24th May 2021
Reducing Trust Spend on Transport by Using Black Cabs
Making Better Decisions in Business Intelligence and Analytics
Reducing Complaints in Forensics
Reducing Waiting Times for Occupational Therapy (OT) Interventions
Value Learning System LaunchOn the 4th May the ELFT Value learning system launched with 23 project team members attending. Sarah Barnett (Financial Viability Programme Manager) kicked off the session by posing the question:
“What do you think of when you hear the word VALUE?”
Value for money is the first thing that springs to mind, but value can also be defined as waste reduction, process efficiency and of course improved experiences for our service users and staff.
Teams were offered support to think through their challenges and to share their learning with each other. Some were at the stage of starting their project and developing an aim while many were at the stage of developing their measurement plan.
Some of the teams that attended included the Corporate Admin team who are seeking to reduce taxi spend and have achieved a huge £250 weekly saving to a total of over £13,000 so far. The team from Informatics were represented and are thinking through flow of requests for information so seeking to reduce the time taken and are so far are seeing improvement. The operations team at Forensics are focusing on improving service user experience by reducing complaints related to the time it takes for inpatients to receive their post.
Read more about these stories below.If you have a project that you would like to start on cost reduction, cost avoidance or income generation and think that attending the ‘Value Learning System’ would be beneficial please contact Katherine Brittin at Katherine.brittin@nhs.net or Sarah Barnett at Sarah.Barnett6@nhs.net. Reducing Trust Spend on Transport by Using Black Cabs
Each year, the Trust encounters significant costs in transporting staff, service users and equipment. A project team led by Linda Springer (Senior Lead Administrator for Inpatients & Crisis Care in Newham) which comprised of colleagues from across a range of different Corporate Services was formed to tackle this.
Their project aim was to reduce the Trust spend with taxi journeys by 20% by 31st May 2021 and improve the quality of taxi provision in the Trust. The team developed a driver diagram (figure 1, below) to help them articulate their theory of change. A range of ideas were developed, with recruiting a black cab driver to the Trust the first one tested. This idea was the brainchild of Theresa Coates (Head of Administration for Newham Mental Health).
Figure 1: A Driver Diagram for the Black Cab Improvement Project
The first black cab driver began working with the Trust towards the end of October 2020. The team tested this over a period of twelve weeks, at which point they began to see some savings. The team decided to scale this by recruiting a second driver who began in January 2021 to cover parts of Tower Hamlets. The black cab drivers have been employed on the Trust’s bank scheme and have attended statutory and mandatory training.
The project is currently saving approximately £250 a week, with total savings to date of more than £13,700 (figure 2.). The weekly savings accrued by the project are compared to the same journeys by the Trust’s contracted firm. In addition to the cost savings, this approach has improved the experience for both the staff booking the journey and individuals needing to be transported.
Figure 2: Weekly savings accrued by the project when compared to equivalent journey from the Trust’s contracted taxi firm
As a result of what has been achieved so far, the Trust is now considering spreading this idea across Hackney, Luton and Bedfordshire. The work of the project has also meant that two local individuals have been supported through regular employment, during a time when cab drivers have seen a drop in their income. This helps the Trust go some way in demonstrating its role as an anchor institution i.e. an organisation which by having a large presence in a community can leverage its resources and in turn give back.
Making Better Decisions in Business Intelligence and AnalyticsIn this 5 minute video, Tom Nicholas (QI Sponsor for Business Intelligence and Analytics) shares the impact of utilising QI to tackle the most pressing issues within his team.
Tom shares how the QI strategy within his team has helped the whole Trust to make better decisions regarding patient care and how focusing on the fundamentals of QI has motivated his team even further.
Reducing Complaints in ForensicsThe Forensic Operational services provides administrative support to clinical and non-clinical teams across John Howard Centre and Wolfson House in Forensics. The team identified an increase in complaints received from service users and staff, mainly around the delays in service users receiving post from home and late delivery of supplies for staff. To tackle this, the team started a Quality Improvement project with the aim of reducing the number of complaints received across Forensics by 50% by July 2021. Having developed a driver diagram (figure 1), the team set about identifying which change ideas to test.
Figure 1: A driver diagram for the complains reduction project in Forensics
The first of these was around developing a rota for staff to collect postal deliveries. Prior to testing the change idea members of staff would drop into Wolfson house to collect and deliver post on an ad-hoc basis. To help tackle this the team decided to test out using bank staff to cover the days staff could not attend. After testing this change idea, they still found that there was missed post and complaints. As a third test of change, the team developed a rota to allocate members of staff Monday to Friday to cover Wolfson House. The team have been testing this last idea since the 20th of March. They found that no complaints around missed post were received since this change ideas were introduced (see figure 2 for control chart).
The next change idea for testing is developing a New IT system to track inventory list. The prediction is that this will help to reduce waste, track orders, and timely delivery of supplies.
Katriye Tascioglu the project lead said “…we have been able to utilise our staffing resource more efficiently and most especially improve satisfaction with our service users”.
Figure 2: Count of complaints (C chart)
UPDATED: Reducing Waiting Times for Occupational Therapy (OT) InterventionsLong wait times for therapeutic interventions can have detrimental and disheartening effects for both service users and staff. The Occupational Therapy (OT) QI team at Bedford CMHT (Community Mental Health Team) came up with an aim to reduce its average waiting times for 1:1 OT interventions from 14 weeks to 7 weeks by the end of June 2021. Several change ideas were generated and tested to reduce the duration and impact of waits, including the following:
Figure 1: PDSA Testing ramp showing progression of tests of change
The teams’ most recent change idea is testing an occupational therapist attending multi-disciplinary (MDT) discharge meetings/huddles. Their prediction was that this would provide earlier and more effective OT input closer to the point when need was identified and would lead to earlier intervention and reduced wait times. Ultimately, this change ideas contributed to a 4-week reduction in wait times for 1:1 OT appointments until June 2021.
In addition, from June 2021 to September 2021 the team further reduced the average wait times for 1:1 OT appointments from 9.5 weeks to 3.7 weeks. Current data shows a sustained shift (i.e. 8 or more data points below the centre line) indicating sustainability of the QI project. Finally, the team has spoken on how the success of this work was due to having a service user involved throughout the project. Reflecting on this, Danielle Maule (Head OT, Bedfordshire and Luton Working Age Community Mental Health Services), shared about the key impact of involving service users in the project, stating: “Having a service user who had been through the OT caseload fully involved and as a full member of the Project Team also led to the success of this project”.
Figure 2: Average waiting times for OT one-to-one interventions -Bedford CMHT
The team is now in the implementation phase to embed the successful changes into business as usual. They are now using the same data they used for the project as part of their quality control system of regularly looking at their system using data and responding where necessary.
18th July 2018
20th May 2019
22nd March 2016
21st January 2021
31st March 2023
18th March 2019
To keep up to date on the latest concerning QI at ELFT, follow us on our socials.
