Lyn McIntyre on her MBE, improvement and change at scale

Lyn McIntyre, Deputy Nurse Director, Patient Experience, NHS England, was recently honoured with an MBE for services to nursing. ‘Harmfree’ care caught up with Lyn to ask her about the work she has been doing.

Lyn McIntyreCongratulations on your MBE, how does it feel to get such an honour?

It was amazing, I knew around 5 weeks before I received it but had to keep it very quiet, and it was hard not telling anybody! I feel very honoured because it is for services to nursing but particularly for the Stop the Pressure work across the region with the 50% reduction and the nutrition and hydration work. It is amazing that these programmes have been recognised and it’s great for nursing too.

You’ve been leading a lot of work in the Midlands, what are you most proud of?

The thing that I am most proud of is the engagement across the whole health economy. Even though Stop the Pressure is a nursing led programme, without the engagement we’ve had from the wider health economy we never would’ve achieved what we have. It was a social movement and it is a fantastic when services are improved when the whole health economy comes together to make it a better experience for patients.

What do you think were the key factors in making this change happen?

We had buy-in from the SHAs originally as they wanted to leave behind as a legacy an improvement in patient safety. That sign up from the top was crucial and then it was working with the organisations that were open and had the motivation to get involved. Once others saw the data and the improvement that was happening, the programme gathered momentum.

Safety Thermometer was amazing because is helped us to measure the data and we needed a measurement tool. Once we started reporting that and we could see not only the numbers but the improvements too it shifted the mentality. It changed from “is it your pressure ulcer or mine?” to “it doesn’t matter, we don’t want the patient having them at all”. Then discussions began about how we avoid them and how we can stop them happening at every part of the pathway and the 88 organisations started working together effectively.

How did you engage the variety of groups including clinicians, mangers and leaders?

We setup a collaborative, which helped massively, bringing organisations together and discussing with them how you get improvement and how you measure properly. We also had change agents in the organisations and we supported them to make the changes. Communications was also important to find out what were the key things that staff needed support with and also to get across our key aims for the campaign.

You have to supply the education and resources needed to enable staff to achieve improvement; we did an education review and tried to make it innovative and fun. One of the methods was the Stop the Pressure board game, this helped us get our messages across in a different way and got people working in teams, discussing their issues.

How was your experience using the Safety Thermometer to measure at scale across the region?

I worked out a timetable where 3 or 4 more PCTs came online each month, we then got the whole health economy doing it every month. We fixed a Safety Thermometer day where the organisations would all collect their data and we would have a conference call afterwards to discuss any problems and what we can learn for next month. Publishing the data was the next big step and we would feedback what it was telling us and the improvements it was showing to the organisations. This helped a lot as people could see from newsletters and feedback we were sending out that they were improving and this spurred them on.

What’s next for you and your region?

We have been hovering around that 50% for a few months now and the next phase is understanding how we can improve further. We also are going to do some work around exactly how many are avoidable. The MBE has highlighted how far we have come and now we’ve got the motivation to do phase two. 50% is not the end of it, we are going to keep going, even if it is 1% less, it is all improvement and a better experience for patients.