Managing the change process - from implementation to reporting

We have provided a number of resources on this page to support you to develop your FeNO project using QI methodology.

Quality Improvement (QI) helps us identify what works well and where we can make changes. In primary care, we don't have time or resources to spend on things that don't work, don't serve our patients, and that could be done more efficiently or effectively. QI is a commitment to continuously improving the quality of healthcare, focusing on the preferences and needs of the people who use services. (Royal College of General Practitioners 2017)

“In order to practise medicine in the 21st century, a core understanding of quality improvement is as important as our understanding of anatomy, physiology and biochemistry. (Stephen Powis, Medical Director, Royal Free London NHS Foundation Trust, 2015. Academy of Medical Royal Colleges)

Driver Diagrams

When dealing with complex change it is often difficult to differentiate between cause and effect and to be able to attribute a particular outcome to one particular change you have made. Driver diagrams can be used to show your theories of cause and effect in your system – in other words, your theories about what changes will likely cause the desired effects. It is helpful to create driver diagrams during the initial planning stages of your change programme, but they should also be used throughout your change programme. Regular review of your driver diagrams will allow you to update them as you refine your theory of change in your system and learn more about the cause and effect relationships that are in play.

Click on the following link to review further information from NHSE - Driver Diagrams

You can also download and print this template to complete your own Driver Diagram. We've put together an example for you to consider, accessible here.

Plan Do Study Act (PDSA)

To get you started we have produced a simple slide deck showcasing the Plan Do Study Act (PDSA) methodology, along with a checklist of items to consider. The slide deck also includes information around Root Cause Analysis (RCA) using 'Fishbone' and 'The 5 Whys' methods. You can access this slide deck here.

In addition you can print out this summary check list to 'tick off' elements as they are considered and completed, and download and tailor this project plan template to help you manage your FeNO planning.

Action Learning Sets (ALSs)

It can be really helpful to plan projects as a mixed group. Inviting your key stakeholders and contributors along to develop and structure your project. To assist you we have developed this Action Learning Set Template which has been designed to take you through from project initiation through to planning, implementation and evaluation.

AAC Pathway Transformation Fund Governance - for ACC PTF Bundle awardees only

There is a requirement for PTF bundle projects to evidence training completed in order to access the FeNO products and begun pathway redesign to incorporate FeNO testing. You can review the Guidance document for product release here and the pro forma to record you training/pathway changes here.

Reporting

As part of the Pathway Transformation Fund (PTF) award and contract, there is a requirement for delivery teams to submit checkpoint reports, along with a final evaluation report. You can download these report templates using the links below;

Clinical Coding - SNOMED CT codes

We have engaged with NHS Digital to explore currently available SNOMED CT codes for FeNO - Suggested codes can be downloaded here