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Health Sector: Clinical System Improvement
The need for improvement in clinical services, both in terms of productivity and clinical quality and safety, is evident. There has recently been considerable interest in and growing practical application of lean thinking in the NHS. The NHS Institute for Innovation and Improvement has been supporting this work and is seeking to promote the widespread take up of lean across the NHS to support the productivity challenge.
We’d echo the findings of early work in the NHS and overseas hospitals that shows considerable scope exists to improve patient care, staff satisfaction, systems performance and cost effectiveness by the widespread adoption of lean. This parallels the experience in other industry sectors – initially seen in the Japanese-led revolution within manufacturing.
However most hospital processes currently being 'leaned' through the application of these principles and tools are relatively linear and less complex than most healthcare services. Our experience from healthcare and industry points to the need for lean to be used within a wider ‘whole systems’ perspective. We understand the need for Wholeness as well as Leanness. We have developed an approach to ‘whole systems rapid improvement events’ which delivers significant, rapid, sustainable performance improvement in health care services even in complex community settings.
Tricordant can offer Whole Systems ‘Rapid Improvement Events' (RIEs):
- The ‘whole system’ comes together in one room. All parties who own parts of the system are identified and invited to meet and to work with each other. Through the process they come to understand their inter-dependence. Teams are built!
- The teams are supported by experienced external facilitators who can bring a deep experience of applying ‘whole systems’ and ‘lean’ principles. Teams are well equipped and supported!
- The team are taught the principles to unpick and solve inherently complex, multi-faceted, non-linear, systems problems. They are equipped with the tools to apply to their system. Novel, holistic solutions are found!
- Rapid Improvement Events have a high profile and senior stakeholders are encouraged to back the RIE process and empower the nominated team to act. Things get done!
- The deliberately tight timescales the RIE creates focus and a sense of urgency. They take only a few days or weeks. Things get done quickly!
- Local organisation improvement leaders can learn about whole system rapid improvement principles and the approach by co-working with us. The approach is transferable!
Relevant papers:
Performance Improvement in Complex Healthcare Services 
Productivity in the NHS - The Whole Story?
Not Invented Here – the Application of Industrial Improvement Approaches in the NHS
Relevant exemplar projects include:
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“I was unsure about the review before we started. But it was really stimulating and useful. You helped a range of clinical and managerial staff step back and understand our service with a fresh perspective. From this we now have a common vision and can work much better together to make it happen. This is good news for our patients and staff.”
Dr Tessa Malone, Consultant and Clinical Director, Contraceptive and Sexual Health Services, Stockport PCT
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