Improvement Collaborative

Improvement Collaborative

Welcome to the Renal Improvement Collaborative! This is a project of the Renal Association UK Renal Registry and the British Renal Society, with help from the NHS Institute for Innovation and Improvement .

How does it work?

Each year the Registry reports variations between renal Units in their achievement of key clinical goals. The same Units usually appear at the top, middle, and bottom of the "league table", indicating that that level of achievement is a stable characteristic, produced by the system in place in that unit for managing that clinical area. If all Units could learn from the high-performing Units, then overall achievement would improve, and the variation would be reduced.

How do I sign up?

Attend the BRS meeting on the 12th June as part of a multidisciplinary team. Email addresses of all participants will be collected at the meeting and you will be sent a login. We will create an automatic login facility on this site in the very near future.

How to improve Anaemia and Phosphate management


Four consistently high-performing Units have put together a 'change package' that summarises their proceses for managing anaemia and managing phosphate. These will be presented at the BRS meeting and the slides will be posted on the website. The idea is that Units test implementation of these ideas, and others suggested by all participants during the course of the next year. We don't know for certain whether the change packages will 'translate' to other Units: a key principle of quality improvement is that no plan is every perfect, and the change packages suggested will have to be adapted to the local environment that your team works in. There is a specific methodology for testing new ways of providing healthcare and working how to to implement 'change packages' - this is called the "Model for Improvement".

The Model for Improvement

We constantly hear about changes that others have implemented to improve outcomes in their units. Implementing these changes in new settings is often problematic because they require change to happen. It's common to come back from a conference with a new idea for improving care, only to run into resistance (e.g. colleagues who weren't at the meeting; committees; policies; paperwork). The Model helps to get round these obstacles by testing out how to implement a new way of doing things incrementally, adapting to the local culture and existing policies.

The Model for Improvement has been developed by the Associates for Process Improvement with the Institute for Healthcare Improvement and has now been used around the world, including the NHS, as the best way of making change happen.

From time to time we'll add important information that is of interest to both new and existing members as well as interested parties outside the collaborative project. This information will be posted within the Journal section. It would be nice to do this as an interactive blog but we aren't that technologically advanced yet!

The journal section will include tutorials and 'refresher' information about the collaborative. These will be short and to the point. New changes to the Journal section will also be posted within the discussion forum area.

How will the Collaborative work?

Participating teams will be taught the basics of the Model for Improvement at the initial plenary session at the BRS on 12th June 2007. Teams will then divide into breakout groups, one for anaemia and one for phosphate. During these breakout sessions teams will be given a 'change package' which comprises the preliminary suggestions, developed by representatives from high-performing Units, on how to improve management of anaemia or phosphate. We will add to these ideas over the course of the year. We hope to have a 'report back' session at the BRS meeting in Glasgow in 2008.

We will also be working with the Anaemia Nurse Specialist Association.


  • Journal entry - July 23rd 2007 Author - Simon Watson

    Thanks for getting the project off the ground and for sending me your data. You’re all doing very interesting things – and quite different things. The first thing I’d encourage you to do is to post the comments you sent me into the collaboration discussion forum – I think they would all generate a lot of interest and further discussion.
    Full story


FileTypeSizeUploaded onDownload
Tom Crocker presentation on mapping of anaemia processesPPT248.50 KB24 Aug, 2013 Download
Simon Watson reliabilityPPT1.07 MB24 Aug, 2013 Download
Russell Roberts anaemia change packagePPT1.18 MB24 Aug, 2013 Download
results of collaborative improvement in fistula rates in the USAPPT85.00 KB24 Aug, 2013 Download
QI 3 min tutorial - Getting started - SJWWWAV3.78 MB24 Aug, 2013 Download
PDSA formDOC24.50 KB24 Aug, 2013 Download
Letter to Clinical Directors about the CollaborativePDF18.57 KB24 Aug, 2013 Download
Institute for Healthcare Improvement White Paper on CollaborativesPDF128.33 KB24 Aug, 2013 Download
Hugh Rogers PlenaryPPT5.31 MB24 Aug, 2013 Download
Hugh Cairns phosphate change packagePPT1.34 MB24 Aug, 2013 Download
Don Goldman's Healthcare reliability presentationPDF186.08 KB24 Aug, 2013 Download
Charlie Tomson What Happens NextPPT470.50 KB24 Aug, 2013 Download
Charlie Tomson introduction to plenary sessionPPT217.50 KB24 Aug, 2013 Download


FileTypeSizeUploaded onDownload
JULY 07 JOURNAL - Sample starting documentDOC25.00 KB24 Aug, 2013 Download
JULY 07 JOURNAL - Sample PDSA worksheetDOC32.00 KB24 Aug, 2013 Download
JULY 07 JOURNAL - Sample GraphXLS16.00 KB24 Aug, 2013 Download
JULY 07 JOURNAL - QI 3 minute audio tutorial - Getting started - Simon WatsonWAV3.78 MB24 Aug, 2013 Download



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