Clinical Quality and Productivity Improvement

Clinical Quality and Productivity Improvement - Overview

Medical Mosaic’s Quality and Productivity services are proven and innovative. We have introduced the sharing of financial risk with our clients, to work alongside our experience, capability and commitment.  We work at any scale, from specific CIP projects through divisional QiPP programmes up to Trust reorganisation and redeployment of services across communities.

·         Most Trusts have completed a number of Quality, Productivity and Cost Improvement projects, starting and achieving them within the single-year timeframe. Although targets have commonly been met, projects have often underperformed and had to be augmented and replaced. Single, self-contained projects are increasingly ‘used-up’. Future Service Improvements and CIPs need longer-term preparation, are more complex and have more dependencies within and outside the Trust. The pressure to save more cost increases all the time.

·         New initiatives require collaboration across whole delivery systems and pathways. Services need to engage and support each other at all levels and opportunities across boundaries need to be exploited. As well as effective project control and management, the key continues to be good clinical engagement, careful analysis and planning which deals with a wide range of needs and dependencies.   The challenge has never been greater – isolated areas of effort will no longer achieve results on the required scale. But it can be difficult for Trusts to commit to such large-scale programmes, without the capability of clinical and staff engagement and very sound project management.

 

Our Approach and Practical Skills

All of our practical skills are required:

  • Clinical Engagement is at the heart of most service improvements. Typically starting with a programme of engagement with clinicians, our programme gathers ideas, problems and opportunities to ensure good project identification and buy-in. Feedback on our style of engagement is very positive, and leads to good ‘championing’ of the projects.   
  • Pathway Challenge, Analysis and Reform has featured in many of our programmes. We run a checklist of the many ways in which pathways may be reformed within a specialty or across a service type. Reforms and benefits are sought in terms of the patient experience, quality of provision, resource saving, costs to commissioners and costs to the provider.
  • Facilitation is at the heart of the programme – speed is usually of the essence, but we also start the transfer of skills on day-1 of the programme. Participating staff are empowered and equipped to deliver projects and outcomes. They should be confident to run a second round of the programme without our support.
  • Leadership Development develops the people and the organisation. It helps to implement structures, roles and relationships, with planning and reporting within the programme and at board level. We have long experience in mentoring, reduction of conflict and improvement of recognition at all levels.
  • Project Structure and Definition are part of the science of Improvement. Our experience – and publications – identify ‘pathway’ projects, supporting or ‘enabling’ projects and ‘realisation’ projects, each with its own approach and characteristics.   
  • Programme and Project Management are vital to success. If the Trust does not have a well-established ‘PMO’, we can provide the basic structure and show how to use it in a critical and positive way.  
  • Process Modelling and Development support pathway reform and all areas of organisation and flow. We have a recognised modelling tool which captures flow-charts for clincians, costed resource-profiles for managers and financial analysis for accounting.
  • We draw upon standard methods without necessarily using the jargon – the vocabularies of Managing Successful Programmes, Theory of Contraints, LEAN, Six-Sigma and Prince-2 are used only when it is needed.  
  • Business Cases and Contract Development are commonly required in service improvement. As well as helping with the formal stage of procurement or contracted provision, we focus on the creative capture and optimal delivery of requirements

Risk/Reward Share – “Results, not Reports!”

 

Our approach lends itself to Risk/Reward share, and we have a track-record of making it work to mutual benefit. It starts as soon as the programme has been defined and fitted to the client’s needs.  

  • During Project Identification, Development and Planning the risk/reward structure is linked to the delivery and acceptance of project plans and objectives.
  • During Project Initiation and Delivery, risk/reward is linked to realisation of the project benefits in terms of quality and cost measures.
  • The risk/reward approach depends on a successful team relationship with the client. Objectives are clearly defined and aligned, and contingency is clearly scoped and managed.
  • Risk/Reward Share is key to our sense of client accountability.  If external consultants are truly going to add value, they will accept that only outcomes are rewarded.

 

Productivity Improvement Case Study

Medical Mosaic is in three-year partnership with the Birmingham Children’s Hospital FT, to deliver a programme of Productivity Improvement with their Clinical Support Services directorate.

Click here to ready the full Birmingham Children's Hospital FT case study