HSJ's Sutton Coldfield GM Live event proved an excellent platform for sharing successful service redesign strategies

Since HSJ's Good Management Live event in May 2006 at Good Hope Hospital trust in Sutton Coldfield, there have been some major steps forward for consultant vascular surgeon Simon Dodds.

Mr Dodds was one of the presenters at the event, showcasing his service redesign work in reducing outpatient waiting times. He had re-organised his conventional, multiple-visit vascular outpatients clinic as a one-stop clinic, with availability of a consultant vascular surgeon, vascular nurse specialist and vascular technologist in the outpatient clinic.

This measure alone reduced the time from referral to definitive management plan from 24 to four weeks and the average number of repeat hospital visits was reduced from six to five.

A second step involved the design of an image-based electronic patient record (EPR) system to link the clinic with community nurses through NHS net. This reduced time from referral to definitive treatment plan to two weeks, and the average number of repeat hospital visits from five to two.

The productivity improvement also created a 40 per cent increase in capacity. By November the potential of the work had developed further.

The numbers game

'This month there are more patients in the clinic than we've ever seen, over 100 per cent more than I was seeing three years ago with the same resources,' says Mr Dodds. 'It shows the importance of having the right process: quality up, waste down and throughput up. I have doubled my productivity. It means getting rid of waste and the stuff that stops you doing what you should be doing. By doing that you can double your productivity.'

One of the changes put in place since June has been for the secretary to attend day clinics and produce a GP letter after each session, instead of the traditional batch approach. Any problems or misunderstanding between consultant and secretary can be dealt with immediately, with GP letters sent out the next day.

His work also captured the attention of event sponsor the NHS Integrated Service Improvement Programme (ISIP). It has since carried out a benefits realisation review of the work, applying the ISIP framework for service improvement to the outpatient clinic redesign.

'That will essentially produce an external evaluation of what we have done by professionals, rather than an audit,' explains Mr Dodds.

'It went out and talked to district nurses who have done some audit on the impact of telemedicine systems, and they have shown similar results to us.

'They are saying the same things as we did. It works, is sustained and is not that difficult to do - so why aren't you doing it? And because ISIP is linked to Connecting for Health (another of the GM Live sponsors) it's a tick in the box for using IT to help patients.

'If I was a primary care trust looking to save money, improve quality and learn how to do service improvement by design, I would be snapping my hand off.'

But Mr Dodds' work has also captured the imagination of others in his trust. In the week I talk to him the team in trauma and orthopaedics was due to carry out rapid improvement work on value stream design in its department.

He describes the GM Live event as a 'catalyst', followed by investigation into lean tools to drive improvement in June and a 'hearts and minds' push in July. 'That created enough momentum for the management to say yes, give it a go,' adds Mr Dodds.

Learning curve

The trust has been looking at what it can learn from other host trusts in the first series of GM Live events, specifically the lean work at Bolton and the use of traffic light systems to drive improvement in length of stay at Mayday Healthcare trust.

'If there is one lesson I've learnt this year it's that it's all about mindset. If you have a can't-do attitude you get exactly what you set out to achieve: nothing.

'Early in the new year I deliberately introduced a mindset shift from &Quot;somebody else's problem&Quot; to &Quot;my problem&Quot; and what do I need to do to make it happen. That's what's made the difference.'

Find out more about Simon Dodds' work at www.threewins.com

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