Frailsafe collaborative

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Implementation

We believe Frailsafe will be effective and scalable because of the consideration we have given to the underpinning principles. We have designed and tested the tool to be:

  • simple to use
  • cheap
  • effective
  • scalable for wide spread in a variety of contexts (it can be easily embedded into paper or electronic patient records)

We expect this project to generate significant learning both for improving the care of frail older patients and have cross cutting relevance to other areas of clinical care. We aim to gain understanding of effective implementation of Frailsafe at scale. This knowledge will include a combination of design, staff engagement, culture, process and outcome measures. We predict that we will demonstrate better joint working between medical and nursing staff as Frailsafe is potentially force for driving closer working.

Set Up Phase

Employ an expert healthcare designer to finalise Frailsafe. The designer will work with the Frailsafe network members to develop a prototype set of materials for implementation as a training package. For example, this is likely to include a ‘How to.’ video, engagement guides and posters.

Prepare faculty for delivery of the collaborative. The faculty will demonstrate the power of combining subject matter experts (geriatric medicine) with improvement experts (profound knowledge) to produce a framework for improvement.

Appoint the project manager (PM) to be the day-to-day leader of the collaborative and act as the principal liaison with the external collaborators. The PM will; ensure teams are prepared for the collaborative, coordinate pre-work calls to clarify the collaborative processes, roles, and expectations of organisational leaders and team members. The PM will be responsible for guiding and advising the participating teams across the phases of the project ensuring that the key milestones are achieved, results visible and learning captured. The PM will ensure effective reporting across partner organisations; manage issue resolution and escalation as necessary. The project manager will have experience of leading quality improvement within healthcare and have the necessary project management and communication skills to work effectively across the stakeholders.

The Frailsafe network will select the hospitals for the Collaborative.

We will process remaining pilot data to finalise the measurement structure with our evaluation partner.

We will launch a Frailsafe website which will combine an external facing website to promote Frailsafe and a member log-in to a forum to share learning and access the WISH data collection tool.

Year 1

The host organisation will deliver a Breakthrough Series Collaborative of 12 hospitals. The Collaborative will exemplify the concept of ‘all teach, all learn’ to generate the knowledge necessary to achieve a national roll out of Frailsafe with a robust and tested training package. The hospitals will have five interprofessional representatives at each learning session.

Data collection will be conducted by local staff using Web Improvement Support for Healthcare (WISH) to collate. This online tool has already been successfully tested in the pilot phase of Frailsafe..

Year 2

We hope to achieve national roll out of Frailsafe led by the British Geriatrics Society with the support of the other national partner organisations.  This will be achieved by a national launch event followed by distribution of Frailsafe through the robust communication channels controlled by the partner organisations. Patient and carer involvement will be mobilised by Age UK.

We will predict challenges from previous work, especially the knowledge gained from implementation of the Surgical Safety Checklist. For unpredicted challenges will are confident that our communication strategy and formative evaluation will help to identify and increase awareness of issues early (see evaluation section for more detail). Our steering group will deliver expert decision making that the Frailsafe programme team will operationalize.