Our clients ask, how do we...
- Meet the increasing demand for our service?
- Manage the costs of our workforce without affecting care?
- Operate effectively within a reduced budget?
- Overhaul our IT and processes?
- Motivate our team and revitalise our culture?
Healthcare organisations commonly speak about the manifestations of poor performance but are less able to define their cause. We work with organisations to:
- Define where the issues come from
- Develop the leadership and culture necessary to improve performance
- Align teams around common goals
- Engage clinicians in the challenge of improving performance
- Put the right management structure in place
- Connect front-line staff to overall programme goals to build confidence in delivery
- Streamline systems and processes
Common challenges include building engagement at all levels in the need for change; working with a dataset that everyone agrees with that supports understanding of current and future performance; knowing which activities will have the greatest impact and prioritising those while desisting with others;
ensuring processes are streamlined and understood, and aligning capacity to demand at all stages of a pathway.
- Performance assessment - Understanding the many moving parts in complicated systems, the demands each one faces and their tolerance to pressure.
- Data relationships - Building understanding beyond individual metrics to show how the interaction between different parts of a system impacts performance.
- Planning and targets - Setting milestones and goals for projects and performance, establishing accountability at all levels and monitoring weekly.
- Implementing change - Supporting in detail the teams faced with a complex change and putting the systems, processes, leadership, capabilities and behaviour in place to enable it
- Launching and sustaining change - Ensuring wider engagement in strategy, objectives and roles.
“CF worked with our system over a period of nine months to support improving flow into, through and out of our acute hospitals. Initially the work was very analytical and using a demand, capacity and flow tool, helped us to get a shared understanding of the true root causes of issues with patient flow and a single version of the truth, and supported myself as SRO and the CEOs group to develop seven key priorities for the system to deliver. With the priorities agreed, CF then supported our teams directly to accelerate delivery on the ground. The work has meant that we have been much better prepared for winter, reducing super-stranded patients by 26%.”
Chief Executive of Kettering Hospital
We worked with the Northamptonshire system who was struggling with poor performance in the accident and emergency (A&E) department, particularly over the winter months. The two acute hospitals struggled with capacity, having had bed occupancy levels over 100% for several years, and were utilising expensive escalation capacity to manage patient demand. We were commissioned to support the system to understand the drivers of historical performance, predict future performance and develop a robust winter plan.
We completed a thorough assessment of historical performance, analysed the drivers behind why the performance had been poor and identified opportunities to improve by understanding the process on the ground and benchmarking to best practice. Having established areas for improvement, we worked with system leaders to prioritise initiatives and create alignment around a plan that would deliver for winter. We went on to define accountability among the leadership team for each of the workstreams and supported teams to mobilise effectively to deliver against those plans.
Throughout the project, we worked with delivery teams to establish and interpret metrics so that decisions could be made based on data on a weekly basis. We also problem-solved emerging issues with teams and chief executives and provided additional support for teams developing solutions on the ground. Alongside this, we worked with commissioner, provider and local authority leaders to build and develop system leadership working, supporting the system to come together and manage demand across the whole system and align the system narrative to the regulators.
The work achieved a 32% reduction in super-stranded patients ahead of winter, which the teams have sustained since. This allowed the system to not only close escalation beds, but also manage a 10% year-on-year increase in demand with improved A&E performance. The system leadership work enabled a clear, unified message to the regulator which supported a successful business case for additional funding, ultimately ensuring gains were maintained and built upon.