Transcript Document 7222715

Implementing the
National Action Plan
The Wheelchair & Seating Services Approach
John Colvin
Introduction & Background
• Moving Forward – March 2006
• Scottish Executive Response to Moving Forward
– January 2007
• Funding announced following National Spending
Review – November 2007
• Business Case Submission – September 2008
• National Action Plan – February 2009
What have the Centres done to
implement the Action Plan?
• Implementing our specific actions on the
National Action Plan
• Implementing our local business cases
• Participating in national work streams
• National Performance Indicators
• We are currently half way through
a 2 year planned, funded project
How have we done this?
• Project Management
–
–
–
–
•
•
•
•
Governance
Planning
Risk Management
Responsibility Charting
Kaizen/Rapid Improvement Events
Continuous Improvement
Change Management
A ridiculous amount of meetings
KEY:
WSS National Action Plan
DELIVERABLES
DELIVERERS
WSS NATIONAL
PROJECT BOARD
RESOURCES
WoS WSS Business Case
Implementation Plan
WoS Input to National Action Plan
WoS WSS
IMPLEMENTATION GROUP
WoS REHABILITATION TECHNOLOGY
CONSORTIUM
WestMARC
NHS Lanarkshire
Business Case
Implementation Plan
SENIOR MGT. GROUP
…….etc, etc etc
Powered Chairs
NHS LANARKSHIRE
PROJECT BOARD
Staff
Governance
QMS
One-Stop Shop
Skills Maximisation
Repair Times
RTP Reductions
NHS LANARKSHIRE PROJECT
TEAM
WoS WSS
HR SUB GROUP
PROCESS
IMPROVEMENT TEAMS
Architects
User Involvement
NHS Estates
Bioengineers
Engineers
Stores
Therapists
Clinical Stakeholders
Mgt & Admin
Technicians
PLG
Project Management
WSS National Action Plan
WSS NATIONAL
PROJECT BOARD
WoS WSS Business Case
Implementation Plan
WoS Input to National Action Plan
WoS WSS
IMPLEMENTATION GROUP
WoS REHABILITATION TECHNOLOGY
CONSORTIUM
NHS Lanarkshire
Business Case
Implementation Plan
WestMARC
SENIOR MGT. GROUP
User Satisfaction Survey
Overall Satisfaction with Wheelchair Service
300
250
200
150
100
50
0
Very Happy
Happy
Not Very Happy
Very Unhappy
WSS National Action Plan
WSS NATIONAL
PROJECT BOARD
WoS WSS Business Case
Implementation Plan
WoS Input to National Action Plan
WoS WSS
IMPLEMENTATION GROUP
WoS REHABILITATION TECHNOLOGY
CONSORTIUM
NHS Lanarkshire
Business Case
Implementation Plan
WestMARC
SENIOR MGT. GROUP
Identify User Need
!
!
Prescribe a
Direct (Paper
Based) Issue
Enter Clinical
Waiting Lists
5 days
!
Perform
ROUTINE
Repair
Immediate
Action by
Clinicians
(Urgents)
Assess at
Scheduled
Clinic
Provision a Safe &
Useable Device
4 – 10 weeks
!
Assess on
Home Visit
Repair
EXISTING
WSS
Equipment
Perform
URGENT
Repair
Screen the
Referral
4 weeks
2 weeks
Referral To Provision
1 day
1 day
WoS WSS
RTT High Level Pathway
Process ALL
OTHER
Requirements
User’s and Carer’s
Forum Established
•
•
•
•
•
•
Steering group established
Forum established (60 members)
Inaugural meeting held October 2009
1st newsletter issued (Feb 2010)
1st Open day planned for May 2010
Identified as a priority group by NHS
Tayside
WSS National Action Plan
WSS NATIONAL
PROJECT BOARD
WoS WSS Business Case
Implementation Plan
WoS Input to National Action Plan
WoS WSS
IMPLEMENTATION GROUP
WoS REHABILITATION TECHNOLOGY
CONSORTIUM
NHS Lanarkshire
Business Case
Implementation Plan
WestMARC
SENIOR MGT. GROUP
Project Managers
Risk Management
ID
L02
L07
L09
L01
Description & Consequence
The approved funding may be
prejudiced due to delays in
achieving phased expenditure.
Refusal or Delays arise in
obtaining Planning Permission
Impact
(1-5)
Ranking
(PxI)
Risk Aversion Strategy
1.
2.
4
5
20
3.
3
Delays to staff recruitment,
particularly Bioengineering staff,
undermine the staffing plan for
the centre.
Funding for lease may not be
available beyond the current 3
year Redesign Programme.
Prob’ty
(1-5)
5
5
3
15
15
1. Minimise the impression of ‘change of use’
on drawings and text
2. Pre-application discussions with NLC
Planning
1. Close working between Westmarc mgt and
HR sub group.
2. Maintain synchronisation between
recruitment and facility plans.
3. Prioritise these groups through Skills
Maximisation workshops.
4. Support any shortfall from WestMARC.
1.
2.
3
5
Determine substitution/protection options
Ensure that the National Project Board is
fully updated on progress and financial
commitments.
Maximise ‘front- end- loaded’ expenditure
15
3.
Assess contractual exit strategy for lease.
Return to centralised service from
WestMARC.
NHSL + WOS WSS investigate contingency
budget cover.
Appendix H – Risk Register (‘The Top 5’)
F’cst
Run
Out
Risk
Manager
(Lead=Bold)
Mar
2010
1.
2.
3.
Jan
2010
1. B.Gault
2. J Dykes/
Design team
J.Colvin
J.Colvin
B.McWatt
Q3,
2010
1.
2.
3.
4.
J.Colvin
H.Collin
H.Collin
J.Colvin
Q1,
2011
1.
2.
3.
J.Dykes
J.Colvin
JD+JC
HIGHLAND WHEELCHAIR & SEATING
SERVICE
WORKING WITH ILM HIGHLAND
• In April 2009, as part of NHS Highland “shifting the balance” strategy
the Wheelchair and Seating Service began a pilot scheme working
with a local “not for profit” organisation called ILM Highland.
• ILM offer a repair and delivery service to wheelchair users living in
Ross-Shire, Sutherland and Caithness who in the past would have
received their equipment via a courier.
• They have carried out over 400 visits since the beginning of the pilot
in April 2009
• Operatives are trained to set up the chair correctly and are able to
identify patients that have postural and pressure issues that may
require a follow up visit by one of our occupational therapist and
rehabilitation teams.
WSS National Action Plan
WSS NATIONAL
PROJECT BOARD
WoS WSS Business Case
Implementation Plan
WoS Input to National Action Plan
WoS WSS
IMPLEMENTATION GROUP
WoS REHABILITATION TECHNOLOGY
CONSORTIUM
WestMARC
NHS Lanarkshire
Business Case
Implementation Plan
SENIOR MGT. GROUP
…….etc, etc etc
Powered Chairs
NHS LANARKSHIRE
PROJECT BOARD
Staff
Governance
QMS
One-Stop Shop
Skills Maximisation
Repair Times
RTP Reductions
NHS LANARKSHIRE PROJECT
TEAM
WoS WSS
HR SUB GROUP
PROCESS
IMPROVEMENT TEAMS
Architects
User Involvement
NHS Estates
Bioengineers
Engineers
Stores
Therapists
Clinical Stakeholders
Mgt & Admin
Technicians
PLG
Project Management
IMPLEMENTATION GROUP
CONSORTIUM
WestMARC
NHS Lanarkshire
Business Case
Implementation Plan
SENIOR MGT. GROUP
…….etc, etc etc
Powered Chairs
NHS LANARKSHIRE
PROJECT BOARD
Staff
Governance
QMS
One-Stop Shop
Skills Maximisation
Repair Times
RTP Reductions
NHS LANARKSHIRE PROJECT
TEAM
WoS WSS
HR SUB GROUP
PROCESS
IMPROVEMENT TEAMS
Architects
Property Advisors
Clinical Stakeholders
Management
Central Legal Office
NHS Estates
Finance
User Involvement
Project Mgt.
NHS Lanarkshire WSS Centre - Floor Layout
Staff
Stores
Toilets,
Workshop
Changing,
Clinic
Rooms
Showers
Break
Area
Office
Area
Goods
In
Reception
Wheel
chair
Skills
Area
Southeast Mobility and Rehabilitation
Technology (SMART) Services
Fife Satellite Clinic
• Lynebank Hospital, Dunfermline
• Service Users involved in Design
• Large Clinic Room with overhead
hoist
• Workshop for minor repairs and
adjustments
• ‘Wheelchair Shop’ – storage for selection
of chairs and equipment
• Looking at developing a similar clinic in
NHS Borders
WSS National Action Plan
WSS NATIONAL
PROJECT BOARD
WoS WSS Business Case
Implementation Plan
WoS Input to National Action Plan
WoS WSS
IMPLEMENTATION GROUP
WoS REHABILITATION TECHNOLOGY
CONSORTIUM
WestMARC
NHS Lanarkshire
Business Case
Implementation Plan
SENIOR MGT. GROUP
…….etc, etc etc
Powered Chairs
NHS LANARKSHIRE
PROJECT BOARD
Staff
Governance
QMS
One-Stop Shop
Skills Maximisation
Repair Times
RTP Reductions
NHS LANARKSHIRE PROJECT
TEAM
WoS WSS
HR SUB GROUP
PROCESS
IMPROVEMENT TEAMS
Architects
User Involvement
NHS Estates
Bioengineers
Engineers
Stores
Therapists
Clinical Stakeholders
Mgt & Admin
Technicians
PLG
Project Management
WestMARC
NHS Lanarkshire
Business Case
Implementation Plan
SENIOR MGT. GROUP
…….etc, etc etc
Powered Chairs
NHS LANARKSHIRE
PROJECT BOARD
Staff
Governance
QMS
One-Stop Shop
Skills Maximisation
Repair Times
RTP Reductions
NHS LANARKSHIRE PROJECT
TEAM
WoS WSS
HR SUB GROUP
PROCESS
IMPROVEMENT TEAMS
Staff Side Representatives (Unions)
Education & Learning
Human Resources
Organisational Development
Finance
Project Mgt.
Westmarc
Westmarc
Head of
Service
WESTMARC WSS
PRE-REDESIGN ORGANISATIONAL STRUCTURE
Operational
Services
Manager
Head of Neuro
Biomechanics
(6) Senior
Bioengineers
(3) Trainee
Bioengineers
Lead
Therapist
+ 2 Sen. Occ. Therapists
+14 Occupational Therapists
+ 1 Physiotherapist
Tech.
Services
Mgr. (Yoker)
Clinical
Psychologist
Admin Team
Leader
(West)
+3 West Admin Team
Admin Team
Leader
(Central)
+7 Central Admin Team
Admin Team
Leader
(East)
+3 East Admin Team
Admin Team
Leader
(Gen+Prosth)
+ 12 G&P Team
Workshop
Supervisor
+4 Refurb.Technicians
+4 Wheelchair Technicians
+2 Upholsterers
Refurb
Supervisor
Team Leader
Central
+6 Mobile Technicians
+ 1 Driver
Team Leader
East
+6 Mobile Technicians
+ 1 Driver
Team Leader
West
Nurse
+ 1 Nurse
+ 2 Healthcare Assistants
Admin Team
Leader
(Yoker)
+ 5 Yoker Admin.
Workshop
Manager
(SGH,
Westmarc)
+ 4 Technical Officers
+ 1 Technician
+ 1 Technical Storeman
+6 Mobile Technicians
+ 1 Driver
Operations
Service
Manager
Stores
Supervisor
+5 Storeman
Team Leader
(Admin.)
+3 WTE
+2 Part Time
Team Leader
Admin.
(Commodities)
+5 Commodity Officers
ReTIS?
GW1, Report Form,
Letter, Fax, Email, or
Conversation
OR,
Select Repairs
Process (Yoker)
OR,
‘Direct Issue’
from Yoker
Receive
Referral
Log-in to
ReTIS
Referral
Screening
(a)
Place on
Waiting List
(b)
ADMIN
ADMIN
CLINICIAN
CLINICIAN
ANALYSE!
ANALYSE!
OR,
Arrange Onward
Referral
- Seating:
BIOENGINEER
- General:
THERAPIST
- Paediatric:
THERAPIST or
BIOENGINEER
- Powered Chair:
THERAPIST
- Waiting List:
THERAPIST or
BIOENGINEER
- Scheduled Clinic:
ADMIN
Includes:
- Consultation
- Examination
- Physical Handling
- Giving Advice
- Agree Objectives
- Letter or Telephone
- Includes Transport
Arrgts
Communicate
Appt Arrgts
Attend
Appointment
Y/N
ADMIN
ADMIN
PATIENT
(nb ‘Flow’ and
Waiting Time
Implications,
for Scheduled
v Waiting List)
2008/9: 8,327 Appts
Takt Time:
11.2 mins/Appt
(Home & Clinic)
Schedule
Appointment
Clinical
Assessment
(c)
CLINICIAN
2008/9: 7,154 Appts
Takt Time:
13.1 mins/Appt
(Home & Clinic)
ANALYSE!
OR,
Yoker(high %)
OR,
- Direct Issue from Yoker,
OR
- Patient Collects
Confirmation or
Provision of a Safe
and Useable Device
Delivery to Patient
Identify User
Need
2008/9:
12,085
Wheelchairs
Takt Time:
7.7 mins/chair
ANALYSE!
Documentation
+ Prescription
(d)
Raise Job
Sheet for
Workshop
Process Job
Sheet
(e)
Deliver Chair
to Westmarc
Assemble
Seating
Check the
WSS
Provision (f)
Arrange
Appointment
(g)
Fitting and
Fixing App’t
(h)
Arrange
Shipment
CLINICIAN
CLINICIAN
WESTMARC
WORKSHOP
YOKER
DEPOT
WESTMARC
WORKSHOP
BIOENGINEER
CLINICIAN
CLINICIAN
?
Key:
~ CAPTURING BIOENGINEERING UNIQUENESS ~
Activity with Patient
Involvement
(Value Added)
Bioengineering
Activity
WESTMARC WSS PATIENT JOURNEY:
RTT VALUE STREAM MAP
SKILLS
MAXIMISATION
WORKSHOP
21 August 2009
WSS National Action Plan
WSS NATIONAL
PROJECT BOARD
WoS WSS Business Case
Implementation Plan
WoS Input to National Action Plan
WoS WSS
IMPLEMENTATION GROUP
WoS REHABILITATION TECHNOLOGY
CONSORTIUM
WestMARC
NHS Lanarkshire
Business Case
Implementation Plan
SENIOR MGT. GROUP
…….etc, etc etc
Powered Chairs
NHS LANARKSHIRE
PROJECT BOARD
Staff
Governance
QMS
One-Stop Shop
Skills Maximisation
Repair Times
RTP Reductions
NHS LANARKSHIRE PROJECT
TEAM
WoS WSS
HR SUB GROUP
PROCESS
IMPROVEMENT TEAMS
Architects
User Involvement
NHS Estates
Bioengineers
Engineers
Stores
Therapists
Clinical Stakeholders
Mgt & Admin
Technicians
PLG
Project Management
…….etc, etc etc
Powered Chairs
Staff
Governance
QMS
One-Stop Shop
Skills Maximisation
Repair Times
RTP Reductions
WoS WSS
HR SUB GROUP
PROCESS
IMPROVEMENT TEAMS
Wheelchair Users
User Involvement
Stores
Bioengineers
Engineers
Mgt & Admin
Therapists
Clinical Stakeholders
Project Mgt.
Technicians
ReTIS
PLG
HOLD
SCHEDULED
CLINIC
ONE-STOP-SHOP
CLINICS
ASSESS
POTENTIAL FOR
ONE STOP SHOP
N
2 October 2009
Maybe!
Viable?
ENTER NORMAL
WSS PROCESS
N
Y
(NO GO)
Expeditable
from Yoker?
ADVISE
CLINICIAN
‘GO/NO GO’
Is
SGH Stock
Available?
N
(GO)
WITHDRAW
FROM STOCK/
UPDATE ReTIS/
REPLEN FROM
YOKER
SET UP &
CHECK
EQUIPMENT
DELIVER TO
SGH
DELIVER TO
CLINIC & ADVISE
CLINICIAN
REPLENISH
STOCKS
CONDUCT
FIXING &
FITTING
PATIENT LEAVES
WITH SAFE
&USEABLE DEVICE
YOKER
CLINICIAN
PROVIDE
TECHNICIAN
SUPPORT
TRANSACT
‘DELIVERY BY
CLINICIAN’
SGH WORKSHOP
Y
Single Clinical Appointment
ISSUE
FEASABILITY
REQUEST
Root Cause Analysis
PROCESS
STOCK
Insufficient Stock
Limited Scope of Materials
Defining OSS Stock
Patient Transport Arrgts
Maximisation of Time
Mgt of the Defined OSS Stock
Clinic Space
Discipline to Standardise Equip
Mgt of the Defined OSS Stock
Insufficient Storage Space
Clinic Times
Thro’put of Waiting Lists
Inventory Management
Staff Training/Discipline
Mistakes
Mistakes
ReTIS Update Discipline
Change in Clinic Structure
Speed of Replenishment
POTENTIAL O.S.S.
.PROBLEMS
Manpower Capacity - Technicians
Patient Tolerance Level
for Appt. Durations
Manpower Capacity - Clinicians
Availability of Suitable ReTIS Reports
Patient Expectations
Clinic Times
Mgt of the Defined OSS Stock
Yoker v Clinician elapsed times?
Mistakes
STAFF
(re 14 days)
Mistakes
COMMUNICATIONS
M.I.S.
Lean Programme: ONE-STOP-SHOP
Start Date: 2 October 2009
Last Update: 7 April 2010
1. PROBLEM STATEMENT
 Most of the patient referrals to Westmarc WSS require at least one follow up
appointment before the patient is equipped with ‘a safe and useable device’
Team Members: S.Gold, R.Fiskin, A.Oliver, E.Beattie,
A.Love, W.Forsyth, K.Lees, P.Greene, D.Devlin,
I.Mackay, H.Collin
Process Owner: Bill Forsyth
Westmarc
A3 Compiler: Henry Collin
Review Team: Westmarc Senior Management Team
4. GAP ANALYSIS
7. IMPLEMENTATION PLANS
PROCESS
STOCK
Insufficient Stock
Limited Scope of Materials
Defining OSS Stock
Patient Transport Arrgts
Maximisation of Time
 This results in:
- discomfort and frustration for the patient due to (potentially unnecessary)
delays in receiving the prescribed device.
- secondary appointments being necessitated for ‘fitting and fixing’.
- an exacerbation of the waiting-list back-log
- ‘double-handling’ by Clinicians, Workshop & Admin Staff.
Mgt of the Defined OSS Stock
Clinic Space
Discipline to Standardise Equip
Mgt of the Defined OSS Stock
Insufficient Storage Space
Clinic Times
Thro’put of Waiting Lists
Inventory Management
Staff Training/Discipline
Mistakes
Mistakes
ReTIS Update Discipline
Change in Clinic Structure
Speed of Replenishment
POTENTIAL OSS
PROBLEMS
Manpower Capacity - Technicians
Patient Tolerance Level
for Appt. Durations
Manpower Capacity - Clinicians
Availability of Suitable ReTIS Reports
Patient Expectations
Clinic Times
Mgt of the Defined OSS Stock
Yoker v Clinician elapsed times?
Mistakes
COMMUNICATIONS
STAFF
Jan01-Dec31, 2009 Data:
• Clinical Appointments held at Westmarc
5. SOLUTION APPROACHES
IMPROVEMENT ACTION
= 1202 Assessments
at WestMARC
clinics
• Current One-Stop-Shop Appointments
= 100 per month
=0
However, for many clinical appointments, the patients needs can be
satisfied
- within a single appointment
- with a ONE-STOP-SHOP service,
- with minimal or no extension to the allotted appointment times,
- by a planned approach to ‘at-hand’ inventory holdings,
- and by an orchestrated interaction between the different staff groups
involved in the Patient Journey (Clinicians, Technicians, Stores and
Admin).
√
02/10/2009
5.2 Determine the preferred listing of chairs + spares from 5.1
02/10/2009
√
02/10/2009
5.3 Quantify the desired stock holding for the above equip.
02/10/2009
√
06/11/2009
5.4 Assess the storage space requirement to satisfy 5.3
02/10/2009
√
27/11/2009
5.5 Compile a ReTIS report to monitor improvement progress
5.6 Implement a manual register of OSS Data (pending 5.5)
02/10/2009 WIP Due May2010
13/11/2010 √
18/12/2009
5.7 Investigate alternative clinician patterns
5.8 Provide OSS training to ALL OTs and Bioengineerss
02/10/2009
19/02/2010
√
√
06/11/2009
19/03/2010
5.9 Perform a 5S Improvement on the OSS Stores area
19/02/2010
√
21/03/2010
5.10 Collect data for Non-OSS outcomes
06/04/2010 WIP Due May2010
Decision by Review Team : GO
6. PROVING TRIALS
Target OSS
Size
Quad
Flotech
Standard
Econo Pad
3.Modifications
1
N
Y
(NO GO)
Is
SGH Stock
Available?
Expeditable N
from Yoker?
ADVISE
CLINICIAN
‘GO/NO GO’
(GO)
WITHDRAW
FROM STOCK/
UPDATE ReTIS/
REPLEN FROM
YOKER
SET UP &
CHECK
EQUIPMENT
DELIVER TO
SGH
DELIVER TO
CLINIC & ADVISE
CLINICIAN
REPLENISH
STOCKS
CONDUCT
FIXING &
FITTING
PATIENT LEAVES
WITH SAFE
&USEABLE DEVICE
YOKER
CLINICIAN
Y
Single Clinical Appointment
ISSUE
FEASABILITY
REQUEST
Appointments
within, say, 6 mths
= 50 Appts/month
PROVIDE
TECHNICIAN
SUPPORT
TRANSACT
‘DELIVERY BY
CLINICIAN’
SGH WORKSHOP
2
3
4
5
= 50% of total appts
Decision by Review Team : GO
4.Instructions
To be completed by Workshop Technician
5.Stock parts used
Part number
?
?
?
?
?
408190
408214
408768
408798
409350
409744
410235
410238
410313
410331
410568
410573
410795
410854
411003
411030
411294
411440
411607
411667
411670
411704
412832
412931
412933
413194
413314
413591
413594
413999
414020
414106
414301
414956
415168
415257
416049
416174
416259
416265
417175
417278
417278
417479
417482
418155
418627
418750
418795
419006
420101
420242
421384
422618
423824
424599
426233
426240
426759
426775
?
?
?
2116443
2124188
2134370
P040258
P042691
99521
2133646
2125322
P021095
2042136
P020846
?
P019902
P069926
P012328
2122215
2042562
2033701
2128771
2045330
2053553
2116032
2127986
P012687
2119091
2008220
1817873
2135281
2048907
737658
P025835
2052169
2005029
2055682
2121638
P016427
2056645
857346
2113486
2135193
P019489
P012328
P066527
?
2004816
2036752
2003742
P009209
2110013
2052209
2123885
2032332
211509
P063984
P046695
2132312
P064569
462218
?
2013643
2037416
2107955
P019723
2124305
2135139
2052468
2112426
P061714
N
N
N
N
N
Y
Y
Y
Y
Y
N
N
Y
N
Y
Y
Y
Y
Y
Y
Y
Y
Y
N
Y
Y
Y
Y
Y
Y
N
Y
Y
Y
Y
Y
Y
Y
Y
Y
N
Y
N
Y
N
N
Y
Y
Y
Y
?
?
?
?
Y
Y
N
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Action3
?
Access
Standard
Action3
Lite
Action3
Standard
Action3
Lite
Access
Econo
Action3NG Standard
Action3J
?
Access
Standard
Azalea Minor N/A
N/A
N/A
N/A
N/A
Access
N/A
N/A
Action3
N/A
C+PV
?
Action3
Quad
Discovery ?
Action3
N/A
Action3J
Econo
Action3
?
Access
?
Rea Azalea ?
N/A
N/A
Action2000 Standard
Action3
Standard
Action3NG ?
Action3
Standard
Access
?
Action3
Standard
N/A
N/A
Action3
Standard
Shadow
?
Mirage
?
Action3NG Standard
Action3
Standard
Shadow
F.Carve
Mirage
?
Action3NG Standard
Action3NG Econo
N/A
N/A
Action3
?
N/A
N/A
Action3
Standard
N/A
N/A
N/A
N/A
N/A
N/A
Shadow
?
Action3
Access
Spectra Plus N/A
Spectra Plus N/A
Action3J
GPV
N/A
Action3NG
Neon
Contour
Action3
?
Action3
Standard
Action3NG Standard
Action3
Action3
Econo
Access
Standard
Action3
?
Action3
Standard
Action3
?
Rea Azalea ?
Access
?
Rea Azalea ?
15x16
24.0
19x17x2 22.0
19X17
12.5
19x17x2
?
18x17xx2424.0
17x17x4 12.5
18x17x2 12.5
16x16x4 12.0
19x17x2 22.0
N/A
N/A
N/A
N/A
N/A
N/A
19x17
?
N/A
N/A
18x18
?
?
16x17
?
?
?
N/A
N/A
16x16x4 12.0
17x17
24.0
18x18x22 22.0
?
?
N/A
N/A
17x17x2 24.0
19x17x2 24.0
?
?
16x16x2 12.5
?
?
17x17x2 24.0
N/A
N/A
19X17
12.0
15 12.5
?
?
16x16x2 24.0
18x17x2 22.0
?
?
18x17
?
19x17x2 24.0
16x16x 12.5
N/A
N/A
18x18
24.0
N/A
N/A
18x17x2 24.0
N/A
N/A
N/A
N/A
N/A
N/A
?
?
17x17
24.0
15x17
12.5
15x17
N/A
N/A
N/A
12x12
?
16x16
24.0
17x17
24.0
N/A
24.0
17x16
24.0
15x16
24.0
15x16
24.0
15x16
12.5
17x17
24.0
17x17
22.0
15x16
24.0
19X17
24.0
15x16
24.0
Medium 18.0
19x17x22 22.0
Small
18.0
B
Sw ap brakes - old/new chair
Reasons for NON One-Stop-Shop
Patient
Other
Ambulance
N
N
N
N
N
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Stock
Instructions/ Parts Used
Couldn't Uplift
Dec09-Jan10
Dec09-Jan10
08/12/09
Dec09-Jan10
Dec09-Jan10
Dec09-Jan10
Dec09-Jan10
Dec09-Jan10
Dec09-Jan10
Dec09-Jan10
10/12/09
Dec09-Jan10
Dec09-Jan10
Dec09-Jan10
Dec09-Jan10
Dec09-Jan10
Dec09-Jan10
Dec09-Jan10
Dec09-Jan10
Dec09-Jan10
Dec09-Jan10
Dec09-Jan10
Dec09-Jan10
22/12/09
Dec09-Jan10
Dec09-Jan10
Dec09-Jan10
Dec09-Jan10
Dec09-Jan10
Dec09-Jan10
Dec09-Jan10
Dec09-Jan10
Dec09-Jan10
12/01/10
Dec09-Jan10
Dec09-Jan10
Dec09-Jan10
Dec09-Jan10
Dec09-Jan10
Dec09-Jan10
21/01/10
26/01/10
01/02/10
27/01/10
Dec09-Jan10
01/02/10
01/02/10
04/02/10
02/02/10
02/02/10
10/02/10
09/02/10
10/02/10
10/02/10
11/02/10
18/02/10
18/02/10
24/02/10
03/03/10
10/03/10
11/03/10
23/03/10
23/03/10
24/03/10
25/03/10
28/01/10
Dec09-Jan10
Dec09-Jan10
Seat/
Cushion
Size"
Could Not Wait
OT
OT
OT
OT
OT
OT
OT
OT
OT
Bio
?
Bio
Bio
Bio
Bio
OT
OT
OT
Bio
OT
OT
OT
OT
Bio
OT
OT
Bio
OT
OT
OT
Bio
OT
Bio
OT
OT
OT
Bio
OT
OT
OT
Bio
Bio
Bio
OT
Bio
Bio
Bio
Bio
OT
OT
OT
Bio
OT
OT
OT
OT
OT
OT
OT
OT
OT
OT
Bio
OT
OT
OT
OT
OT
Seat
Make
Chair Not Avail.
?
?
RF
?
?
?
?
?
?
PG
?
NG
KL
NG?
SL
Cent.
Cent.
Cent.
KL
AR
KS
RF
?
SH
RF
RF
SH
RF
KS
RF
MC
LA
NG
LD
CH
KS
KL
LD
RF
RF
KL
SL
NG
SG
KL
NG
KL
KL
KS
LA
LD
NG
AR
FB
AR
FB
RF
AR
AR
SG
CH
RF
?
RF
AR
SG
CF
?
Chair
Model
Wheel Dia"
Job Patient
Sheet
Ref.
Parts Not Avail.
Patient Ref
2. Cushion details Type
ENTER NORMAL
WSS PROCESS
One-Stop-Shop
- Summary Details -
Serial nos
Other Non Avail.
Patient name
Roho
A
Model
Wheel size
Assessor
2 October 2009
Maybe!
Viable?
Date
Designation
Manufacturer
Seat size
OSS - Y/ N?
Bio/OT
1.Wheelchair details
Assessment
Date
Prescriber
ONE-STOP-SHOP
CLINICS
ASSESS
POTENTIAL FOR
ONE STOP SHOP
N
STATUS
02/10/2009
Chair Issued?
3. THE TARGET CONDITION
ASSIGNED
5.1 Determine the Equipment Scope for the OSS service
Decision by Review Team : GO
HOLD
SCHEDULED
CLINIC
M.I.S.
Decision by Review Team : GO
Decision by Review Team : GO
2. THE PRESENT STATE (@ October 2009)
(re 14 days)
Mistakes
Details
X X Chair couldnt be taken in ambulance
X
X X
X
X
Cushn mod'd from 16x16 to 10x10
Shorten Hangers
Adj. Moulded Seat and fit. Castor on outrigger Bracket
Fit Slimline Adductors? To seat base
Fit ??? Clamps to stop skidding. Fit Cator Outriggers
Fit Hip Guides, Aductor, Pommel to Seat Board. Fit Lateral to Back Board
Modify Protech Back. Replace 'H' Harness
Roho 109HP, 18"Protech Bkrst Cover
QS99C Roho Quatro
L8-P24-6-ARMS Cont.Adj.H/rest, Type G?
Reduce anti tip by 2". Add 1/2 folding push handles
Adjust: seat ht, Rr w heel,Castor, Hd set support, Seat angle
RMS 50mm Armrest raisers
Adj. Backrest to suit Back Cushion
Fit Actiflex 'H' type Harness A12T
Med. Aberdeen LB (fitted)
Tabu Medium
200B TABU Back Canvas
Fit PTV16 rmve PSV14. Fit ankle huggers, rmve scoops, Adj. Infill Pad items
Replace Hangers and shorten
Fit foam carve using interface
Slice 4cm from bottom of cushion
Anti-tips t/f'd from existing Action 2000
Make up ??? +protech lateral to fit to RHS of O.B.C.F.Seat
Raise Uprest ~ 1". Redrill hole
Reset Armrests and fit ????? Harness
Change bkrest to Std TABU. Reduce Ft.Pl.height by1"
Sw ap Otto Bock carved foam seat from Discovery to Shadow
Fit Active Design Knee Block to Tydex board
Move L hooks on O.B.C.F.Seat by 3/4"
Enlarge holes on O.B. C.F Seat to allow ??? i/face to fit
17" w ide transparent Tray, 1450923
Calf Pad Qbitis, WM3
Cut 2" from Footplate Stems
Push button sw ing aw ay Protech/AEL. Fit new Pads
Remove 12" STD Protech. Fit 12" TALL backrest
Shorten+adjust Ft Pl height. Adj. Backrest Mech'm
Replacement for defective chair 095938
Fit size 18 Protech Back +Lumber Pad
Fit size 3 RM5 Ankle Huggers to prev issued chair085406
(Cushion 16x16)
(Cushion 16x16x2)
(Cushion 16x16x2)
Chair + Cushion unavailable
A ‘Clinician Request
to Workshop’ form
‘A’ was created
which also enables
data collection. This
data is currently,
manually entered
into a register ‘B’ in
order to permit the
metics on OSS
thro’put and
inventory usage.
TABu 200A
This method of data collection will continue, while establishing the robustness
of the OSS process and system requirements, prior to agreeing a bespoke
ReTIS report which can track the progress towards achieving the One-StopShop targets.
Decision by Review Team : G0
Decision by Review Team :
GO
8. THE CONFIRMED STATE
At 31 March 2010:
• To date, >60 OSS Clinics were successfully held
• This comprises an average of 15 OSS Clinics/Month
• A ramp up of >3x is required to achieve the Target State
Ramp-up Measures:
• The capacity for OSS clinics was increased by opening the scope to ALL
clinicians in March (was only 2 x OTs for 3 months)
• Data collection measures being introduced for reasons for NON OSS clinics
Decision by Review Team : WIP
9. LESSONS LEARNT
• Don’t assume – check, quantify and check again.
• Involve the staff who are essential to the process, to gain their ‘buy-in’.
• Don’t be afraid to experiment (in a controlled environment).
• Don’t rush in – Do the homework and preparation.
• Choose the correct tools/techniques for the task.
•
•
•
•
•
•
Decision by Review Team : WIP
KEY:
WSS National Action Plan
DELIVERABLES
DELIVERERS
WSS NATIONAL
PROJECT BOARD
RESOURCES
WoS WSS Business Case
Implementation Plan
WoS Input to National Action Plan
WoS WSS
IMPLEMENTATION GROUP
WoS REHABILITATION TECHNOLOGY
CONSORTIUM
WestMARC
NHS Lanarkshire
Business Case
Implementation Plan
SENIOR MGT. GROUP
…….etc, etc etc
Powered Chairs
NHS LANARKSHIRE
PROJECT BOARD
Staff
Governance
QMS
One-Stop Shop
Skills Maximisation
Repair Times
RTP Reductions
NHS LANARKSHIRE PROJECT
TEAM
WoS WSS
HR SUB GROUP
PROCESS
IMPROVEMENT TEAMS
Architects
User Involvement
NHS Estates
Bioengineers
Engineers
Stores
Therapists
Clinical Stakeholders
Mgt & Admin
Technicians
PLG
Project Management
• Any comments?