Providing ‘The Right Care’ and reducing care variation


Phil Kloer, Medical Director

Jessica Svetz, Head of Improvement and Transformation

Christine Davies, Head of Organisational Development


Hywel Dda University Health Board


This Bevan Exemplar project aims to improve care by focusing on the needs of the patient.


Background


The ‘Right Care’ approach is driven by what matters to and for patients. The ‘Right care’ approach is focused on providing the most effective care to those who want and need it. It aligns the standards of care within the available resources, ensuring equity in the delivery of care and maximising the available skills and resources across the pathway.


Aims


The ‘Right Care’ pilot project is aimed at testing a robust improvement and organisational development methodology focused on reducing variation in one care pathway. At the core of the pilot is testing how the Health Board encourages staff at all levels to engage with patients and develop standards of care focused on value added to the patient’s care and experience.


The aim of the project is to test the thinking about how the Health Board as an organisation fosters a ‘Right Care’ culture by putting into practice key organisational development and improvement approaches within the hip fracture pathway.


Challenges


The main challenge was creating an environment which supported engagement, collaboration and team working from multi-professional teams across a three-hospital system. This collaboration will enable NHS professionals to learn from what works well (and not so well) and be able to develop a shared vision of standard of care.


To overcome the challenge, the team:

  • Created and hosted an environment where different voices and perspectives of the system can be heard.

  • Used the role of the “credible expert” early in the group process to provide appropriate clinical gravitas and external system challenge.

  • Ensured they provided the time and space to have conversations, as people will coalesce around doing the right things if provided with reflective time and the right support to work things through together.


Outcomes


The anticipated benefits from this pilot are:

  1. Improved patient experience.

  2. Improved staff experience.

  3. Timely access to the most appropriate clinician.

  4. Reduced de-conditioning.

  5. Reduction of average length of stay in hospital.

  6. Decreased mortality rate.

  7. Reduced cost of care.

  8. Improved patient outcomes.

Reduction of flow constraints of care in in-patient areas


Next steps


The multi-professional group has collaboratively developed a standardised pathway of care for patients who suffer a hip fracture. This pathway is being piloted in Winter 2018/2019.


In addition, a frailty orthopaedic standardised pathway of care has also been developed which will be piloted in Winter 2018/2019.


Another workshop is planned in early 2019 to discuss the outcome of pilot and next steps.



“We have found this project has benefited from being a Bevan Exemplar in that it has provided us with recognition, credibility, support and a challenge.Jessica Svetz, Head of Improvement and Transformation




Part of cohort Bevan Exemplar Projects 2017-18