- Eight types of waste (tool)
In a health and care context, value is a combination of what is valued by patients within a care pathway and the achievement of appropriate health outcomes. Any activity that does not contribute to this value can be classified as “waste”. The eight wastes approach can help to achieve improvement in health and care services by enabling teams to examine their own workplace and eliminate activities that do not add value, i.e. wasteful activities. This approach can improve the patient experience and release time that frontline teams can reinvest in care. Considering the eight wastes can be a useful exercise within any service improvement effort.
Source of graphic: West of England Academic Health Science Network
2. PDSA cycle (tool)
We can use PDSA cycles to test an idea for change by temporarily trialling a change and assessing its impact. There are four distinct stages to the PDSA cycle:
- Plan – the change that needs to be tested or implemented
- Do – carry out or test the change
- Study – data before and after the change and reflect on what is learned
- Act – plan the next change cycle or full implementation
We may not get the results you expect when making changes to our processes, so it is safer, and more effective to test out improvements on a small scale before implementing them across the board. As with any change, ownership is key to implementing the improvement successfully. If we involve a range of colleagues and service users in trying something out on a small scale before it is fully operational, we will reduce the barriers to change.
3. SBAR (method)
Situation – Background – Assessment – Recommendation (SBAR) is a structured form of communication that enables information to be transferred accurately between individuals. SBAR was originally developed by the United States military for communication on nuclear submarines, but has been successfully used in many different healthcare settings, particularly relating to improving patient safety.
SBAR consists of standardised prompt questions in four sections to ensure that staff are sharing concise and focused information. It allows members of the team to communicate assertively and effectively, reducing the need for repetition and the likelihood for errors. As the structure is shared, it also helps team members anticipate the information needed by colleagues and encourages assessment skills. Using SBAR prompts staff to formulate information with the right level of detail.
Example SBAR tool from East Midlands Emergency Medicine Educational Media
4. Six Thinking Hats (Tool)
The six thinking hats is a method used to amplify creative conversations, by making sure that a broad variety of viewpoints and thinking styles are represented. Using six roles (or “hats”), the framework — developed by Dr. Edward de Bono — allows teams to more easily structure abstract thinking for productive results.