The Renal Association

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.

The Discussion Forum is here

By clicking on this link, you will be able to access a password-protected part of the website. To register (in order to be able to write as well as read, and to access 'Clinical' areas), click on Register at the top. Important - enter your full name, renal unit, position - or we won't be able to confirm your registration (this is a manual process to keep out spam).

Once you've registered you'll be able to see what other teams are doing, to post the results of your own tests of change, and (most important) to post the results of your monthly audits of haemoglobin and phosphate. You'll also be able to post questions and suggestions for all other participants to see. You'll get an e-mail every time any participant in the Collaborative adds new material.

The Journal is here

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.

Downloads

1. Charlie Tomson introduction to plenary session

   .ppt file (217.50 KB)

   Download

2. Charlie Tomson What Happens Next

   .ppt file (470.50 KB)

   Download

3. Don Goldman's Healthcare reliability presentation

   .pdf file (186.08 KB)

   This is a presentation from a recommended talk that Simon Watson went to.

   Download

4. Figure 9.1

   .jpg file (74.35 KB)

   Download

5. Hugh Cairns phosphate change package

   .ppt file (1.34 MB)

   Download

6. Hugh Rogers Plenary

   .ppt file (5.31 MB)

   Download

7. Institute for Healthcare Improvement White Paper on Collaboratives

   .pdf file (128.33 KB)

   This paper describes the IHI's collaborative quality improvement programme.

   Download

8. Letter to Clinical Directors about the Collaborative

   .pdf file (18.57 KB)

   This is the letter that was sent to Clinical Directors encouraging them to send teams to the collaborative session

   Download

9. PDSA form

   .doc file (24.50 KB)

   This is the form that you should use when designing a small cycle test of change.

   Download

10. QI 3 min tutorial - Getting started - SJWW

    .wav file (3.78 MB)

    Download

11. results of collaborative improvement in fistula rates in the USA

    .ppt file (85.00 KB)

    This is an example of what can be achieved by collaboratives: in this case an improvement in fistula rates across the USA

    Download

12. Russell Roberts anaemia change package

    .ppt file (1.18 MB)

    Download

13. Simon Watson reliability

    .ppt file (1.07 MB)

    Download

14. Tom Crocker presentation on mapping of anaemia processes

    .ppt file (248.50 KB)

    Download