ve made by developing strong implementation plans for the successful change ideas, as well as seeing if they can achieve further improvement.

Congratulations to both teams for their hard work and success!

For more information about the genetic testing project see this published article: https://onlinelibrary.wiley.com/doi/abs/10.1002/ajmg.b.32732

The Genetic testing poster can be found here.


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