We received a fantastic response with over 145 applications across the ten categories. It is hugely encouraging to see so much great quality improvement work taking place to help improve services for babies, children and families across Scotland. Click on a category below to see the projects have reached the shortlist:
Achieving Results at Scale Award
Increasing access to financial inclusion advice for pregnant women, South Lanarkshire Council and NHS Lanarkshire
South Lanarkshire Council and NHS Lanarkshire developed a quality improvement aim that by December 2015, 70% of all referrals to the Tackling Poverty Fund Telephone Advice Line will come from ante-natal services and 75% of these will be from universal midwifery. Using the quality improvement method to map, study and adapt the referral process and test how best to engage pregnant women the teams shared and spread their learning across all teams in South Lanarkshire; resulting in 95 per of referrals to the Advice Line now coming from midwives. Feedback from women who have used the service has been positive and this learning has helped to influence similar projects in other parts of Scotland.
Reliable administration of Synthetic Oxytocin for the induction/augmentation of labour, NHS Ayrshire and Arran
NHS Ayrshire and Arran undertook a quality improvement project to introduce a standardised regime and guidance for the administration of the high risk medication – oxytocin – for the induction and augmentation of labour in Ayrshire Maternity Unit by June 2015. They applied quality improvement methodology to test a new regime entailing a lower dose of oxytocin and associated guidance. Midwives report 100 per confidence using the new regime and outcomes to date demonstrate improved compliance to the new regime, reduced risk and more positive birth experiences for babies and women. This improvement project has been shared with other health boards.
Increasing the uptake of the 27-30 month review, NHS Lanarkshire
NHS Lanarkshire’s improvement aim was to increase the uptake of the 27-30 Month Child Health Review (CHR) in South Lanarkshire from baseline of 69% to 85% by December 2015. Using improvement methodology, the Health Visiting Team in South Lanarkshire reviewed current processes and better ways to engage families in the CHRs. The improvements were spread across all South Lanarkshire health visiting areas with an uptake of 84% suggesting that change is being embedded locally. As well as spreading improvements locally, South Lanarkshire has shared its learning with other parts of Scotland who have adopted a similar improvement approach.
Co-production With Families and Our Services Award
Little Explorer’s Nurture Day (LEND), East Dunbartonshire Council
East Dunbartonshire Council, in its work to develop a multi-agency model to support and attract families to services, developed an aim to: by the end of June 2015, there will be a 50% increase in families with children pre-birth to age five, attending the Little Explorer’s Nurture Day (LEND) on Thursdays within Hillhead Community Centre. Using improvement methodology, and working from a baseline of two families attending the Community Centre, they tested and measured the range of services on offer and various ways to publicise them, using LEND as means to get families into the Community Centre in the first instance. This increased the number of families attending the centre from an average of two to an average of 40 or more. As well as ensuring partnership working across agencies, this has result in parents and carers feeling confident enough to take ownership of some of the projects on offer.
Understanding your child – HMP Shotts Dads Group, North Lanarkshire Council, Learning & Leisure Services
HMP Shotts developed an improvement aim; by June 2016, the ‘adapted’ Understanding Your Child Parenting Programme will result in 80% of the dads who attend [the weekly group] having a greater understanding of their children’s behaviour. Using improvement methodology, the prison worked with North Lanarkshire Partnership and Getting Better Together to test and measure different aspects of the programme including, training, roles, wider networks and resources. Through measuring attendance at a weekly group and the responses of dads, outcomes included dads having more positive relationships with their children, more discussion between dads about their children and overall, an increased understanding of their children’s needs and behaviours. This improvement work has been shared across agencies and recognised internationally.
East Plean Nursery Food Project, Adult Learning Team, Stirling Council
A collaborative project involving Stirling Council Adult Learning Team, East Plean Nursery and NHS Forth Valley Department of Nutrition and Dietetics with the following aim: at least 50% of parent/carers of pre-school children engage in a series of five Tots Make and Taste sessions with their child and sign up for further adult learning opportunities by June 2016. Using improvement methodology, the partners shared skills and worked together to test, measure, review and refine the processes and responsibilities in place to engage families in the Make and Taste sessions and in further learning.
This resulted in 58% of families engaging in the Make and Taste sessions by the end of Year 1. Data from round 2 revealed 75% of participants expressed greater confidence around food activities and an intention to continue with literacy/numeracy activities with their child at home.
Inspiring Leadership Award
Xenia Dennison,Speech and Language Therapist,NHS Lanarkshire
Xenia Dennison is a Speech and Language Therapist (SLT) who worked for NHS Lanarkshire for seven years. Over the past two years she has led a project which aimed to improve speech, language and communication (SLC) outcomes for children attending a family learning centre in an area of high deprivation. Xenia’s work, which includes establishing
training for Early Years Workers and co-locating SLT appointments and drop in sessions into the nursery, has led to more effective ways ofworking, children making gains in SLC skills and better parental engagement. She has also spearheaded improvement work with the SLT team in Airdrie which has led to a reduction in clinic waiting times from 25 to less than 4 weeks, with associated impact on staff morale as well as earlier treatment for children and young people. Xenia is committed to use of the Model for Improvement and has now completed the Scottish Improvement Leaders programme. Inspired by the MfI she has transferred her skills to a new role as Programme Improvement Manager with the Family Nurse Partnership.
Leigh Jolly, Children’s Services Social Work Manager,Aberdeenshire Council
Leigh Jolly is a Social Work Manager working in Aberdeenshire. Her focus is on Corporate Parenting and her nomination is for leadership of the Permanence and Care Excellence programme. Leigh Chairs the local group which brings together a range of practitioners to drive the improvement in her area and she has led the PACE leads team to develop change ideas into tests. Leigh’s leadership has led to the area meeting the aim of having 90% of children accommodated before their 12th birthday having a permanence plan within 9 months by the end of January 2016. This has led to significant improvement in permanence planning for looked after children in Aberdeenshire. Leigh’s leadership was pivotal in making this issue a priority in Aberdeenshire and her use of data to describe the problem and track whether improvements were made has been vital in the success of this work.
Anne Scott, Early Years Centres, Scottish Borders Council
Anne Scott was the Early Years Centre Manager in the Scottish Borders until her retrial in June this year. For the past 2 and a half years Anne has project managed the development of 4 Early Years Centres in the Borders, based in primary schools in areas of significant deprivation. Through her work Anne has delivered the 4 centres and has facilitated a new way of partnership working, providing a hub for multi-agency working with the resultant improvement of services for families. She has overcame barriers, resolved challenges and ensured broad stakeholder engagement. Anne’s leadership has ensured that the Model for Improvement has become embedded in the work of the Centres, through supporting and encouraging staff to become involved in improvement projects, recognising the importance of improving outcomes, and evidencing these through data.
Merit Award for QI in Early Years
Engaging Parents in Early Learning and Childcare, Argyll and Bute CPP
The Engaging Parents in Early Learning Project took place in Argyll and Bute and was focussed on increasing parental engagement in learning in one early Level class with 24 ELCC and 16 P1 children. The aims was to have 60% of children having at least one example of parental engagement with their learning every week. The project focussed on improving the children’s Personal Learning Plans (PLPs) through sending them home every week and including opportunities for parents to comment. The approach was implemented using PDSAs testing the return rate. By the end of the project weekly parental engagement had risen to an average of 85%. The team involved in the project have grown and learned, becoming champions of parental engagement and Quality Improvement. The team plan to share and spread this approach throughout their 3-18 campus, spreading their knowledge on the model for improvement.
Improving Speech, Language and Communication Outcomes, NHS Lanarkshire and North Lanarkshire Council
The ‘Improving Speech, Language and Communication Outcomes’ project was delivered in Airdrie, North Lanarkshire. The project involved co-locating a Speech and Language Therapy service in a Family Learning Centre within an area of high multiple deprivation. The aim was to improve speech, language and communication (SLC) outcomes by addressing known challenges around access, collaboration and partnership working. The Model for Improvement allowed the project team to test a variety of changes to processes and service delivery, including a focus on targeted training with Early Years Practitioners (EYP) to build capacity to support SLC in the least intrusive way possible for children and families. Corresponding learning from Plan, Do, Study, Act cycles resulted in the production of a bundle of high impact practices, clearly identifying that regular collaboration with parents/carers and EYPs is at the heart of effective, child centred support. The bundle is now being spread and implemented within the wider Speech and Language Therapy service in North Lanarkshire. Children in the Family Learning Centre are making gains in their SLC abilities and parents/carers are engaging positively in their child’s development.
Child Health Allied Health Professionals 0-3 years Children’s Pathway, NHS Tayside
Work has been undertaken in Tayside to improve services for children who see more than one AHP, leading to the introduction of the Child Health AHP 0-3 Children’s pathway. The aim was to reduce multiple therapy appointments for families and improve parent confidence, by ensuring that 100% of families referred for more than one service would receive a joint goal-setting session within 8 weeks of the second referral. The work was progressed through identifying families, testing new ways of working to support shared sessions, and testing role burring between AHPs, using PDSAs This work has led to a new pathway where the families of children with complex needs are seen jointly by AHPs in partnership, reducing the number of appointments. This project was carried out in partnership with third sector colleagues, and has changed the philosophy of the staff. The model has been rolled out in Angus and is now being spread across Tayside.
Merit Award for QI in Maternity, Neonatal and Paediatric Services
Reducing Severe Postpartum haemorrhage, NHS Lanarkshire
Postpartum haemorrhage (PPH) is a major cause of maternal morbidity and NHS Lanarkshire chose this as a priority area for their Quality Improvement work. This included developing a PPH prevention and management bundle of care, which was tested and spread across all of maternity services in Lanarkshire with engagement from 10 community antenatal clinics, three specialist hospital antenatal clinics, four acute wards and in theatres with introduction of a standardised communication tool recognising the PPH risk assessment score. Positive results have been achieved with further areas identified to drive this work. NHS Lanarkshire is the only Trust to adopt a whole system approach for this measure and this work has been showcased to other units and presented at national events.
Reduction of term admissions through ‘Warm Bundle Of Care’, NHS Lanarkshire
The work at Wishaw General Hospital looked at introducing three key steps at the delivery of a newborn baby to reduce cold stress and the harms associated with this, such as unnecessary separation between mother and baby. The quality improvement aim was to reduce term admissions from Ward 22 to the Neonatal Unit by 15% by June 2016 through implementation of a warm bundle of care. The team established baseline data, undertook process mapping and multiple small scale testing to determine changes that led to improvement. Alongside this, key to success was a facebook campaign to Involve the public with improvements and raise awareness of the warm bundle. The aim has been achieved. A reduction of 42% in the test ward has been achieved exceeding the 15% aim. In addition, 20% fewer babies during this time period received unnecessary IV antibiotics, 45% of babies admitted were warmer meaning a reduction in complications associated with cold stress.
SAFER (Safe Assessment Form to Evaluate Risk), NHS Borders
The aim of this project is to provide a safe and robust antenatal risk assessment for pregnant women and to engage them at the earliest stage of their pregnancy in the identification and management of pregnancy associated risk. This online SAFER form has been created, tested and introduced to all maternity service users within NHS Borders. The SAFER form produces an individual risk assessment and a calculates a management plan for each woman and her pregnancy . It has reduced the use of up to eight risk assessment forms into one and preliminary analysis has shown an improvement in the assessment of venous thrombo embolism fetal growth and post partum haemorrhage.
Merit Award for QI in Raising Attainment for All
Raising Attainment in Reading, Langlee Primary School, Scottish Borders
Langlee Primary School has been focussed on raising attainment in reading by targeting coaching from a support for learning teacher for pupils with below expected reading levels. Having seen initial success in testing this approach with a couple of pupils, it has been spread with data showing excellent results. This has been achieved in partnership with teaching staff, support for learning staff, pupils and their parents.
Early Literacy, South Ayrshire Council
Principal teachers, Daniella Miller and Karen Miller have been leading a long-term South Ayrshire project to raise attainment in literacy. In recognition of research that pupils from areas of high deprivation are typically 18 months behind in vocabulary, the ultimate aim of this work was to close the gap for pupils from SIMD deciles 1 and 2 . The project has a very clear objective: 90 P2 pupils attending boost groups in the schools will achieve their chronological reading age or above by the end of P2. To achieve this, the project has focused on literacy within nursery, primary 1 and primary 2.
Improving Numeracy Attainment through the use of Conceptual Development in Numeracy strategies, Angus
Using the Conceptual Development in Numeracy (CDiN) approach and quality improvement methods, Hayshead and the Arbroath North Cluster ( Friockheim, St Thomas’, Warddykes and Inverkeilor Primary) have changed the way they have delivered numeracy in schools. This has resulted in improvement in attainment in most stages but very positive trends throughout primary 1-3.
Most Inspiring or Innovative Project Award
Language, Learning and Literacy, NHS Lanarkshire, South Lanarkshire Council and Happy Feet Nursery
With an aim of ensuring that 90% of children will reach their developmental milestones by the time the child leaves nursery, a partnership group involving Speech and Language Therapy, Educational Psychology, council and partner nurseries and the local Early Years Collaborative brought two pieces of work together to develop a tool to support nursery staff to work in a focused way of speech and language with children in their group. This work is already scaling up across nursery establishments in South Lanarkshire in a project that will change the way all three services work with children and each other for better language, literacy and learning outcomes.
Reading, nurture and building resilience, Bannockburn Primary School and Nursery
The improvement work in this school displays innovative approaches to nurture and resilience building.This includes an innovative approach to building confidence in reading with children in partnership with a partner organisation and involving dogs. This in combination with the approach of this school has taken using improvement methodology to create a nurturing environment for children who need it most is inspiring.
Bannockburn High School
With a vision to raise the aspiration, confidence and attainment of pupils in Bannockburn High School, this team have creatively used improvement methodology to implement a shared pupil and teacher led approach to improve the commitment to learning in school. They have coupled this work with an innovative approach to increase pleasure in reading and impacting on the literacy skills of pupils.
Outstanding Contribution to Improving Outcomes for Children, Young People and their Families Award
Permanance and Care Excellence (PACE), Aberdeenshire Council
The PACE quality improvement work in Aberdeenshire has surpassed their original aim of 90% of children accommodated before their 12th birthday having a permanence plan within 12 months. Achieved by interdependent services working together to reduce drift and delay in permanence this work increases the chances of these children experiencing improved outcomes through childhood and into adulthood.
Lanarkshire’s Additional Midwifery Service (LAMS), North Lanarkshire Integrated Addiction Service
Lanarkshire’s Additional Midwifery Services (LAMS) has made a significant impact to the families they have engaged with, support services have included; antenatal care, stabilising/reducing substance misuse and improving birth weights – to name a few. Aiming to get ALL woman in North Lanarkshire, with a history of drug or alcohol misuse, to attend antenatal care and support, the specialist service provision and the use of improvement methodology has significantly changed the outlook for families within Lanarkshire.
Raising Attainment in numeracy, Clovenfords and Stow Primary School, Scottish Borders
Aiming to increase the percentage of pupils who were achieving at or above expected levels in numeracy, the staff at Clovenfords and Stow have supported pupils through a number of numeracy sessions with significant progress being evidenced amongst the targeted pupils in terms of success with specific concepts, increased confidence and attainment. Learning from this approach has spread across the school.
Quality Improvement Champion Award
Cheryl Clark, Improvement Advisor Midwife, NHS Lanarkshire is a staff midwife in NHS Lanarkshire and was appointed as the Maternity and Children’s Quality Improvement Champion in 2014. Cheryl teaches quality improvement by example and has achieved results. She was pivotal to the NHS Lanarkshire reducing Harm Collaborative and has strengthened quality improvement in the neonatal unit. She introduces fun and innovative ways to demonstrate data with her patient safety boards and newsletters and has created social media forums for midwives to communicate aspects of the safety work, bringing in elements of healthy competition.
NHS Forth Valley: Val Arbuckle – Additional Support Midwifery Sister; Elaine Ronald – Infant Feeding Advisor/Nutrition Co-ordinator; Kirsty MacInnes – Practice Development Midwife/Sister Midwife Neonatal Unit – Working together the three nominees have responsibility for leading Workstream 1 of the Early Years Collaborative (EYC) in Forth Valley with a Lead Practitioner role for Maternity Services in Falkirk, Stirling and Clackmannanshire. The nominees established a working group of midwives to share knowledge and skills in improvement methodology, which has evolved over time with increasing membership as interest has risen. The nominees have supported a range of improvement projects, one example of a successful test was working collaboratively with the Prebirth Planning Service to develop a process where Police concerns involving pregnant women or their partners are shared with Maternity Services. This provides the opportunity to initiate early and effective multi-agency interventions and to improve outcomes for identified families living in Forth Valley.
Lesley Robertson,Scottish Borders Council is the manager for the Early Years Centres in Langlee and Philiphaugh in the Scottish Borders. Lesley’s role has been vital to the success of the Early Years Centres and specific quality improvement projects including work on increasing the uptake of Story Sacks and Healthy Start. These would not have been achieved without her dedication and focus. Her commitment to the methods and ethos around the Early Years Collaborative has been exceptional and she has advocated quality improvement at each and every stage of her work.
The Argyll and Bute Family Pathway – Growing up in Kintyre, Argyll and Bute CPP
The Family pathway aimed to create coherence in support for children pre-birth to school entry and their families. With an aim of 80% of all children within Kintyre area of Argyll and Bute having achieved their developmental milestones by the time they leave nursery, practitioners set out to work with families throughout the child’s journey to support key stages of their developmental milestone using their increasing creditable data to inform and target specific needs.
Somewhere over the rainbow, NHS Tayside
This Allied Health Prossion (AHP) project recognises a gap in child development and the need to do something new to address these issues. They have embraced improvement methodology and aimed for transformational change in AHP support for the early years. Somewhere Over the Rainbow was developed to train early years workers and other multi agency staff to improve their knowledge of key messages from AHPs. This work has successfully enaged with over 300 staff across Tayside.
Boosting incomes for pregnant women in Leith, NHS Lothian
Setting out to boost family incomes in Edinburgh by £250,000, the Leith Early Years Collaborative Pioneer Site exceeded their aim by using Quality Improvement to test various interventions around the uptake of healthy start food and vitamin vouchers for low income families. The work, which started with a single midwife and woman, has boosted low income families household budgets considerably.On average, women accessing welfare rights advice through Granton Information Centre benefitted by £4,000, totalling almost £1m between March 2015 and May 2016.