Nick John, Analyst, shows us how he’s using the Model for Improvement to scale up and spread the next generation of NHS Safety Thermometers.
The ‘Next Generation’ Safety Thermometers are national tools that have been designed to measure commonly occurring harms in people that engage with specific services (medications, maternity, mental health, children and young people). They are point of care surveys that are carried out on a single day each month. This data capture supports improvement in patient care and patient experience, prompts immediate actions by healthcare staff and integrates measurement for improvement into daily routines.
With the majority of the next generation Safety Thermometers’ pilots ending last year, we wanted to focus on the ‘scale up and spread’ of these tools. We decided to use improvement methodologies and the model of improvement to increase the likelihood of success, and to maximise the use of the Safety Thermometers across the country and beyond.
As you can see from the map above, 132 organisations across England and Northern Ireland have submitted data as part of the pilot over the last 12 months.
Setting an Aim
The first step of our improvement journey was to set a ‘SMART’ aim. We looked at what data we were already collecting and decided that the ‘number of organisations submitting data to a next generation Safety Thermometer’ would be a good place to start. We looked at the current participation numbers and compared this to the total number of organisations in the country.
After some discussion we thought that a 50% increase in the number of submitting organisations would be both realistic and achievable. Including a time period in your aim is very important. To find a reasonable time period we looked at our previously collected data and used this as a baseline. We did some analysis and simple linear regression to add a ‘line of best fit’ to this data. This gave us the current rate of growth of organisations submitting data. Using this information we surmised that at our current rate of growth it would take 11 months to reach our goal of a 50% increase.
To challenge ourselves we decided to attempt to reach this goal in half the time – Feb 15 to Jul 15. Putting all this together, our final aim statement became: 50% increase in the number of organisations submitting to the next generation Safety Thermometers by July 2015.
Building a Driver Diagram
Now we had a solid aim statement we could begin the creation of a driver diagram. We used an existing template, with the primary drivers being focused on:
This gave us a starting point to work from. We decided that the primary drivers for our system should be:
- Webtool (technical platform)
- Collection to publication process
Once these drivers were in place then we could flesh out the secondary drivers and even add some initial ideas for potential tests of change. The first draft of our driver diagram can be seen below.
With the driver diagram complete, our next step will be to design a robust measurement strategy including outcome, process and balancing measures. Once this is in place then we can begin to run rapid small scale PDSA’s and see the effect this has towards our overall aim. We’ll keep you updated with our progress.