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SSA Toolkit

Implement actions

 

Implement actions

Implement actions

Putting the actions into practice and evaluating their effectiveness

This section looks at how to plan the selected actions, including both plans for putting them into practice and plans for evaluating their effectiveness. This is important to ensure that the actions are actually effective in practice. It is not the purpose of this Toolkit to repeat in depth other work on best practice in change management. As a result, this section just gives an outline of some aspects that need to be considered. Some of the links below may be helpful for providing further information on creating change in healthcare systems.

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Implement actions is the third activity in the Improve phase of SSA

Implement actions is an activity in the Improve phase of SSA

 

Further information

  • The NHS England website has a section on the NHS Change Model, which provides a framework and advice for creating sustainable change in healthcare systems.
  • The now closed NHS Institute for Innovation and Improvement produced a series of Improvement Leaders' Guides which can be helpful in thinking through various aspects of change management.

 


Detailing actions

At this point it is often necessary to describe the actions that have been chosen for implementation in more detail. When doing this it can be helpful to consider the ‘what, why, when, how, where and who’ of the action.

This process will vary accordingly to the complexity of the action. Note that the level of detail required may often be more than initially expected. For example, the implementation of a hand washing policy in a hospital requires not only an awareness campaign to encourage participation but also the infrastructure to guarantee a ready supply of the hand gel / soap.

Detailing actions may involve finding out more information about the options available. For example, with the hand wash, it may be necessary to find out more about the different types of washes available, their levels of effectiveness against particular infections, the effects of frequent use on skin and their costs. Alternatively, detailing actions may involve some elements of design, for example, the design of a new procedure or a hand wash dispenser. In such cases, it may be helpful to hold separate meetings to decide on the details. The researchers at the Cambridge Engineering Design Centre are currently developing a toolkit to assist with the design of healthcare systems and products.

A quote from a poem in Rudyard Kipling's tale, The Elephant's Child: I keep six honest serving men (They taught me all I knew); Their names are What and Why and When And How and Where and Who.

This poem highlights key questions to keep in mind when detailing actions

Putting ‘Detailing actions’ into practice

Space to record this information is provided in the SSA Assessment Form. To do this:

  1. Copy the highlighted actions from the ‘Propose actions’ page to the ‘Implement actions’ page in the Assessment Form. Enter the ID numbers of the actions in the first column (ID) of the first table, and a short description of the action in the next column (Planned actions).
  2. For each of the Planned actions, enter additional information in the column headed Further details, as appropriate. If there is a lot of information, it may be more suitable to record this in a separate document and include a reference to this document in the Assessment Form.
  3. If more meetings need to be held to work out the details, record this in the column headed Further details.
Screenshot of Implement actions page of the assessment form

 


Case Study

The completed ‘Implement actions’ page from the Section 136 case study is shown opposite. Further explanation of this stage in the case study can be found on the Section 136 page about Detailing actions.


Planning for delivery

It is now important to identify the requirements for the successful delivery of each of the actions. This includes identifying those responsible for delivering each action, the time by which it needs to be completed, and how it will be verified that the action has indeed been completed. It may also be helpful to describe any resources needed to complete the action.

If planning in further detail is required, a more in-depth project plan can be developed separately, such as a Gantt chart. This could include high-level tasks, more detailed activities, the people responsible, timescales, milestones, meetings, and monitoring of progress of activities against the project plan.

Putting ‘Planning for delivery’ into practice

Space to record this information is provided in the SSA Assessment Form. To do this:

  1. Select the ‘Implement actions’ page in the Assessment Form.
  2. For each Planned action in the table, enter the name of the Person responsible for making sure it is carried out, and the Timescale allowed for its completion in the columns provided.
Screenshot of the Implement actions page of the assessment form

Case Study

The completed ‘Implement actions’ page from the Section 136 case study is shown opposite. Further explanation of this stage in the case study can be found on the Section 136 page about Planning for delivery.


Planning evaluation

It is also important to monitor the system and determine if the implemented actions are effective in practice. This is because actions may not always work in exactly the way expected. Monitoring the system can help in deciding whether to continue an action or to consider alternatives and, in some cases, whether to implement actions on a wider scale. This links with the on-going Monitor system activity in the Manage phase of the SSA.

To do this, it is helpful to identify Evaluation measures or outcome measures. These will vary according to the action and its intended consequences. For example, an action may be intended to reduce the likelihood of there being insufficient staff available and having to pull them from other areas of the unit. In this case, an evaluation measure might be the frequency of incidents in which this occurs.

Putting ‘Planning evaluation’ into practice

Space to record this information is provided in the SSA Assessment Form. To do this:

  1. Select the ‘Implement actions’ page in the Assessment Form.
  2. For each action in the first table, enter details of the Evaluation measures that will be used to determine if the action in successful.
Screenshot of Implement actions page of the assessment form

Case Study

The completed ‘Implement actions’ page from the Section 136 case study is shown opposite. Further explanation of this stage in the case study can be found on the Section 136 page about Planning evaluation.