Transcript U Using Care Bundles Steve Kingsbury and Ann York Habit Handle Demand Extend capacity. Let go of families. Process map and redesign. Flow management. Use Care Bundles. Average 43% 40% 30% 30% 38% 8% Look after staff. 68% Data from.

U
Using Care Bundles
Steve Kingsbury and Ann York
Habit
Handle Demand
Extend capacity.
Let go of families.
Process map and
redesign.
Flow management.
Use Care Bundles.
Average
43%
40%
30%
30%
38%
8%
Look after staff.
68%
Data from 100 teams in 2005
Average total score 38% (42/111)
Remember…artificial variation
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Natural variation
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Users are different
We are different
Artificial variation
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How we do things
Research shows that artificial
variation has greatest impact on
services!
Use Care Bundles
Links to High Impact Changes number 6:
‘increase reliability of interventions
by designing care based on:
what is known to work
and
that service users and carers inform and
influence’
Care Bundles
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Manage complex problems
Reduce variation in practice
Aim to ensure everyone receives the best
care
Defines what you do
Draws on evidence, expert view and user
views
Easy to monitor compliance
Table discussion A

What problems could you develop
care bundles for?
Developing a Care Bundle
1. Know current best practice
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Decide what you are going to develop a
Bundle on!
Something where a combination of
approaches are needed
Find evidence e.g. NICE, Drawing on the
Evidence
Developing a Care Bundle
2. Local best practice
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Evidence from research may not be
available!
Discuss and reach consensus
Ask users what works
Developing a Care Bundle
3: Implement and monitor
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Quick checklist in file
Monitor frequently
e.g.Surgical site infection Bundle
Appropriate antibiotic prophylaxis
Control of blood glucose
Use of ‘clipping' not shaving
Maintain core temperature above 36.6 C
Developing a Care Bundle for Anorexia
Nervosa in Richmond CAMHS
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Eating Disorders team gathered evidence
Asked users what helped
Agreed together what needed to be done
at assessment and by whom
Agreed package of interventions
Agreed monitoring
Wrote up
Have a bundle implementation plan
Richmond Anorexia nervosa bundle
(1)
Assessment
Choice appointment unless BMI under 15
 Multi-disciplinary assessment within 2 weeks
 Systemic
 Dietetic
 Psychiatric
 Physical
 EDE
Richmond Anorexia nervosa bundle
(2)
Intervention with 3 monthly reviews
 Physical care
 Family therapy
 Psychiatric
 Multifamily groups
 Individual
 Dietetic
School refusal bundle
development in E Herts.
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Process
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Did a team role play to explore various
experiences
Formed a working group
Met and written a draft pathway and bundle
Planning initial meeting with EWO
management to understand their process
After that will have multi-agency workshop to
consider plan
Forgotten user input!
Table discussion B
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Go back to your suggestions
Pick one and devise a Bundle for one of
them…
Who, what, where, when…