VENTILATION SYSTEMS


Deming’s PDSA management method is used extensively in business for the control and continuous improvement of processes and products.


(W. Edwards Deming, The New Economics for Industry, Government, Education, third edition, figure 13, page 91, reprinted courtesy of The MIT Press and the Deming Institute.)


risk information in an easily digested format by clinicians and administrators saw a 90% risk reduction achieved in the repeat prescription of medicines. The risk management model was based on systems thinking, and in particular Edwards Deming’s iterative four stage PDSA (Plan Do Study Act) management method,4


which is used extensively in


business for the control and continuous improvement of processes and products. In order to achieve improvements, outcomes are monitored and then reviewed so that processes can be revised to enhance performance even further.


Systems thinking – optimising the delivery of better ventilation outcomes Systems thinking is a holistic approach to problem-solving. It is often used to develop effective actions for complex situations, and it focuses on both how a system’s constituent parts inter-relate, and how that system works within the context of larger systems. Deming’s PDSA cycle is a proven example of Systems Thinking which enables continuous quality improvement processes. It is an ideal approach for VSGs to adopt to deliver better ventilation outcomes.


PDSA process Informed by verification data, the PDSA process can be introduced to drive continuous improvement. Information derived from the analysis of the verification data can immediately support the study step of the process for an abbreviated initial cycle, which then informs the actions, and allows a plan to be established for the ongoing improvement cycles. With suitable engagement by all concerned, this continuous quality improvement process will have positive outcomes which impact directly on the Trust’s performance, and thus result in increased theatre availability and revenue.


116 Health Estate Journal October 2022


Organisational culture While the PDSA improvement process can be established easily, its success is entirely dependent on the organisation’s culture. Deming realised this, and proposed his System of Profound Knowledge (SPoK), which provides a highly integrated framework for the cultural transformation needed to support continuous improvement. Beginning with transformation of the individual, SPoK will ensure that managers become leaders, and also ensure that people in those organisations continually improve, with the aim of everybody winning. His book, The New Economics for Industry, Government, Education,5


presents a


detailed explanation of his SPoK. It echoes the work of Peter Senge, who also emphasised the need for building a shared vision, and team learning ,which was summarise in his book, The Learning Organisation.6


References 1 HTM 00: Polices and principles of healthcare engineering. Department of Health, 2014.


2 HTM 03-01: Specialised ventilation for healthcare buildings. Department of Health and Social Care 2022


3 Humphreys H. Infection prevention and control considerations regarding ventilation in acute hospitals Infect Prev Pract 2021 Oct 20; 3(4):100180.


4 R Moen: Foundation and History of PDSA Cycle; 2009. https://tinyurl.com/yeyshjeb


5 Edwards Deming W. The New Economics. 1993.


6 Senge P. The Learning Organisation. 1990.


With an associated cultural


shift, teams can progress from simply reacting to the present issues, and become focused on delivering continuous improvement to create the better future outcomes. Systems thinking is becoming more widely adopted in healthcare, and it forms the basis of several similar management techniques, such as Kaizen and Six Sigma. They each have slightly different terminologies and focus, but they all require cohesion and learning. There is already good NHS support


for these smarter ways of working through NHS Elect, which provides leadership and organisation development programmes to Trusts. Collaborative support is also available from the NHS National Performance Advisory Group. Its Operating Theatre Best Value Group shares information, and provides insights, to assist with daily activities, and strives for continuous service improvement.


Conclusions


While not specifically written about data and the rapidly changing world, HTM 03-01 outlines the functional responsibilities of designated staff, and the data to be collected during verification, and provides a sound platform to establish procedures which support resource optimisation. Smart logbooks such as Seeker


Ventilation improve the visibility of verification information. This enables AP(V)s to improve their control of maintenance and the flow of information to their VSG, both of which can lead to higher levels of theatre availability. However, when that smart collaborative technology is also coupled with the innovative management practices which deliver continuous quality improvement, every VSG can lead improvements in their Trust’s management of ventilation systems, and optimise their availability.


Stephen Bartlett


Stephen Bartlett is an information professional with considerable experience of resource planning, risk management, and healthcare estates management. Having qualified as a Chartered Accountant and, after a spell as Finance director of a database publisher, he then worked with central government to establish some of the initial Internet infrastructure needed for departments to ‘begin their shift from paper’. With a strong focus on knowledge management, this work included establishing taxonomies and real-time services providing immediate access to essential information. Subsequently he was Deputy Chairman of a provider of resource scheduling software, before joining Invigilatis as CEO, and leading its evolution into ‘a leading provider of compliance solutions for healthcare and complex healthcare estates’. He ensures that compliance solutions enable both the compliance performance achievement to be viewed easily, and the underlying non-compliances to be understood. Invigilatis’ solutions ‘empower managers while supporting collaborative management processes’. The company says that its most successful solution resulted in a 90% reduction in risk.


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