SPSP Acute Adult Collaborative

This programme uses a breakthrough series collaborative approach lasting 2 years to bring together NHS Scotland boards seeking improvement in the topic area of falls and deteriorating patient.

About SPSP Acute Adult Collaborative

Developed by the Institute for Healthcare Improvement (IHI), a breakthrough series collaborative is a focused improvement project and learning system that brings together teams from hospitals or clinics, schools or agencies in a focused topic area towards a common aim.

The collaborative uses QI methodology and works through the stages of The Quality Improvement Journey

Examples of using quality improvement for people living with frailty

The breakthrough series collaborative model has been used within the SPSP Acute Adult Programme to deliver previous improvement work.

Frailty at the Front Door Improvement Collaborative worked with 5 NHS boards to deliver the following impacts:

• New roles to support deliver of screening and care co-ordination for people living with frailty
• New frailty teams and specialty beds that deliver Comprehensive Geriatric Assessment
• Decreased length of stay of patients
• Increased discharge of people over 75 years old within 48 hours

Key steps of establishing and delivering a breakthrough series collaborative within the SPSP Acute Adult Programme

Key steps in developing and delivering the SPSP Acute Adult Breakthrough Series Collaborative

1. Creating the Conditions: Involved establishing a team with the appropriate improvement and project skills, governance and resources to deliver the work.
   
   
2. Understanding Systems: A co-design approach was taken to this work and an Expert Reference Group (ERG) was formed with clinical and quality improvement experts from all NHS Scotland boards. Using key data and quantitative feedback, challenges and needs within the system were identified to help shape the work.
   
   
3. Developing Aims: Working in partnership with the ERG, the aim and change package was developed. This work was underpinned by the SPSP Essentials of Safe Care (EoSC).
   
   
4. Testing Changes: Change ideas and measures were tested with NHS boards to ensure they were practical, achievable and measureable whilst supported with the correct resources and evidence.
   
   
5. Implement: Support is provided to NHS boards to implement the changes in a small identified area within their service. Support is offered through coaching, data measurement and feedback. Interventions such as project surgeries and improvement networks run throughout the duration of the collaborative.
   
   
6. Spread: A learning system is developed to capture the work of boards and impact that is being realised. This learning is shared to help others accelerate their own improvement.

Resources to implement

• Falls Change Package: This resource will support NHS boards to make improvements to support the reduction of falls and falls with harm by focusing improvement activity around the driver diagram.
  
  
• Falls Measurement Framework: This resource will support NHS boards in gathering data against defined measures to help identify if the changes they make result in an improvement.
  
  
• Deteriorating Patient Change Package: This resource will support NHS boards to improve the recognition and response to deterioration and associated reduction in the cardiac arrest rate.
  
  
• Deteriorating Patient Measurement Framework: This resource will support NHS boards in gathering data against defined measures to help identify if the changes they make result in an improvement.

An Equality Impact Assessment (EQIA) has been completed for this programme of work. Please contact the Acute Care team if you would like to view a copy of this at his.acutecare@nhs.scot