Three things to think about NOW if you want to transform outpatient services

1. Engage early and engage broadly

It may sound obvious but it’s vital, because outpatient services involve a diverse team of people. Patients and staff of all levels may be needed in an outpatients transformation project. Think broadly about who needs to be consulted from the outset: some of the Trusts in this project experienced delays because the Information Governance team was involved at a later stage, or due to not engaging administrative staff who would be required to capture new information and were reluctant to increase data capture until learning the purpose.

Estates and Facilities may be needed in unexpected ways: Oxleas did not initially have enough rooms available to conduct virtual consultations alongside face-to-face consultations despite having the staff available and patients keen to get started. Another Trust, Kingston, described the need to find the right kind of space that was bright enough for the best possible visual interaction for its virtual consultation. HR may need to be involved to provide advice on flexible working if looking to advance conducting virtual consultations from home.

Whatever the project, our tip is to make sure to think beyond the initial team who will deliver the service, map these additional stakeholders(links to stakeholder mapping resource) and engage them early to save time later in the project.

 2. Use simple change models to help

There are a myriad of change models and tools out there, and we focused consistently on the methodology used by the IHI given this is where the breakthrough collaborative model originated.

Resources found to be most useful were the simplest – especially the Plan-Do-Study-Act to stakeholder mapping and process mapping tools.

There’s also Life QI which is a great tool for planning, measuring and communicating about projects, and connecting with others doing similar improvement work across the country. Life QI is a free tool to use, simply contact your local AHSN to gain membership.

Trusts reported finding the models and tools useful, but it wasn’t a one-size-fits-all. This resource library  pulls together some of the most common tools that people found useful. Explore them but don’t waste time using them as tick-boxes for change management: some will suit the project and organisation in question better than others. Learn about them all and choose what will add the most value.

Spread & Adoption

  • Don’t be afraid to share your failures
  • Share early, and share often
  • Share the simple stuff too
  • Turst your colleagues, your staff, your peers and yourself
  • Patients are your biggest advocates
  • Keep learning from each other

(Jones, 2017)

 3. Seek out others who are doing similar things and share your experiences

In amongst the learning, the successes, the experiences, laughter and fears discussed throughout the Collaborative the enormous power of sharing between different organisations became clear.

Being able to listen to how others had solved similar challenges sparked ideas and solutions for people to take back to their own Trust and made change faster and easier. Every Trust team had experienced some sort of barrier or internal resistance at some level along the way: hearing about how others had dealt with this and preserved with change was valuable. There were brilliant examples of trusts sharing practical resources – in one instance a trust was able to advance in five months what a fellow trust had taken 18months to do because the latter was generous enough to share Its learning and key documents.

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“This collaborative has really helped us accelerate testing video consultations with out-patients”

Jonathan Grellier, Kingston Hospital

Kingston Hospital

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Always ask. Across the NHS colleagues are enormously generous but you need to seek them out. If you can’t find others to meet with face-to-face, try Life QI which helps you to link up with other people doing similar projects (link)or contact your local AHSN or NHS Improvement regional team.

And if inspired – read more here about setting up your own Collaborative!

“Start anywhere, start small, just start something!”

Louise Molloy, Outpatient Improvement Programme Manager, King’s College Hospital NHS Foundation Trust, on getting started with a transformation project. Read more from Louise here