Planning template
*As Kerry (Project Manager on this project) had now gone on maternity leave, Rikke and I (Vivien) facilitated this session*
The aim of the day was to move the ideas closer towards being tested (the ‘do’ stage of this work). This is the programme we worked through, our goals were:
- Working groups to provide progress reports on improvement ideas
- Action planning for testing out improvement ideas
- Measuring impact of improvement ideas
- Agreeing homework and next steps
Attendance
Nine people attended this session, there were two apologies and one person was unwell.
Connecting up
For our ice-breaker activity, we asked each person to think of three interesting or unusual facts about themself. Two of the facts were to be true and one false. The three facts were then shared with the group, who discussed which was true and which false for each person. Amid much laughter and some debate, we uncovered tales of sporting achievements and interesting previous careers. We also found out a bit about what people would liked to have done in their lives.
Progress reports from each working group
Group 1: ‘Organisations and services (front line staff) to be aware/comfortable talking about heart failure’
The group had consulted with the Dementia Friendly Motherwell team, to learn from some of their approaches in engaging local communities. These included raising awareness about dementia and identifying simple ways that people can be supported while shopping or using local resources. A short ‘tips’ list had been produced and distributed.
The idea of a logo – ‘I am heart aware’ was suggested. Information postcards, stickers or badges could be produced. It was suggested that the campaign could focus on supermarkets, pharmacies or leisure centres.
Group 2: ‘Education and awareness of GPs/practice staff/stable heart failure patients – more literature in practices/contacting GPs to find out what would help’
The group had previously considered inviting a GP/GPs to join the KiP group, however this had not been possible. It was now considered that the group should contact GPs/Practice Nurses by email and by speaking to groups at MCN (Managed Clinical Network) meetings or other relevant events.
The group felt that GPs were more likely to respond to something concrete, like a request to share the information/FAQ sheet. It was also recognised that GPs may be more likely to use the information if they had evidence that is is a resource their patients would value. The group considered whether sharing patients’ stories e.g. Chris’ story on the KiP blog would be an effective way of raising awareness amongst GPs or other healthcare professionals.
Group 3 /4: ‘Diagnostic bundle/tool – patient information/FAQs’ / local online information for people with heart failure
Irene had discussed with colleagues, who were supportive of the idea of producing information for patients. In particular, the Chest Heart and Stroke advice line had received requests for similar information and therefore recognised the need.
There was some discussion about the possibility of SIGN (Scottish Intercollegiate Guidelines Network) creating a pathway for people with heart failure.
It was acknowledged that not all tests were available throughout Scotland and that a gap in the availability of information was widely recognised.
The possibility of the group creating a Lanarkshire pathway was discussed. This could be in the form of a flow diagram with information about how to manage the condition and with colour coding to identify professionals/supports involved at each stage.
Discussion on progress
There had not been a great deal of progress since session 4 and there was a sense from the group that there was not enough time remaining for KiP to have any effective impact. There were questions about how this work could be sustained and whether there would be any resources – financial or other support from IRISS to continue towards implementing the changes explored throughout the project.
The original plan for KiP was revisited, this highlighted a key aspect of the project – that the group members were the people with the power to make change rather than IRISS whose role was to facilitate the group.
The group discussed what could be realistically achieved before the next session, this thinking informed the afternoon action planning sessions.
It was agreed that there is an information gap for people with heart failure and therefore, that supporting GPs to provide more tailored information to patients would be a useful outcome of this project.
The group also agreed that the information produced could be shared through the work of group 2 – Andrea agreed to contact GPs/PNs/Practice Managers directly. The materials could also be shared through carers groups or training courses.
European Heart Failure Day and associated website was considered as a route for sharing information produced through KiP more widely.
Example of one of the project report templates that had been completed
Action Planning
This session started with a recap on improvement methodology using the slide show from session 4. The outcomes ‘cake’ analogy was also introduced. This sets out the difference between the concepts: inputs, process, outputs and outcomes. In particular, highlighting that ‘outputs’ and ‘outcomes’ are often confused. Outputs being what is produced, in this case the cake and the outcome being the impact, in this case the happiness felt by the child
The aims of the action planning session were for each group to set out a plan for:
- Testing ideas before the next session (3 Dec)
- Identifying impact measures for tests
- Sharing tests and impact measures with other groups
- Arranging meetings/contact before next session
The groups were asked to focus on:
- Amendments to original plan based on this session’s discussions
- Producing timetable for when things would happen (within and post project)
- Developing a plan for measuring impact and how to learn from this
- Scoring against guidance on approaches to improvement
The three groups then worked on their action plans from session 4 and identified actions to move forward.
Group 2 action plan
Feedback/discussion to main group
The groups fed back to the main group. This allowed group 2 and 3 to come together and their tests of change to be linked.
Group 1: ‘Organisations and services (front line staff) to be aware/comfortable talking about heart failure’
The idea from group 1 was about developing an awareness campaign ‘I am heart aware’. The group discussed how well the learning for the dementia awareness raising campaign could be transferred to work for this group. There were questions about what being ‘heart aware’ might mean for people working in a supermarket. It was suggested that they may know about food content, but they may be reluctant to give advice without background medical knowledge. Likewise in a leisure centre, People with heart failure may be excluded on the basis of risk and even with extra information, staff may be reluctant to offer advice to a person with heart failure. The group agreed that this idea should be further explored before the final session.
Group 2: ‘Education and awareness of GPs/practice staff/stable heart failure patients – more literature in practices/contacting GPs to find out what would help’
Group 2 looked at engaging with professionals. Andrea identified that there would be an opportunity to meet a group of local GPs at the MCN meeting in November. There was also the possibility of attending an event for professionals on ‘breathlessness’. This might include professionals who provide diagnoses and support for people with heart failure. The materials produced by group 3 would be introduced to GPs and staff. Andrea would circulate the materials to GPs, Practice Nurses and Practice Managers.
Tests would be around asking for feedback on the materials and asking for other ideas about how this information could be disseminated.
- email contact
- speaking to groups at meetings (seeking endorsement – collecting statements)
- spreading to other/all GP practices
- making information available at libraries
- making information available on line
Group 3 : ‘Diagnostic bundle/tool – patient information/FAQs’ / local online information for people with heart failure
Group 3 decided to focus on developing an information sheet for people awaiting diagnosis of heart failure. A short information sheet was suggested with links to various relevant resources and a short description of each resource. The information would also include FAQs. These would be identified by people with heart failure and carers within the group.
Richard and Irene agreed that there was already some useful information within their organisations. Chris identified that before his involvement with KiP, he wouldn’t have known that Chest Heart and Stroke or British Heart Foundation could be a source of information.
Tests would involve development of materials. Richard and Irene agreed to produce information and get feedback from other group members on its accessibility relevance etc.
- develop resources list and signposting information (by 14/11)
- test within group for consensus on content and accessibility
- feedback from wider KiP group and colleagues
- develop FAQs for those at point of diagnosis (by 17/11)
- test within group for consensus on content and accessibility
- feedback from wider KiP group and colleagues
Measures of success for groups 2 and 3 would include:
- Endorsement from GPs
- Information sheets are requested (numbers?)
- Feedback on content (group/ colleagues/GPs/ other staff/people with HF)
Feedback and evaluation
All smiley faces.
What went well?
- We feel we have made progress
- Our goals feel achievable
- The group was a good size
What didn’t work so well?
- The room was still a bit cold
- Only de caff coffee
- Didn’t like the tea
- Wi-fi in building!
What will you take away from the day?
- We have clear actions plans and homework
- We have an end goal in sight
- Enjoyment