Workflow Optimisation hereweare org uk Workflow Optimisation Who

Workflow Optimisation hereweare. org. uk

Workflow Optimisation Who we are: Fourth Floor, 177 Preston Jonathan Serjeant Rd, Brighton, BN 1 6 AG Lewis Smith +44 (0)1273 560 243 info@hereweare. org. uk

About Here is a not-for-profit, social enterprise, membership organisation delivering NHS services. Our members are local GPs, Practice Managers, Practice Nurses and our own staff. We believe these things to be true: • Care is something we can choose to show for ourselves for each other at any time. • Care is not exclusive to an appointment or a medical intervention. • We have a right to take control of our lives. • It takes courage to step forward and effect change. The capacity to lead is within us all. • Every interaction can be powerful if we choose to engage consciously. We know the ripples from these movements can go on to create profoundly positive change. • True care is a way of living that creates meaning between us all. We believe these things to be true: Care Unbound. To create more possibilities for care in every moment. hereweare. org. uk

About Workflow Optimisation http: //www. workflowoptimisation. co. uk/ hereweare. org. uk

Summary • Workflow Optimisation is a new approach to administration entering a General Practice • It saves up to 40 mins per day per GP • Data quality is enhanced in the medical record • The patient journey is facilitated • Robust governance structures supported by MDOs • We have now trained in excess of 80 practices and have further training planned for more than 200 practices hereweare. org. uk

Origins of Workflow Optimisation • Extended Integrated Primary Care (EPi. C) Prime Ministers Challenge Fund April 2014 • 5 Workstreams • Extended modes of access • Community Navigators • Community Pharmacy • Extended Hours • Redirection of Workflow • 1: 1 training • Dr Robert Varnam – Head of General Practice Development NHS England came to visit as initial data stood out • Access fund to develop further 40 practices in 3 months • 11 practices trained hereweare. org. uk

Process development • 1 practice – Benfield Valley Healthcare Hub • 1 GP – Dr Jonathan Serjeant • 1 Administrator – Jayne Williams • 4 months to develop working through a variety of letters • Dr Jonathan Serjeant – 1 hour per week for governance • 11 practices trained • 1: 1 training hereweare. org. uk

I have never been involved in a change programme that has led to such a dramatic improvement in service so quickly. In one week the surgery was transformed Dr Naz Khan – Chief of Clinical Leadership and Engagement Brighton and Hove CCG hereweare. org. uk

Our Purpose Our purpose is to help people make informed decisions about their care with their clinician. How we achieve what matters to the person is by processing their clinical correspondence in a timely, safe and efficient manner and ensuring that their medical record is up to date when they need it. This is achieved through a comprehensive training package and supporting materials. hereweare. org. uk

Our training journey hereweare. org. uk

Our training journey • Significant shift in how we trained people • Went from 1: 1 to classroom based • Initial Challenges • Time Constraints • Clinical System and IT issues • Lack of Docman installed on our systems • Releasing the “right” staff • Developing the training model after EPi. C hereweare. org. uk

Our training journey • Training sessions developed • Group working • Feedback from students “…I thoroughly enjoyed the course. It has given me the confidence to push forward the final stages of implementing workflow redirection. As a result of the course I am going to recommend the additional actions as advised. I think you have done a marvellous job in training a group of people with very different skill levels. Thank you very much. . . ” Chapel Street Surgery “This has proved to be more than worth the initial investment in time required to train the admin team. There has been a very noticeable reduction in the number of letters. The quality of coding of information improved in terms of both consistency and coverage - Dr Peter Devlin “…It is a very relaxed atmosphere. It didn't matter how many questions you asked. The trainers were always happy to help. It would have been good if the venue was a little nearer! I will take back all the info to the surgery and become more efficient in coding and helping GPs to have more time to see patients. I can't think of anything I would like more help with, it will be nice to have the follow up visits, where I am sure there will be lots of questions…” Norton Brook Medical Centre hereweare. org. uk

Our training journey • Current model • Learning • Robust practice protocol in advance of training • GP Champion identified and fully engaged – separate half day course • Administrator time agreed to implement/process workflow • Backlog busting hereweare. org. uk

Learning Intention • To understand the purpose of Workflow Optimisation. • To be able to recognise clinically relevant information contained in the clinical correspondence. • To be able to process and action a letter to completion or to forward to the correct recipient. • To begin to implement the Workflow Optimisation process in practice. hereweare. org. uk

Learning Outcomes • To be able to process a letter to completion in a safe, efficient and timely way • To move a person through their journey in a safe, efficient and timely way • To provide an accurate and up to date record for the patient when they need it, allowing them, with their clinician, to make an informed decision as to their care hereweare. org. uk

Clinical Governance Fourth Floor, 177 Preston Rd, Brighton, BN 1 6 AG +44 (0)1273 560 243 info@hereweare. org. uk

Clinical Governance • How to do this safely? • The structure • GP Champion • Medication Protocol • Audit and Feedback tool • Significant event collection • Medicolegal assurance . hereweare. org. uk

GP Champion • Fundamental requirement • 1: 1 support • Initially support, audit and feedback on weekly basis • Interval stretched over time • Collate feedback from clinicians • Helps form practice policies • Schedule requirements 10 -12 hours GP input over first 3/12 in this role . hereweare. org. uk

Medication protocol • Our learning shaped the protocol • High risk • DMARDS • Anticoagulation • HIV Medication • Drugs prescribed outside of primary care • Enhanced patient safety when implemented • Role of pharmacist supporting? . hereweare. org. uk

Audit and Feedback • Medication • Under-coding • Mis-coding • Over-coding • Incorrect action • RAG Status hereweare. org. uk

Audit and Feedback PCCPA GP Audit Date: Print Name: Audit by: Signature: Feedback Date: RAG Status: R = Red (Unallowable), A = Amber (Allowable), G = Green (Perfect). Patient ID Date of Letter Type / Speciality Medication Over-Coding Under-Coding Mis-Coding Incorrect Action RAG Status Other Notes hereweare. org. uk

MDU Underwriting hereweare. org. uk

Benefits - At a practice level • Timely updating of medical record • Accurate and consistent information entered • Stewardship of the patient journey • • DNA Check • Blood test booked there and then • Follow up appointment resolved • Etc. Clinician time saving • Epic pilot data 40 mins per day per full time GP • Data from wave two of training 63 practices 30 mins per day per full time GP • Consistent 80% letters, read, coded, actioned and completed when fully implemented by trained practices • Assumptions underpinning time saving • Upskilling of team • Increased resilience • Ability to review back office functions and better practice sharing hereweare. org. uk

At a CCG level • Change management programme successfully implemented AND maintained • Data quality • Greater impact for risk stratification, risk modeling etc. • Consistent data entry across the geographical footprint • Ability to adapt Read code use to local requirements • ? Read code formulary • Easier audit potential re chosen clinical areas • Local practice resilience increased • Skill to train Workflow Optimisations remains within your local team. hereweare. org. uk

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Where are we now? hereweare. org. uk

NHSE Funding hereweare. org. uk

What you get • Signed Mo. U (preparation required, expectations, and benefits) • Manuals and Protocols • E-Learning tool • CPD accreditation • Web. EX GP Champion support “I thoroughly enjoyed the course. It has given me the confidence to push forward the final stages of implementing Workflow Redirection. As a result of the course I am going to recommend the additional actions as advised. I think you have done a marvellous job in training a group of people with very different skill levels. Thank you very much”- Chapel Street Surgery • Forum – Moodle (E-Learning and Forum functionality) • Classroom training here/there – 4 days + ½ day GP Champion training • Site visits/ Web. EX offered as ongoing support • On-going online, telephone + Web. EX support to trainers, to embed the learning . hereweare. org. uk

Any Questions? hereweare. org. uk

Fourth Floor, 177 Preston Rd, Brighton, BN 1 6 AG +44 (0)1273 560 243 info@hereweare. org. uk