Clinical Audit, Research and Innovation Strategy 2014 2017 Final Version 30 th June 2014
Contents Foreword 3 Introduction 4 Review of Current Clinical Audit, Research and Innovation Activities 5 Clinical Audit, Research and Innovation Vision 8 Clinical Audit, Research and Innovation Objectives 9 1. Embed Clinical Audit, Research and Innovation as Core Rehabilitation Network Business 10 2. Engage Staff in Clinical Audit, Research and Innovation to Improve Patient Safety, Experience and Clinical Outcomes 11 3. Harness Clinical Audit, Research and innovation to Improve Services and Outcomes 12 4. Promote the Outputs of Clinical Audit, Research and Innovation 13 5. Increase Opportunities for Patients/Carers/Public to Participate and Benefit from Clinical Audit, Research and Innovation 14 6. Promote our Reputation for Clinical Audit, Research and Innovation Nationally and Internationally 15 Delivering and Monitoring the Implementation of the Clinical Audit, Research and Innovation Strategy 16 2 Clinical Audit, Research and Innovation Strategy 2014-2017
Foreword Foreword The Cheshire and Merseyside Rehabilitation Network provides a whole system model of care across hospital and community; providing us with a unique opportunity to deliver high quality clinical audit, research and innovation through our collaborative partnerships to support the development of the highest standard of specialist rehabilitation care and improved clinical outcomes. We work in partnership with The Walton Centre NHS Foundation Trust, St Helens and Knowsley Teaching Hospitals NHS Trust, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Wirral University Teaching Hospital NHS Foundation Trust, Mersey Care NHS Trust, Bridgewater Community Healthcare NHS Trust, Liverpool Neuro Physio, and Health and Social Care Partnerships. This strategy has been developed in consultation with our staff and outlines how clinical audit, research and innovation contribute to achieving the strategic objectives set out in the Rehabilitation Network Strategy (2014-2017). It sets out our vision for our clinical audit, research and innovation, which together with the accompanying implementation plan and programme, outlines a clear delivery plan with defined milestones and outcome measures. We recognise that our staff are fundamental to providing high quality patient-centred care and we endeavour to embed clinical audit, research and innovation as core business, develop a high calibre multi-disciplinary research workforce to deliver evidence based quality improvements into service delivery and improve patient outcomes. Chris Harrop Peter Enevoldson Louise Jenkins Sponsor Chief Executive and Chair Sponsor Medical Director Manager of Strategic Board Rehabilitation Network Rehabilitation Network Rehabilitation Network Audit, Research and Innovation Strategy 2014 2017 3
Introduction Communications and Engagement Strategy Audit, Research and Innovation Strategy Workforce and Education Strategy Introduction Why do we need a Clinical Audit, Research and Innovation Strategy? This Strategy is one of a suite of strategies that underpin the delivery of the Rehabilitation Network Strategy 2014-2017 (see figure 1). It sets out our clinical audit, research and innovation vision and objectives, which together with the supporting annual implementation plan and programme, outlines a clear delivery plan with defined milestones and outcome measures. MISSION Figure 1: Framework to support delivery of the strategies and supporting work programmes/plans. Rehabilitation Network Strategy Our Rehabilitation Network mission that defines what we do is: To provide high quality specialist rehabilitation care, underpinned by best practice, research and education to optimise clinical outcomes of Cheshire and Merseyside patients. STRATEGIC OBJECTIVES Our strategic objectives which shape our work are: 1. Establish a service pathway across the Rehabilitation Network; 2. Deliver patient focused services; 3. Deliver cost efficient services; 4. Attract and retain a high calibre workforce; 5. Work in partnership to deliver high quality clinical audit, research and innovation to drive excellent patient care (i.e. safety, experience and clinical outcomes). Rehabilitation Network Work Programme Implementation Plan Implementation Plan and Programme Implementation Plan and Training Plan 4 Clinical Audit, Research and Innovation Strategy 2014-2017
Introduction Who are our stakeholders? Clinical audit, research and innovation are integral to transforming the delivery of evidence based, safe, efficient and cost effective rehabilitation care to improve clinical outcomes. The Rehabilitation Network will facilitate a range of collaborations to develop and support audit, research and innovation programmes. We will collaboratively work with our staff across hospital and community organisations to develop and support the delivery of long term, sustainable programmes of audit, research and adoption and spread of innovation to transform and improve patient outcomes and improve quality and productivity of services, including: o The Walton Centre NHS Foundation Trust; o St Helens and Knowsley Teaching Hospitals NHS Trust; o Royal Liverpool and Broadgreen University Hospitals NHS Trust; o Wirral University Teaching Hospital NHS Foundation Trust; o Mersey Care NHS Trust; o Bridgewater Community Healthcare NHS Trust; o Liverpool Neuro Physio; o Health and Social Care Partnerships. The Rehabilitation Network will explore possible collaborations with academia to develop applications for research funding. We will explore collaborations with the North West Coast Academic Health Science Network to embed research and innovation outcomes into clinical practice and improve service delivery. We will also explore opportunities to develop collaborations with other healthcare organisations (e.g. Cheshire and Merseyside Major Trauma Collaborative, Cheshire and Merseyside Critical Care Services, and other nationally accredited specialist rehabilitation services) regionally, nationally and further afield in response to specific clinical audit, research and / or innovation funding. These will be discussed and approved by the Strategic Board to ensure strategic and operational fit. We will aim to increase the opportunities for patients to participate in and benefit from research. We will work with our local commissioners in their endeavour to deliver evidence based care. We will work closely with our Partners Communications Teams to effectively promote activities to enhance the Network s reputation for high quality specialist rehabilitation clinical audit, research and innovation. Audit, Research and Innovation Strategy 2014 2017 5
Review of Current Audit, Research and innovation Activities Review of Current Clinical Audit, Research and Innovation Activities Staff within each of the constituent member organisations were undertaking clinical audit, research and innovation activities. The Audit, Research and innovation (ARI) Strategy aims to build on this work to create a strategic approach and coherent programme of activities in support of the Rehabilitation Network Strategy 2014-2017. In the development of this strategy we have reviewed our strengths, weaknesses, opportunities and threats which is summarised below: STRENGTHS Effective staff engagement in the production of this strategy and development of the clinical audit, research and innovation programme. Baseline assessment of current clinical audit, research and innovation activities to support development of a coherent Rehabilitation Network Audit, Research and Innovation Programme. Network and service level clinical audits providing potential research questions. Collaborations across the partners to deliver a whole system approach to clinical audit, research and innovation. Opportunities to maximise cross organisational data set to support clinical audit, research and innovation activities. WEAKNESSES Barriers: staff time and lack of experience in research and innovation. Failure to effectively promote clinical audit, research and innovation activities contributing to ineffective promotion of the Rehabilitation Network. 6 Clinical Audit, Research and Innovation Strategy 2014-2017
Review of Current Audit, Research and innovation Activities Review of Current Clinical Audit, Research and Innovation Activities (continued) OPPORTUNITIES National policy drivers to support research and innovation. Opportunities to work with commissioners to support the development of evidence based practice. Regional research and Innovation funding available to deliver projects. Opportunities to work with academia to develop National Institute for Health Research grants to support delivery of research projects. Opportunities to work collaboratively with North West Coast Academic Health Science Network to support the adoption of innovation. Opportunities to work in collaboration with other healthcare organisations/ rehabilitation services e.g. Cheshire and Merseyside Major Trauma Collaborative, Cheshire and Merseyside Critical Care Services, other nationally accredited specialist rehabilitation services. THREATS Highly competitive funding environment. Failure to align clinical audit, research and innovation projects with Rehabilitation Network objectives. Failure to support culture change to create a learning environment for adoption of clinical audit findings, research outputs and innovation. Failure to attract/develop/retain staff with the necessary skills to undertake clinical audit, research and innovation. Audit, Research and Innovation Strategy 2014 2017 7
Audit, Research and Innovation Vision Clinical Audit, Research and Innovation Vision The Rehabilitation Network has been operational since January 2013 and we recognise clinical audit, research and innovation are integral to the delivery of evidence based, safe, efficient and cost effective rehabilitation care and improved clinical outcomes. We aspire to be a world class Rehabilitation Network with developed specialist rehabilitation hospital and community services with integrated and embedded clinical audit, research and innovation to benefit our patients. Our Rehabilitation Network audit, research and innovation vision is: A Rehabilitation Network which undertakes high quality clinical audit, research and innovation, embedded as core business ; Through effective collaborative partnerships we deliver high quality research that is nationally and internationally recognised and acknowledged; A high calibre multidisciplinary research workforce to deliver high quality clinical audit, research and innovation Processes set up to translate clinical audit findings, research outputs and innovation into clinical practice to benefit our patients. 8 Clinical Audit, Research and Innovation Strategy 2014-2017
Audit, Research and Innovation Objectives Clinical Audit, Research and Innovation Objectives Promote our reputation for audit, research and innovation nationally and internationally Increase opportunities for patients/carers to participate and benefit from research Embed research, audit and innovation as core Rehabilitation Network business High quality clinical audit research and innovation Promote the outputs of audit, research and innovation Engage staff in audit, research and innovation to improve safety, experience and clinical outcomes Harness audit, research and innovation to improve services and clinical outcomes In order to achieve our vision for clinical audit, research and innovation, we have developed six audit, objectives in consultation with staff. These objectives support the delivery of the Rehabilitation Network strategic objective to: work in partnership to deliver high quality clinical audit, research and innovation to drive excellent patient care Audit, Research and Innovation Strategy 2014 2017 9
1. Embed Audit, Research and Innovation and Core Business Objective 1: Embed Clinical Audit, Research and Innovation as Core Rehabilitation Network Business Development of an audit, research and innovation ethos across the Rehabilitation Network services will support the delivery of high quality specialist rehabilitation. We are committed to delivering clinical audit, research and innovation activities that can translate into tangible benefits for patients. We will work at board level, with staff and with patients to embed clinical audit, research and innovation as core Rehabilitation Network business. Board Engagement The Cheshire and Merseyside Rehabilitation Network Strategic Board has developed a strategic objective for clinical audit, research and innovation as part of its 3-year strategy to create an environment that drives forward the agenda and encourage activities that help address clinical needs and translate findings into practice. To achieve our aspirations progress against annual implementation plans and programmes for clinical audit, research and innovation will be reported to the Strategic Board. Staff Engagement We aim to increase the opportunities for all staff groups to engage in clinical audit, research and innovation by: raising awareness of the research and innovation funding opportunities available; providing training to undertake clinical audit and research; supporting staff to access outputs to inform service improvement; and supporting staff to promote their clinical audit, research and innovation. Patient Engagement We aim to increase the opportunities for patients to participate in and benefit from clinical audit, research and innovation. Communications Teams We will work closely with our partner Communications Teams to effectively promote research and innovation activities to enhance our reputation for high quality clinical audit, research and innovation. 10 Clinical Audit, Research and Innovation Strategy 2014-2017
2. Engage Staff in Audit, Research and Innovation to Improve Services Objective 2: Engage Staff in Clinical Audit, Research and Innovation to Improve Safety, Experience and Clinical Outcomes We recognise that our staff are fundamental to providing high quality patient-centred care. It is important that staff understand how clinical audit, research and innovation fits into their clinical practice. It is important that staff are able to draw upon and use evidence in their everyday practice to ensure safety and improve patient outcomes. We are committed to supporting the adoption and spread of innovation to transform and improve patient outcomes and improve quality and productivity of services. The Rehabilitation Network enables staff across all partner organisations who collectively have a wide range of expertise, coupled with access to a broad population base, to maximise opportunities in clinical audit, research and innovation to benefit patient care. The opportunity to engage in research and innovation also attracts high quality staff and productive external stakeholder relationships. We will ensure that - Staff are encouraged and supported to conduct clinical audit, research and innovation as part of their work, in line with the Rehabilitation Network strategic objectives by: o Communicating information via the website / email briefings; o Securing funding to undertake research and innovation, building backfill costs for staff time into applications o Celebrating successes in clinical audit, research and innovation; o Producing reports highlighting audit, research and innovation projects, key findings and actions and improvements. Staff have access to training to undertake clinical audit, research and innovation by: o Working closely with Audit and Research, Development and Innovation Teams to provide training in audit and research; o Ensuring there is adequate expertise for support with data collection and analysis for translation of evidence into actions / service improvement; o Working with Library Services to support staff to access the latest clinical audit, research and innovation outputs to inform service improvement. Evidence from audit, research and innovation is fed back into services by: o Maximising opportunities for partnership working to support the adoption of good practice to transform/improve patient outcomes and quality/productivity of services across the pathway. Audit, Research and Innovation Strategy 2014 2017 11
3. Harness Audit, Research and Innovation to Improve Services Objective 3: Harness Clinical Audit Research and Innovation to Improve Services and Outcomes To support and further promote clinical audit, research and innovation, and to underpin the strategy, there is a need to harness activities to improve services and outcomes. We will work closely with Audit and Research, Development and innovation Teams to provide training sessions to build staff capability. Work collaboratively with Library Services to access the latest clinical audit, research and innovation outputs to inform service improvement. We will ensure that clinical audit findings, research outcomes and innovation is linked to outcomes and feeds into service improvement plans by: o As part of the registration and governance process, ensure a system is in place for translating evaluation and clinical audit findings into service improvement plans, cost improvement plans or refined outcome measures o Develop programme of work for clinical audit, to provide evidence needed to support the cycle of continuous improvement through PDSA (Plan, Do, Study, Act) cycles o Engage with the Strategic Board via the monitoring of clinical audit findings, research outcomes and implementation of innovation and improvement activities; We will establish a clear link between the Strategic Board, Operational Committee and specialist rehabilitation units/services by: o Ensuring our clinical audit, research and innovation objectives feed into the Rehabilitation Network Strategy objectives; o Producing an annual programme of Clinical Audit, Research and Innovation in consultation with the Strategic Board and staff across the pathway to align local and national priorities. o Reporting on progress against the programme and action plans and improvements via the completion of clinical audit cycles, research outcomes and implementation of innovation and improvement activities; Work collaboratively with IT Teams and Communications Teams to promote innovative methods for sharing good practice and support the development of a learning Rehabilitation Network to improve service and clinical outcomes. 12 Clinical Audit, Research and Innovation Strategy 2014-2017
4. Promote the Outputs of Audit, Research and Innovation Objective 4: Promote the Outputs of Clinical Audit, Research and Innovation To support effective engagement of staff the Rehabilitation Network will explore ways of improving dissemination of clinical audit, research and innovation findings and translation into clinical practice. We will work closely with our Communications Teams to effectively embed clinical audit, research and innovation across the Rehabilitation Network (e.g. case studies, patient newsletters, staff briefings); We will provide evidence that clinical audit, research and innovation is leading to improved outcomes. We will ensure that clinical audit is linked to incident reporting, complaints etc and findings triangulated with other evidence such as from outcome measures, to include PROMS (patient reported outcome measures) and patient feedback by: o Establishing a system for identifying audit need as a result of incidents and complaints and quality priorities; o Assuring triangulation of information from incident reporting, patient experience and other quality indicators inform programmes of clinical audit and service evaluation. We will provide an annual report of the Rehabilitation Network s clinical audit, research and innovation activities and outputs to celebrate successes in relation to audit, research and innovation activities undertaken, successful funding applications, publications, talks and posters at conferences. Audit, Research and Innovation Strategy 2014 2017 13
5. Increase Opportunities; Patients to Participate/Benefit from Research Objective 5: Increase Opportunities for Patients to Participate and Benefit from Clinical Audit, Research and innovation Patient and public involvement is a vital part of clinical audit, research and innovation and will be a key tenet of the evidence based practice culture at the Rehabilitation Network. User involvement ensures that work is: useful, relevant and of high quality; and it helps us to ensure equality and diversity in participant recruitment, particularly in accessing harder to reach patient groups. We aim to increase patients/carers/public involvement by: Improving awareness of opportunities for patients via improved communications; Increasing the opportunities for patients/carers/public to participate in and benefit from clinical audit, research and innovation by developing links with patient voluntary groups; Working with the Research, Development and Innovation Patient Group to develop a programme of activities for effective patient/carer/public involvement and engagement; Lay membership in all significant or strategic events/ groups such as: membership on the Strategic Board; membership in clinical audit, research an innovation forums; membership on panels for awarding prizes etc; input into changes to stragegy. Capturing examples of good practice to share across the Rehabilitation Network. 14 Clinical Audit, Research and Innovation Strategy 2014-2017
6. Promote our reputation for audit, research and innovation Objective 6: Promote our Reputation for Clinical Audit, Research and Innovation Nationally and Internationally We aim to be recognised as a Rehabilitation Network of excellence in specialist rehabilitation care. This research should be relevant at a local, national and potentially international level. The Rehabilitation Network should engage in audit and research and innovative activities that make a real difference to patient benefit. The Rehabilitation Network is committed to promoting its clinical audit findings, research outputs and innovation activities to: Enhance its reputation with stakeholders; Encourage staff and patient participation in clinical audit, research and innovation; Encourage staff to undertake clinical audits to improve service outcomes and benchmark against national standards; Encourage staff to develop and adopt innovation developed elsewhere to improve specialist rehabilitation services. Audit, Research and Innovation Strategy 2014 2017 15
Delivering and Monitoring the Implementation of the Strategy Delivering and Monitoring the Implementation of the Clinical Audit, Research and Innovation Strategy The Audit, Research and Innovation Strategy, and supporting annual Implementation Plan and Programme which will include specific actions and projects relating to the implementation of this strategy will be submitted to the Strategic Board and thereafter monitored by the Operational Committee. OUTCOME MEASURES We will review the outcome measures and produce an annual report to the Rehabilitation Network Strategic Board. Outcome measures include: Development and implementation of the Clinical Audit, Research and Innovation Implementation Plan; Development and implementation of the Clinical Audit, Research and Innovation Programme; Increased numbers of multi-disciplinary staff involved in clinical audit, research and innovation activities; Increased number of clinical audit, research and innovation projects; Increased number of successful research and innovation funding applications; Increased number of publications; Increased number of abstracts and posters to regional and national conferences. Review This strategy will be reviewed annually by the Operational Committee over the period of the strategy 2014-2017. 16 Clinical Audit, Research and Innovation Strategy 2014-2017