INNOVATION & EFFICIENCY
For this article, ‘initiatives’ will be used, and is all of the above – basically a project that is intended to deliver a target and a service redesign piece.
QIPP initiatives should not be many lit- tle projects to deliver a huge target. What should happen is to identify what changes to a service are wanted, and how transfor- mation will be built into the initiatives to not only deliver efficiency in cost, but de- liver a better service.
QIPP can seem like an arduous task, or even something to ignore because it seems like an uphill battle, but with a few support tools in place QIPP can be managed.
Below are areas to concentrate upon, and if implemented, will manage an organisa- tion’s and/or service’s QIPP programme to drive through initiatives and to deliver on target.
1. Engage and determine who will be the champion
Who will be the person who will help sup- port the QIPP programme, and be the one escalated to when there is a risk to deliv- ery? Is it a clinician, manager, QIPP lead or other – this is dependent on the culture and how they will engage others to buy into the delivery programme of QIPP across the service or organisation.
The champion for the programme is the ally; use them to escalate and drive through the initiatives. Also, this is the person who can begin the development of initiatives, and getting buy-in on all those areas to be focussed on during the year. Who this cham- pion will be, depends on the organisation.
2. Drive the initiatives to the target set
The target has been set by executives, turn- around directors, service leads or the sec- tor. Accept it and start the process of deliv- ery.
Plan from the set target, not a planned target, a proposed target, a target that is a dream, a moving target or other – plan to the target set. Sometimes that target moves, because there is a stretch target placed on top to do just as the word states, stretch. Report each separately – the original target and stretch – so it is clear to all players the rules of the game, what is being monitored and how to mitigate risk accordingly.
3. Segment the initiatives into differ- ent categories
When identifying initiatives, bundling 36 | national health executive Nov/Dec 11
them into separate categories can direct and begin an action plan.
Examples of categorisation are: • Quick wins • Service redesign • Back office • Procurement • Pathway redesign • NHS London categories • Bundling to the care provided or work stream • Colour coding
All are good ways of identifying the initia- tives and will give particular patterns once analysis is started. For example, all quick wins should be easier, not involve consul- tations, and should deliver quick and easy efficiencies; this gives a starting position. Begin.
4. Realise how to measure success – EARLY
When categorising initiatives, think about how the initiative will measure the success throughout the year. If an initiative is to re- duce the use of prescribing drugs for exam- ple, know early on how the target was de- rived, what the definition is to be measured, how it will be measured (systems) and the timeline it will be reported. This way there is no confusion. Questions such as ‘will we simply be measuring actuals to target’ will be answered and understood for the devel- opment of reports. How all this information will be fed to appropriate people to action will need to be understood also, and under- stood early in the QIPP programme. This
will also give a better understanding on what tool to develop and for whom.
5) Develop user-friendly tools
First of all, what is a tool? A tool is a report- ing document that adds value to the user to monitor report and/or provide informa- tion to a user. Wikipedia defines a tool as ‘a device that can be used to produce an item or achieve a task, but that is not consumed in the process’. This is exactly what a tool should be: not consumed in the process, or complex. Remember, be as user-friendly as possible.
Monitoring tools come in many forms, but realise the value of each one and be user-friendly. That means that if anybody printed off any one of the developed re- ports to monitor the QIPP programme, it would be self-evident what that tool does. An example would be a risk log. If there is a RAG (red, amber, green) rating being used, display the definition, have this readily on the log, for user-friendliness. If any tool is printed off, remember to title the page, insert page numbers and have the logo of the organisation on it for professionalism, but also so that it is not an isolated piece printed off without a clear understanding of its use.
Dashboards, databases, and automated systems are great, but only if the user can access them, find their value to inform the business needs and there is a sustainability plan on the development and continuation of the tool developed.
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