{"page":0,"change":"none","str":"Design, implement and measure: ","dir":"ltr","width":"414.71","height":"26.04","transform":["26.04","0.00","0.00","26.04","99.26","387.31"],"x":99.264,"y":387.31}
{"page":0,"change":"none","str":"A guide to ","dir":"ltr","width":"134.29","height":"26.04","transform":["26.04","0.00","0.00","26.04","514.03","387.31"],"x":514.03,"y":387.31}
{"page":0,"change":"none","str":"improving transfers of care","dir":"ltr","width":"336.67","height":"26.04","transform":["26.04","0.00","0.00","26.04","99.26","352.99"],"x":99.264,"y":352.99}
{"page":0,"change":"none","str":"& Ali Cole","dir":"ltr","width":"75.59","height":"15.96","transform":["15.96","0.00","0.00","15.96","630.58","80.04"],"x":630.58,"y":80.04}
{"page":1,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","394.49","30.84"],"x":394.49,"y":30.84}
{"page":1,"change":"none","str":"Where can things go wrong?","dir":"ltr","width":"150.94","height":"11.04","transform":["11.04","0.00","0.00","11.04","104.66","368.95"],"x":104.66,"y":368.95}
{"page":1,"change":"none","str":"How do you achieve it? (The six step improvement process)","dir":"ltr","width":"313.68","height":"11.04","transform":["11.04","0.00","0.00","11.04","104.66","349.99"],"x":104.66,"y":349.99}
{"page":1,"change":"none","str":"“I got so used to the system being ","dir":"ltr","width":"170.88","height":"12.65","transform":["12.00","0.00","4.00","12.00","551.35","452.50"],"fontName":"ABCDEE+Eras Light ITC","x":551.35,"y":452.5}
{"page":1,"change":"none","str":"broken I prepared and copied my ","dir":"ltr","width":"170.54","height":"12.65","transform":["12.00","0.00","4.00","12.00","551.35","436.78"],"fontName":"ABCDEE+Eras Light ITC","x":551.35,"y":436.78}
{"page":1,"change":"none","str":"own handover sheet about my ","dir":"ltr","width":"158.42","height":"12.65","transform":["12.00","0.00","4.00","12.00","551.35","421.15"],"fontName":"ABCDEE+Eras Light ITC","x":551.35,"y":421.15}
{"page":1,"change":"none","str":"All the things ","dir":"ltr","width":"67.96","height":"12.65","transform":["12.00","0.00","4.00","12.00","665.38","405.43"],"fontName":"ABCDEE+Eras Light ITC","x":665.38,"y":405.43}
{"page":1,"change":"none","str":"I knew they needed to know and ","dir":"ltr","width":"169.09","height":"12.65","transform":["12.00","0.00","4.00","12.00","551.35","389.83"],"fontName":"ABCDEE+Eras Light ITC","x":551.35,"y":389.83}
{"page":1,"change":"none","str":"asked every time he was admitted. ","dir":"ltr","width":"176.87","height":"12.65","transform":["12.00","0.00","4.00","12.00","551.35","374.23"],"fontName":"ABCDEE+Eras Light ITC","x":551.35,"y":374.23}
{"page":1,"change":"none","str":"I handed them to ","dir":"ltr","width":"90.17","height":"12.65","transform":["12.00","0.00","4.00","12.00","551.35","245.93"],"fontName":"ABCDEE+Eras Light ITC","x":551.35,"y":245.93}
{"page":1,"change":"none","str":"AND ward staff as the sheets had ","dir":"ltr","width":"169.20","height":"12.65","transform":["12.00","0.00","4.00","12.00","551.35","230.33"],"fontName":"ABCDEE+Eras Light ITC","x":551.35,"y":230.33}
{"page":1,"change":"none","str":"often disappeared by the time he ","dir":"ltr","width":"168.24","height":"12.65","transform":["12.00","0.00","4.00","12.00","551.35","214.61"],"fontName":"ABCDEE+Eras Light ITC","x":551.35,"y":214.61}
{"page":1,"change":"none","str":"had a bed. I do wonder where they ","dir":"ltr","width":"181.55","height":"12.65","transform":["12.00","0.00","4.00","12.00","551.35","199.01"],"fontName":"ABCDEE+Eras Light ITC","x":551.35,"y":199.01}
{"page":2,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","394.49","30.84"],"x":394.49,"y":30.84}
{"page":2,"change":"none","str":"This guide was ","dir":"ltr","width":"76.40","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","494.62"],"x":99.264,"y":494.62}
{"page":2,"change":"none","str":"by the Authors in their own time whilst they worked at the NHS Institute for ","dir":"ltr","width":"364.04","height":"11.04","transform":["11.04","0.00","0.00","11.04","333.65","494.62"],"x":333.65,"y":494.62}
{"page":2,"change":"none","str":"Innovation and Improvement. Some of the examples and many of the ideas emerged as a result of the lead author’s field work ","dir":"ltr","width":"615.62","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","482.02"],"fontName":"Arial","x":99.264,"y":482.02}
{"page":2,"change":"none","str":", and through extensive discussions with the second author. ","dir":"ltr","width":"294.00","height":"11.04","transform":["11.04","0.00","0.00","11.04","446.69","469.30"],"x":446.69,"y":469.3}
{"page":2,"change":"none","str":"Since the closure of the NHS Institute, additional ","dir":"ltr","width":"239.15","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","456.70"],"x":99.264,"y":456.7}
{"page":2,"change":"none","str":"material has been added by the second Author based on ","dir":"ltr","width":"279.47","height":"11.04","transform":["11.04","0.00","0.00","11.04","338.45","456.70"],"x":338.45,"y":456.7}
{"page":2,"change":"none","str":"experience of ","dir":"ltr","width":"68.93","height":"11.04","transform":["11.04","0.00","0.00","11.04","637.06","456.70"],"x":637.06,"y":456.7}
{"page":2,"change":"none","str":"working as a QI practitioner","dir":"ltr","width":"133.83","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","443.98"],"x":99.264,"y":443.98}
{"page":2,"change":"none","str":"The guide is a working documen","dir":"ltr","width":"158.60","height":"11.04","transform":["11.04","0.00","0.00","11.04","239.18","443.98"],"x":239.18,"y":443.98}
{"page":2,"change":"none","str":"t and it is our intention to refresh it periodically as new learning ","dir":"ltr","width":"306.76","height":"11.04","transform":["11.04","0.00","0.00","11.04","397.73","443.98"],"x":397.73,"y":443.98}
{"page":2,"change":"none","str":"A timeline for its production can be found on the back page. ","dir":"ltr","width":"292.75","height":"11.04","transform":["11.04","0.00","0.00","11.04","148.34","431.38"],"x":148.34,"y":431.38}
{"page":2,"change":"none","str":"Both Authors would like to thank the following for their contributions: ","dir":"ltr","width":"333.19","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","406.03"],"x":99.264,"y":406.03}
{"page":2,"change":"none","str":"Louise Jacox, Rebecca Bartholomew and the ","dir":"ltr","width":"203.24","height":"9.96","transform":["9.96","0.00","0.00","9.96","135.26","393.67"],"x":135.26,"y":393.67}
{"page":2,"change":"none","str":"staff of the George Eliot Hospital","dir":"ltr","width":"143.79","height":"9.96","transform":["9.96","0.00","0.00","9.96","338.69","393.67"],"x":338.69,"y":393.67}
{"page":2,"change":"none","str":"Staff at the NHS Institute for Innovation and Improvement","dir":"ltr","width":"253.74","height":"9.96","transform":["9.96","0.00","0.00","9.96","135.26","381.43"],"x":135.26,"y":381.43}
{"page":2,"change":"none","str":"Staff at the Heart of England NHS Trust","dir":"ltr","width":"175.54","height":"9.96","transform":["9.96","0.00","0.00","9.96","135.26","369.31"],"x":135.26,"y":369.31}
{"page":2,"change":"none","str":"Fellows of the Improvement Faculty","dir":"ltr","width":"157.75","height":"9.96","transform":["9.96","0.00","0.00","9.96","135.26","357.07"],"x":135.26,"y":357.07}
{"page":2,"change":"none","str":"This guide references some key documents that the Authors believe wil","dir":"ltr","width":"347.20","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","274.13"],"x":99.264,"y":274.13}
{"page":2,"change":"none","str":"l help inform good practice","dir":"ltr","width":"129.18","height":"11.04","transform":["11.04","0.00","0.00","11.04","446.57","274.13"],"x":446.57,"y":274.13}
{"page":2,"change":"none","str":": It is only a proportion of ","dir":"ltr","width":"123.47","height":"11.04","transform":["11.04","0.00","0.00","11.04","575.83","274.13"],"x":575.83,"y":274.13}
{"page":2,"change":"none","str":"the good ","dir":"ltr","width":"45.89","height":"11.04","transform":["11.04","0.00","0.00","11.04","699.34","274.13"],"x":699.34,"y":274.13}
{"page":2,"change":"none","str":"The topic of handovers and ","dir":"ltr","width":"136.48","height":"11.04","transform":["11.04","0.00","0.00","11.04","194.66","261.53"],"x":194.66,"y":261.53}
{"page":2,"change":"none","str":"transfer of care continue to be researched and ","dir":"ltr","width":"228.70","height":"11.04","transform":["11.04","0.00","0.00","11.04","331.13","261.53"],"x":331.13,"y":261.53}
{"page":2,"change":"none","str":"were a ","dir":"ltr","width":"36.08","height":"11.04","transform":["11.04","0.00","0.00","11.04","559.99","261.53"],"x":559.99,"y":261.53}
{"page":2,"change":"none","str":"subject theme for The Health ","dir":"ltr","width":"144.25","height":"11.04","transform":["11.04","0.00","0.00","11.04","596.11","261.53"],"x":596.11,"y":261.53}
{"page":2,"change":"none","str":"Foundation’s Clinical Systems Improvement Programme (","dir":"ltr","width":"281.11","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","248.81"],"fontName":"Arial","x":99.264,"y":248.81}
{"page":2,"change":"none","str":". Despite research in this area, our ","dir":"ltr","width":"171.10","height":"11.04","transform":["11.04","0.00","0.00","11.04","527.35","248.81"],"x":527.35,"y":248.81}
{"page":2,"change":"none","str":"experience in pra","dir":"ltr","width":"84.46","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","236.21"],"x":99.264,"y":236.21}
{"page":2,"change":"none","str":"ctice suggests that very few places have used a robust method to implement small scale or systems wide ","dir":"ltr","width":"514.55","height":"11.04","transform":["11.04","0.00","0.00","11.04","183.74","236.21"],"x":183.74,"y":236.21}
{"page":2,"change":"none","str":"approaches to ","dir":"ltr","width":"72.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","223.49"],"x":99.264,"y":223.49}
{"page":2,"change":"none","str":"the many aspects of transfers of care that must be addressed in order to deliver a reliable service to ","dir":"ltr","width":"487.50","height":"11.04","transform":["11.04","0.00","0.00","11.04","214.22","223.49"],"x":214.22,"y":223.49}
{"page":2,"change":"none","str":"If you have achi","dir":"ltr","width":"77.08","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","185.54"],"x":99.264,"y":185.54}
{"page":2,"change":"none","str":"eved this goal the Authors would love to hear from you and help spread the learning so that others can understand ","dir":"ltr","width":"559.49","height":"11.04","transform":["11.04","0.00","0.00","11.04","176.30","185.54"],"x":176.3,"y":185.54}
{"page":2,"change":"none","str":"how they might adapt and adopt your learning to achieve reliable transfers of care in their own service. ","dir":"ltr","width":"500.66","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","172.94"],"x":99.264,"y":172.94}
{"page":2,"change":"none","str":"nsed to the public under a crea","dir":"ltr","width":"151.17","height":"11.04","transform":["11.04","0.00","0.00","11.04","119.42","101.42"],"x":119.42,"y":101.42}
{"page":2,"change":"none","str":"opyright on diagrams shown","dir":"ltr","width":"137.35","height":"11.04","transform":["11.04","0.00","0.00","11.04","154.46","88.10"],"x":154.46,"y":88.104}
{"page":3,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","394.49","30.84"],"x":394.49,"y":30.84}
{"page":3,"change":"none","str":"There are many reasons why teams, departments or even whole organisations will want to improve ","dir":"ltr","width":"484.66","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","481.42"],"x":99.264,"y":481.42}
{"page":3,"change":"none","str":"the way handover or transfers of ","dir":"ltr","width":"160.76","height":"11.04","transform":["11.04","0.00","0.00","11.04","584.23","481.42"],"x":584.23,"y":481.42}
{"page":3,"change":"none","str":"for their patients ","dir":"ltr","width":"81.98","height":"11.04","transform":["11.04","0.00","0.00","11.04","168.98","466.90"],"x":168.98,"y":466.9}
{"page":3,"change":"none","str":". Studies have identified clinical handover as a ‘high risk scenario for patient safety","dir":"ltr","width":"401.23","height":"11.04","transform":["11.04","0.00","0.00","11.04","337.13","466.90"],"fontName":"Arial","x":337.13,"y":466.9}
{"page":3,"change":"none","str":"Clinical Handover Literature Review","dir":"ltr","width":"174.87","height":"11.04","transform":["11.04","0.00","0.00","11.04","102.98","452.38"],"x":102.98,"y":452.38}
{"page":3,"change":"none","str":"‘discontinuity of care, adverse eve","dir":"ltr","width":"165.57","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","437.74"],"fontName":"Arial","x":99.264,"y":437.74}
{"page":3,"change":"none","str":"nts and legal claims of malpract","dir":"ltr","width":"154.11","height":"11.04","transform":["11.04","0.00","0.00","11.04","264.86","437.74"],"x":264.86,"y":437.74}
{"page":3,"change":"none","str":"But the task of passing on important information happens in ","dir":"ltr","width":"292.70","height":"11.04","transform":["11.04","0.00","0.00","11.04","439.37","437.74"],"x":439.37,"y":437.74}
{"page":3,"change":"none","str":"every care setting and between care settings (transfers of care) every day ","dir":"ltr","width":"361.75","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","423.19"],"x":99.264,"y":423.19}
{"page":3,"change":"none","str":"in patient’s homes, backs of ambulances, community ","dir":"ltr","width":"260.23","height":"11.04","transform":["11.04","0.00","0.00","11.04","461.35","423.19"],"fontName":"Arial","x":461.35,"y":423.19}
{"page":3,"change":"none","str":"clinics, surgeries to name some. Although many of the examples we have been able to find easily are from hospitals, the ","dir":"ltr","width":"588.66","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","408.67"],"x":99.264,"y":408.67}
{"page":3,"change":"none","str":"information in this guide has been written for use in all settings. ","dir":"ltr","width":"309.36","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","394.15"],"x":99.264,"y":394.15}
{"page":3,"change":"none","str":"here is ","dir":"ltr","width":"36.08","height":"11.04","transform":["11.04","0.00","0.00","11.04","106.10","364.99"],"x":106.1,"y":364.99}
{"page":3,"change":"none","str":"he human cost; the distress, anxiety and loss of confidence that we know poor handovers can lead to for patients","dir":"ltr","width":"548.86","height":"11.04","transform":["11.04","0.00","0.00","11.04","168.50","364.99"],"x":168.5,"y":364.99}
{"page":3,"change":"none","str":"and their families","dir":"ltr","width":"83.01","height":"11.04","transform":["11.04","0.00","0.00","11.04","133.58","350.47"],"x":133.58,"y":350.47}
{"page":3,"change":"none","str":"and for staff too","dir":"ltr","width":"76.53","height":"11.04","transform":["11.04","0.00","0.00","11.04","219.74","350.47"],"x":219.74,"y":350.47}
{"page":3,"change":"none","str":"This guide is not about the justification for improving handovers","dir":"ltr","width":"307.50","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","321.43"],"x":99.264,"y":321.43}
{"page":3,"change":"none","str":"; that is covered in detail in other documents such as the ","dir":"ltr","width":"277.52","height":"11.04","transform":["11.04","0.00","0.00","11.04","406.85","321.43"],"x":406.85,"y":321.43}
{"page":3,"change":"none","str":"the Royal College of Physicians’","dir":"ltr","width":"157.07","height":"11.04","transform":["11.04","0.00","0.00","11.04","321.89","306.77"],"fontName":"Arial","x":321.89,"y":306.77}
{"page":3,"change":"none","str":"Acute Care Toolkit: 1 Handover","dir":"ltr","width":"153.53","height":"11.04","transform":["11.04","0.00","0.00","11.04","482.11","306.77"],"x":482.11,"y":306.77}
{"page":3,"change":"none","str":"Nor is this guide a ","dir":"ltr","width":"91.02","height":"11.04","transform":["11.04","0.00","0.00","11.04","641.86","306.77"],"x":641.86,"y":306.77}
{"page":3,"change":"none","str":"detailed manual for improving ","dir":"ltr","width":"147.24","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","292.25"],"x":99.264,"y":292.25}
{"page":3,"change":"none","str":"aspect of your handover process. ","dir":"ltr","width":"165.71","height":"11.04","transform":["11.04","0.00","0.00","11.04","276.65","292.25"],"x":276.65,"y":292.25}
{"page":3,"change":"none","str":"Focusing mainly on good","dir":"ltr","width":"122.40","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","263.21"],"x":99.264,"y":263.21}
{"page":3,"change":"none","str":"one of the most important","dir":"ltr","width":"124.67","height":"11.04","transform":["11.04","0.00","0.00","11.04","310.97","263.21"],"x":310.97,"y":263.21}
{"page":3,"change":"none","str":"factors for safe and timely","dir":"ltr","width":"126.00","height":"11.04","transform":["11.04","0.00","0.00","11.04","438.65","263.21"],"x":438.65,"y":263.21}
{"page":3,"change":"none","str":"rs of care ","dir":"ltr","width":"48.87","height":"11.04","transform":["11.04","0.00","0.00","11.04","601.39","263.21"],"x":601.39,"y":263.21}
{"page":3,"change":"none","str":"this guide, and ","dir":"ltr","width":"74.56","height":"11.04","transform":["11.04","0.00","0.00","11.04","659.50","263.21"],"x":659.5,"y":263.21}
{"page":3,"change":"none","str":"the six step process at the heart of it,","dir":"ltr","width":"179.74","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","248.57"],"x":99.264,"y":248.57}
{"page":3,"change":"none","str":"offers teams a","dir":"ltr","width":"69.55","height":"11.04","transform":["11.04","0.00","0.00","11.04","282.29","248.57"],"x":282.29,"y":248.57}
{"page":3,"change":"none","str":"that we know has worked well in many ","dir":"ltr","width":"190.10","height":"11.04","transform":["11.04","0.00","0.00","11.04","531.67","248.57"],"x":531.67,"y":248.57}
{"page":3,"change":"none","str":"It draws on some tried and tested tools that will help ","dir":"ltr","width":"255.44","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","205.01"],"x":99.264,"y":205.01}
{"page":3,"change":"none","str":"as a manager or clinician","dir":"ltr","width":"122.11","height":"11.04","transform":["11.04","0.00","0.00","11.04","378.77","205.01"],"x":378.77,"y":205.01}
{"page":3,"change":"none","str":"your improvements to the wider strategic aims of your organisation ","dir":"ltr","width":"326.86","height":"11.04","transform":["11.04","0.00","0.00","11.04","154.94","175.10"],"x":154.94,"y":175.1}
{"page":3,"change":"none","str":"and understand the imp","dir":"ltr","width":"115.56","height":"11.04","transform":["11.04","0.00","0.00","11.04","205.10","159.86"],"x":205.1,"y":159.86}
{"page":3,"change":"none","str":"your changes are having","dir":"ltr","width":"120.35","height":"11.04","transform":["11.04","0.00","0.00","11.04","338.45","159.86"],"x":338.45,"y":159.86}
{"page":3,"change":"none","str":"the sort of structured communication tools that are delivering significant improvements in safety and quality for care ","dir":"ltr","width":"562.20","height":"11.04","transform":["11.04","0.00","0.00","11.04","156.14","144.62"],"x":156.14,"y":144.62}
{"page":3,"change":"none","str":"organisations and other ","dir":"ltr","width":"118.12","height":"11.04","transform":["11.04","0.00","0.00","11.04","135.26","129.98"],"x":135.26,"y":129.98}
{"page":3,"change":"none","str":"industries across the world (e","dir":"ltr","width":"143.01","height":"11.04","transform":["11.04","0.00","0.00","11.04","320.09","129.98"],"x":320.09,"y":129.98}
{"page":3,"change":"none","str":"SBAR, ISOBAR and IDEAL). ","dir":"ltr","width":"143.53","height":"11.04","transform":["11.04","0.00","0.00","11.04","478.51","129.98"],"x":478.51,"y":129.98}
{"page":3,"change":"none","str":"of the detailed tools and examples that you might want to use are included as appendices towards the end of the guide. This ","dir":"ltr","width":"607.19","height":"11.04","transform":["11.04","0.00","0.00","11.04","129.14","90.86"],"x":129.14,"y":90.864}
{"page":3,"change":"none","str":"means you can move through the guide more swiftly, but have a wealth of examples and ideas at your fingertips if you need the","dir":"ltr","width":"619.42","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","76.32"],"x":99.264,"y":76.32}
{"page":4,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","394.49","30.84"],"x":394.49,"y":30.84}
{"page":4,"change":"none","str":"Welcome to ","dir":"ltr","width":"61.10","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","481.18"],"x":99.264,"y":481.18}
{"page":4,"change":"none","str":"has been developed ","dir":"ltr","width":"102.08","height":"11.04","transform":["11.04","0.00","0.00","11.04","222.86","481.18"],"x":222.86,"y":481.18}
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{"page":9,"change":"none","str":"You can use:","dir":"ltr","width":"64.26","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","344.83"],"x":99.264,"y":344.83}
{"page":9,"change":"none","str":"(consider using photos","dir":"ltr","width":"110.73","height":"11.04","transform":["11.04","0.00","0.00","11.04","251.54","323.59"],"x":251.54,"y":323.59}
{"page":9,"change":"none","str":"Think about what","dir":"ltr","width":"83.80","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","272.45"],"x":99.264,"y":272.45}
{"page":9,"change":"none","str":"happens before and after the transfer of care.","dir":"ltr","width":"221.24","height":"11.04","transform":["11.04","0.00","0.00","11.04","186.26","272.45"],"x":186.26,"y":272.45}
{"page":9,"change":"none","str":"How is information prepared for the transfer of care?","dir":"ltr","width":"254.88","height":"11.04","transform":["11.04","0.00","0.00","11.04","135.26","251.09"],"x":135.26,"y":251.09}
{"page":9,"change":"none","str":"Is information easy to find?","dir":"ltr","width":"131.48","height":"11.04","transform":["11.04","0.00","0.00","11.04","135.26","235.85"],"x":135.26,"y":235.85}
{"page":9,"change":"none","str":"What happens to documentation after the transfer of care?","dir":"ltr","width":"285.02","height":"11.04","transform":["11.04","0.00","0.00","11.04","135.26","220.61"],"x":135.26,"y":220.61}
{"page":9,"change":"none","str":"You might start using observation and ","dir":"ltr","width":"187.81","height":"11.04","transform":["11.04","0.00","0.00","11.04","283.97","186.74"],"x":283.97,"y":186.74}
{"page":9,"change":"none","str":"process mapping techniques to help ","dir":"ltr","width":"179.20","height":"11.04","transform":["11.04","0.00","0.00","11.04","283.97","172.22"],"x":283.97,"y":172.22}
{"page":9,"change":"none","str":"you understand where the problems in ","dir":"ltr","width":"190.22","height":"11.04","transform":["11.04","0.00","0.00","11.04","283.97","157.70"],"x":283.97,"y":157.7}
{"page":9,"change":"none","str":"r of care processes might ","dir":"ltr","width":"126.36","height":"11.04","transform":["11.04","0.00","0.00","11.04","342.17","143.18"],"x":342.17,"y":143.18}
{"page":9,"change":"none","str":"be, but they will be valuable tools later ","dir":"ltr","width":"188.98","height":"11.04","transform":["11.04","0.00","0.00","11.04","283.97","128.54"],"x":283.97,"y":128.54}
{"page":9,"change":"none","str":"in the improvement process too, when ","dir":"ltr","width":"188.94","height":"11.04","transform":["11.04","0.00","0.00","11.04","283.97","114.02"],"x":283.97,"y":114.02}
{"page":9,"change":"none","str":"you are gathering and generating ","dir":"ltr","width":"165.11","height":"11.04","transform":["11.04","0.00","0.00","11.04","283.97","99.50"],"x":283.97,"y":99.504}
{"page":9,"change":"none","str":"ideas for improvement.","dir":"ltr","width":"111.85","height":"11.04","transform":["11.04","0.00","0.00","11.04","283.97","84.98"],"x":283.97,"y":84.984}
{"page":9,"change":"none","str":"Royal College of Physicians, ","dir":"ltr","width":"129.37","height":"9.96","transform":["9.96","0.00","0.00","9.96","564.67","85.82"],"x":564.67,"y":85.824}
{"page":10,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":10,"change":"none","str":"the processes you are observing. ","dir":"ltr","width":"165.15","height":"11.04","transform":["11.04","0.00","0.00","11.04","147.02","507.70"],"x":147.02,"y":507.7}
{"page":10,"change":"none","str":"You will need to do more detailed ","dir":"ltr","width":"165.38","height":"11.04","transform":["11.04","0.00","0.00","11.04","312.29","507.70"],"x":312.29,"y":507.7}
{"page":10,"change":"none","str":"measurement later in ","dir":"ltr","width":"106.47","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","493.06"],"x":99.264,"y":493.06}
{"page":10,"change":"none","str":", but gathering some initial data ","dir":"ltr","width":"155.75","height":"11.04","transform":["11.04","0.00","0.00","11.04","329.81","493.06"],"x":329.81,"y":493.06}
{"page":10,"change":"none","str":"here as part of your observations is a good idea.","dir":"ltr","width":"235.44","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","478.54"],"x":99.264,"y":478.54}
{"page":10,"change":"none","str":"ime the transfer ","dir":"ltr","width":"79.33","height":"11.04","transform":["11.04","0.00","0.00","11.04","142.10","436.66"],"x":142.1,"y":436.66}
{"page":10,"change":"none","str":"ount the number of interruptions during ","dir":"ltr","width":"192.58","height":"11.04","transform":["11.04","0.00","0.00","11.04","143.18","421.39"],"x":143.18,"y":421.39}
{"page":10,"change":"none","str":"transfer of ","dir":"ltr","width":"52.47","height":"11.04","transform":["11.04","0.00","0.00","11.04","354.29","421.39"],"x":354.29,"y":421.39}
{"page":10,"change":"none","str":"ount the number of times transfer of care documentation is ","dir":"ltr","width":"287.92","height":"11.04","transform":["11.04","0.00","0.00","11.04","143.18","391.51"],"x":143.18,"y":391.51}
{"page":10,"change":"none","str":"ist the type information included in transfers of care and record ","dir":"ltr","width":"307.46","height":"11.04","transform":["11.04","0.00","0.00","11.04","141.38","361.75"],"x":141.38,"y":361.75}
{"page":10,"change":"none","str":"how often this ","dir":"ltr","width":"70.98","height":"11.04","transform":["11.04","0.00","0.00","11.04","135.26","347.11"],"x":135.26,"y":347.11}
{"page":10,"change":"none","str":"information is included in each communication","dir":"ltr","width":"224.90","height":"11.04","transform":["11.04","0.00","0.00","11.04","206.30","347.11"],"x":206.3,"y":347.11}
{"page":10,"change":"none","str":"ow often ","dir":"ltr","width":"44.69","height":"11.04","transform":["11.04","0.00","0.00","11.04","187.22","331.87"],"x":187.22,"y":331.87}
{"page":10,"change":"none","str":"A flipchart is a simple but good way to record ","dir":"ltr","width":"201.55","height":"9.96","transform":["9.96","0.00","0.00","9.96","136.82","154.22"],"x":136.82,"y":154.22}
{"page":10,"change":"none","str":"urther ideas of how to ","dir":"ltr","width":"108.78","height":"11.04","transform":["11.04","0.00","0.00","11.04","141.26","274.97"],"x":141.26,"y":274.97}
{"page":10,"change":"none","str":"resources section for links to:","dir":"ltr","width":"142.45","height":"11.04","transform":["11.04","0.00","0.00","11.04","118.58","260.33"],"x":118.58,"y":260.33}
{"page":10,"change":"none","str":"Quality and Value Toolkit","dir":"ltr","width":"131.29","height":"11.04","transform":["11.04","0.00","0.00","11.04","176.66","235.13"],"x":176.66,"y":235.13}
{"page":10,"change":"none","str":"Productive Mental Health ","dir":"ltr","width":"134.43","height":"11.04","transform":["11.04","0.00","0.00","11.04","308.21","205.37"],"x":308.21,"y":205.37}
{"page":10,"change":"none","str":"Productive Community Hospital","dir":"ltr","width":"166.81","height":"11.04","transform":["11.04","0.00","0.00","11.04","188.30","190.70"],"x":188.3,"y":190.7}
{"page":10,"change":"none","str":"Productive General ","dir":"ltr","width":"104.07","height":"11.04","transform":["11.04","0.00","0.00","11.04","177.14","160.94"],"x":177.14,"y":160.94}
{"page":10,"change":"none","str":"for general practice","dir":"ltr","width":"94.17","height":"11.04","transform":["11.04","0.00","0.00","11.04","327.05","160.94"],"x":327.05,"y":160.94}
{"page":10,"change":"none","str":"Care Homes Wellbeing Programme","dir":"ltr","width":"183.46","height":"11.04","transform":["11.04","0.00","0.00","11.04","177.14","145.58"],"x":177.14,"y":145.58}
{"page":10,"change":"none","str":"for the care home ","dir":"ltr","width":"89.30","height":"11.04","transform":["11.04","0.00","0.00","11.04","363.65","145.58"],"x":363.65,"y":145.58}
{"page":10,"change":"none","str":"Some of these resources are still available on the NHS Instit","dir":"ltr","width":"292.87","height":"11.04","transform":["11.04","0.00","0.00","11.04","154.58","106.34"],"x":154.58,"y":106.34}
{"page":10,"change":"none","str":"For alternatives contact us at ","dir":"ltr","width":"144.25","height":"11.04","transform":["11.04","0.00","0.00","11.04","154.58","67.32"],"x":154.58,"y":67.32}
{"page":11,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":11,"change":"none","str":"What does ","dir":"ltr","width":"85.18","height":"15.96","transform":["15.96","0.00","0.00","15.96","99.26","523.66"],"x":99.264,"y":523.66}
{"page":11,"change":"none","str":"At this stage","dir":"ltr","width":"60.60","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","500.98"],"x":99.264,"y":500.98}
{"page":11,"change":"none","str":"it is useful to ","dir":"ltr","width":"64.12","height":"11.04","transform":["11.04","0.00","0.00","11.04","165.98","500.98"],"x":165.98,"y":500.98}
{"page":11,"change":"none","str":"what ‘good’ would look like for the people in your care. One way of thinking about this is to ","dir":"ltr","width":"440.75","height":"11.04","transform":["11.04","0.00","0.00","11.04","274.85","500.98"],"fontName":"Arial","x":274.85,"y":500.98}
{"page":11,"change":"none","str":"consider what processes and behaviours you would want to see happen for yourself or a member of your family whose care is bei","dir":"ltr","width":"630.33","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","486.46"],"x":99.264,"y":486.46}
{"page":11,"change":"none","str":"transferred to another person or ","dir":"ltr","width":"158.39","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","471.94"],"x":99.264,"y":471.94}
{"page":11,"change":"none","str":"u don’t usually include patient","dir":"ltr","width":"144.28","height":"11.04","transform":["11.04","0.00","0.00","11.04","309.05","471.94"],"fontName":"Arial","x":309.05,"y":471.94}
{"page":11,"change":"none","str":"s in your improvement work, we’d encourage you to ","dir":"ltr","width":"254.13","height":"11.04","transform":["11.04","0.00","0.00","11.04","453.43","471.94"],"fontName":"Arial","x":453.43,"y":471.94}
{"page":11,"change":"none","str":"their opinion, and if you want to do more see the link below on experienced","dir":"ltr","width":"364.34","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","457.42"],"x":99.264,"y":457.42}
{"page":11,"change":"none","str":"Use what you have l","dir":"ltr","width":"99.00","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","436.78"],"x":99.264,"y":436.78}
{"page":11,"change":"none","str":"earnt from your observations,","dir":"ltr","width":"143.19","height":"11.04","transform":["11.04","0.00","0.00","11.04","198.26","436.78"],"x":198.26,"y":436.78}
{"page":11,"change":"none","str":"and compare your current processes with ","dir":"ltr","width":"204.71","height":"11.04","transform":["11.04","0.00","0.00","11.04","528.67","436.78"],"x":528.67,"y":436.78}
{"page":11,"change":"none","str":"the elements in the ","dir":"ltr","width":"96.04","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","422.23"],"x":99.264,"y":422.23}
{"page":11,"change":"none","str":"good practice ","dir":"ltr","width":"69.18","height":"11.04","transform":["11.04","0.00","0.00","11.04","195.26","422.23"],"x":195.26,"y":422.23}
{"page":11,"change":"none","str":"for examples of questions you can use to ","dir":"ltr","width":"202.99","height":"11.04","transform":["11.04","0.00","0.00","11.04","396.41","422.23"],"x":396.41,"y":422.23}
{"page":11,"change":"none","str":"prompt discussion and ","dir":"ltr","width":"113.09","height":"11.04","transform":["11.04","0.00","0.00","11.04","599.59","422.23"],"x":599.59,"y":422.23}
{"page":11,"change":"none","str":"ideas with staff, patients or clients.","dir":"ltr","width":"167.38","height":"11.04","transform":["11.04","0.00","0.00","11.04","145.82","407.71"],"x":145.82,"y":407.71}
{"page":11,"change":"none","str":"Find out more about how to use:","dir":"ltr","width":"157.83","height":"11.04","transform":["11.04","0.00","0.00","11.04","103.58","164.06"],"x":103.58,"y":164.06}
{"page":11,"change":"none","str":"Experienced based design","dir":"ltr","width":"129.83","height":"11.04","transform":["11.04","0.00","0.00","11.04","139.58","138.86"],"x":139.58,"y":138.86}
{"page":11,"change":"none","str":"Root cause analysis","dir":"ltr","width":"98.38","height":"11.04","transform":["11.04","0.00","0.00","11.04","139.58","108.26"],"x":139.58,"y":108.26}
{"page":11,"change":"none","str":"(including the ‘Five whys’) ","dir":"ltr","width":"128.88","height":"11.04","transform":["11.04","0.00","0.00","11.04","241.10","108.26"],"fontName":"Arial","x":241.1,"y":108.26}
{"page":11,"change":"none","str":"You could u","dir":"ltr","width":"58.18","height":"11.04","transform":["11.04","0.00","0.00","11.04","260.30","346.75"],"x":260.3,"y":346.75}
{"page":11,"change":"none","str":"se process ","dir":"ltr","width":"56.22","height":"11.04","transform":["11.04","0.00","0.00","11.04","318.53","346.75"],"x":318.53,"y":346.75}
{"page":11,"change":"none","str":"to map communication of ","dir":"ltr","width":"126.02","height":"11.04","transform":["11.04","0.00","0.00","11.04","260.30","332.23"],"x":260.3,"y":332.23}
{"page":11,"change":"none","str":"information between shifts, teams ","dir":"ltr","width":"166.92","height":"11.04","transform":["11.04","0.00","0.00","11.04","260.30","317.59"],"x":260.3,"y":317.59}
{"page":12,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":12,"change":"none","str":"Define and scope","dir":"ltr","width":"198.62","height":"24.00","transform":["24.00","0.00","0.00","24.00","156.26","488.50"],"x":156.26,"y":488.5}
{"page":12,"change":"none","str":"Once you have identified and captured what ‘good","dir":"ltr","width":"244.64","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","441.22"],"fontName":"Arial","x":99.264,"y":441.22}
{"page":12,"change":"none","str":"looks like in your transfer of care ","dir":"ltr","width":"161.36","height":"11.04","transform":["11.04","0.00","0.00","11.04","349.49","441.22"],"x":349.49,"y":441.22}
{"page":12,"change":"none","str":"processes, and started to id","dir":"ltr","width":"135.12","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","426.70"],"x":99.264,"y":426.7}
{"page":12,"change":"none","str":"entify what you need to improve in your own systems","dir":"ltr","width":"258.03","height":"11.04","transform":["11.04","0.00","0.00","11.04","234.38","426.70"],"x":234.38,"y":426.7}
{"page":12,"change":"none","str":", the next key ","dir":"ltr","width":"68.44","height":"11.04","transform":["11.04","0.00","0.00","11.04","492.55","426.70"],"x":492.55,"y":426.7}
{"page":12,"change":"none","str":"step is to define a clear ","dir":"ltr","width":"116.15","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","412.27"],"x":99.264,"y":412.27}
{"page":12,"change":"none","str":"for your project.","dir":"ltr","width":"76.43","height":"11.04","transform":["11.04","0.00","0.00","11.04","237.38","412.27"],"x":237.38,"y":412.27}
{"page":12,"change":"none","str":"This is where the","dir":"ltr","width":"83.29","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","383.11"],"x":99.264,"y":383.11}
{"page":12,"change":"none","str":"Model for Improveme","dir":"ltr","width":"111.21","height":"11.04","transform":["11.04","0.00","0.00","11.04","185.54","383.11"],"x":185.54,"y":383.11}
{"page":12,"change":"none","str":"published in ","dir":"ltr","width":"61.64","height":"11.04","transform":["11.04","0.00","0.00","11.04","310.37","383.11"],"x":310.37,"y":383.11}
{"page":12,"change":"none","str":"(Langley et ","dir":"ltr","width":"57.41","height":"11.04","transform":["11.04","0.00","0.00","11.04","493.75","383.11"],"x":493.75,"y":383.11}
{"page":12,"change":"none","str":"can help you","dir":"ltr","width":"62.32","height":"11.04","transform":["11.04","0.00","0.00","11.04","145.22","368.47"],"x":145.22,"y":368.47}
{"page":12,"change":"none","str":". Whatever your project and however big or small, the Model for ","dir":"ltr","width":"312.33","height":"11.04","transform":["11.04","0.00","0.00","11.04","207.50","368.47"],"x":207.5,"y":368.47}
{"page":12,"change":"none","str":"Improvement will give y","dir":"ltr","width":"114.24","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","353.95"],"x":99.264,"y":353.95}
{"page":12,"change":"none","str":"ou a simple, adaptable and ","dir":"ltr","width":"135.30","height":"11.04","transform":["11.04","0.00","0.00","11.04","213.50","353.95"],"x":213.5,"y":353.95}
{"page":12,"change":"none","str":"framework for ","dir":"ltr","width":"70.32","height":"11.04","transform":["11.04","0.00","0.00","11.04","395.33","353.95"],"x":395.33,"y":353.95}
{"page":12,"change":"none","str":". Using the Model for Improvement means ","dir":"ltr","width":"207.96","height":"11.04","transform":["11.04","0.00","0.00","11.04","230.78","339.43"],"x":230.78,"y":339.43}
{"page":12,"change":"none","str":"are more ","dir":"ltr","width":"46.96","height":"11.04","transform":["11.04","0.00","0.00","11.04","508.03","339.43"],"x":508.03,"y":339.43}
{"page":12,"change":"none","str":"likely to lead to the improvement you set out to make","dir":"ltr","width":"256.86","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","324.79"],"x":99.264,"y":324.79}
{"page":12,"change":"none","str":"For more information on the Model for ","dir":"ltr","width":"187.51","height":"11.04","transform":["11.04","0.00","0.00","11.04","369.05","324.79"],"x":369.05,"y":324.79}
{"page":12,"change":"none","str":"Improvement, see Appendix ","dir":"ltr","width":"139.81","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","310.25"],"x":99.264,"y":310.25}
{"page":12,"change":"none","str":"What are we trying to accomplish?","dir":"ltr","width":"263.95","height":"15.96","transform":["15.96","0.00","0.00","15.96","99.26","276.65"],"x":99.264,"y":276.65}
{"page":12,"change":"none","str":"s is the first question in the Model for I","dir":"ltr","width":"185.13","height":"11.04","transform":["11.04","0.00","0.00","11.04","114.62","250.85"],"x":114.62,"y":250.85}
{"page":12,"change":"none","str":"mprovement. Being clear about","dir":"ltr","width":"152.75","height":"11.04","transform":["11.04","0.00","0.00","11.04","299.93","250.85"],"x":299.93,"y":250.85}
{"page":12,"change":"none","str":"of the work ","dir":"ltr","width":"56.80","height":"11.04","transform":["11.04","0.00","0.00","11.04","496.27","250.85"],"x":496.27,"y":250.85}
{"page":12,"change":"none","str":"will improve your chances of success. ","dir":"ltr","width":"187.08","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","236.21"],"x":99.264,"y":236.21}
{"page":12,"change":"none","str":"Using a SMART aim is one way to focus your project. ","dir":"ltr","width":"265.73","height":"11.04","transform":["11.04","0.00","0.00","11.04","289.61","236.21"],"x":289.61,"y":236.21}
{"page":12,"change":"none","str":"For more on SMART aims see Appendix ","dir":"ltr","width":"200.40","height":"11.04","transform":["11.04","0.00","0.00","11.04","102.98","221.69"],"x":102.98,"y":221.69}
{"page":12,"change":"none","str":"‘By December 2015, reduce the time the team spends on ","dir":"ltr","width":"306.64","height":"12.00","transform":["12.00","0.00","0.00","12.00","445.61","144.86"],"fontName":"Arial,Italic","x":445.61,"y":144.86}
{"page":12,"change":"none","str":"transfer of care ","dir":"ltr","width":"84.02","height":"12.00","transform":["12.00","0.00","0.00","12.00","311.45","129.02"],"x":311.45,"y":129.02}
{"page":12,"change":"none","str":"(productivity) AND make the information handed over or transferred ","dir":"ltr","width":"361.18","height":"12.00","transform":["12.00","0.00","0.00","12.00","395.57","129.02"],"x":395.57,"y":129.02}
{"page":12,"change":"none","str":"appropriate, easy to remember, easy to understand and easy to act upon (quality)’.","dir":"ltr","width":"439.13","height":"12.00","transform":["12.00","0.00","0.00","12.00","311.45","113.18"],"fontName":"Arial,Italic","x":311.45,"y":113.18}
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{"page":13,"change":"none","str":"Link your improvement project to ","dir":"ltr","width":"258.55","height":"15.96","transform":["15.96","0.00","0.00","15.96","99.26","523.66"],"x":99.264,"y":523.66}
{"page":13,"change":"none","str":"A project that meets ","dir":"ltr","width":"100.94","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","500.98"],"x":99.264,"y":500.98}
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{"page":13,"change":"none","str":"the priorities of the ","dir":"ltr","width":"93.48","height":"11.04","transform":["11.04","0.00","0.00","11.04","606.91","500.98"],"x":606.91,"y":500.98}
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{"page":13,"change":"none","str":"likely to succeed. ","dir":"ltr","width":"86.80","height":"11.04","transform":["11.04","0.00","0.00","11.04","320.21","486.46"],"x":320.21,"y":486.46}
{"page":13,"change":"none","str":"will have a number of key issues identified as priorities. We know that ","dir":"ltr","width":"340.31","height":"11.04","transform":["11.04","0.00","0.00","11.04","400.85","465.94"],"x":400.85,"y":465.94}
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{"page":13,"change":"none","str":"You can find your ‘big issues’:","dir":"ltr","width":"145.46","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","426.82"],"fontName":"Arial","x":99.264,"y":426.82}
{"page":13,"change":"none","str":"in the organisation’s business plan or annual report","dir":"ltr","width":"248.89","height":"11.04","transform":["11.04","0.00","0.00","11.04","135.26","401.47"],"fontName":"Arial","x":135.26,"y":401.47}
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{"page":13,"change":"none","str":"or commissioning group ","dir":"ltr","width":"119.82","height":"11.04","transform":["11.04","0.00","0.00","11.04","193.46","386.23"],"x":193.46,"y":386.23}
{"page":13,"change":"none","str":"website or intranet","dir":"ltr","width":"89.69","height":"11.04","transform":["11.04","0.00","0.00","11.04","313.37","386.23"],"x":313.37,"y":386.23}
{"page":13,"change":"none","str":"Examples of ‘big issues’ include:","dir":"ltr","width":"158.35","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","346.39"],"fontName":"Arial","x":99.264,"y":346.39}
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{"page":13,"change":"none","str":"Capturing and ","dir":"ltr","width":"84.70","height":"12.00","transform":["12.00","0.00","0.00","12.00","99.26","234.41"],"x":99.264,"y":234.41}
{"page":13,"change":"none","str":"You can track the links and test your ideas using simple ","dir":"ltr","width":"273.92","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","213.53"],"x":99.264,"y":213.53}
{"page":13,"change":"none","str":"This type of diagram can be useful to generate ","dir":"ltr","width":"229.90","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","192.98"],"x":99.264,"y":192.98}
{"page":13,"change":"none","str":"and commitment from your ","dir":"ltr","width":"133.83","height":"11.04","transform":["11.04","0.00","0.00","11.04","368.45","192.98"],"x":368.45,"y":192.98}
{"page":13,"change":"none","str":"sponsor, your project team and others you are working with. It will also help you ","dir":"ltr","width":"389.89","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","178.34"],"x":99.264,"y":178.34}
{"page":13,"change":"none","str":"understand the impact of improvement work ","dir":"ltr","width":"217.05","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","163.82"],"x":99.264,"y":163.82}
{"page":13,"change":"none","str":"undertaken at the front line ","dir":"ltr","width":"133.80","height":"11.04","transform":["11.04","0.00","0.00","11.04","316.49","163.82"],"x":316.49,"y":163.82}
{"page":13,"change":"none","str":"and its ","dir":"ltr","width":"35.44","height":"11.04","transform":["11.04","0.00","0.00","11.04","450.43","163.82"],"x":450.43,"y":163.82}
{"page":13,"change":"none","str":"contribution to the organisation","dir":"ltr","width":"150.43","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","149.30"],"x":99.264,"y":149.3}
{"page":13,"change":"none","str":"Find a good sponsor","dir":"ltr","width":"118.76","height":"12.00","transform":["12.00","0.00","0.00","12.00","518.23","417.19"],"x":518.23,"y":417.19}
{"page":13,"change":"none","str":"It is important that your project ","dir":"ltr","width":"151.04","height":"11.04","transform":["11.04","0.00","0.00","11.04","518.23","392.23"],"x":518.23,"y":392.23}
{"page":13,"change":"none","str":"c and empowered sponsor. ","dir":"ltr","width":"135.77","height":"11.04","transform":["11.04","0.00","0.00","11.04","600.91","377.71"],"x":600.91,"y":377.71}
{"page":13,"change":"none","str":"The right sponsor will","dir":"ltr","width":"103.80","height":"11.04","transform":["11.04","0.00","0.00","11.04","518.23","348.67"],"x":518.23,"y":348.67}
{"page":13,"change":"none","str":"level support for your ","dir":"ltr","width":"105.73","height":"11.04","transform":["11.04","0.00","0.00","11.04","617.95","333.31"],"x":617.95,"y":333.31}
{"page":13,"change":"none","str":"elp to engage other team members","dir":"ltr","width":"171.27","height":"11.04","transform":["11.04","0.00","0.00","11.04","560.35","288.17"],"x":560.35,"y":288.17}
{"page":13,"change":"none","str":"link your improvement project aim to ","dir":"ltr","width":"179.71","height":"11.04","transform":["11.04","0.00","0.00","11.04","554.23","272.93"],"x":554.23,"y":272.93}
{"page":13,"change":"none","str":"your organisation’s big issues/ ","dir":"ltr","width":"150.49","height":"11.04","transform":["11.04","0.00","0.00","11.04","554.23","258.41"],"fontName":"Arial","x":554.23,"y":258.41}
{"page":13,"change":"none","str":"elp remove obstacles to ","dir":"ltr","width":"119.21","height":"11.04","transform":["11.04","0.00","0.00","11.04","560.35","228.53"],"x":560.35,"y":228.53}
{"page":13,"change":"none","str":"Director of Nursing or Matron","dir":"ltr","width":"141.89","height":"11.04","transform":["11.04","0.00","0.00","11.04","554.23","182.66"],"x":554.23,"y":182.66}
{"page":13,"change":"none","str":"Medical or Clinical Director","dir":"ltr","width":"130.80","height":"11.04","transform":["11.04","0.00","0.00","11.04","554.23","167.42"],"x":554.23,"y":167.42}
{"page":13,"change":"none","str":"Practice or Care Home Manager","dir":"ltr","width":"158.30","height":"11.04","transform":["11.04","0.00","0.00","11.04","554.23","151.94"],"x":554.23,"y":151.94}
{"page":14,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":14,"change":"none","str":"transfer of care improvement aim to the organisational aim ","dir":"ltr","width":"310.40","height":"11.04","transform":["11.04","0.00","0.00","11.04","274.85","528.34"],"x":274.85,"y":528.34}
{"page":14,"change":"none","str":"Throughout the guide you will ","dir":"ltr","width":"146.64","height":"11.04","transform":["11.04","0.00","0.00","11.04","611.23","423.55"],"x":611.23,"y":423.55}
{"page":14,"change":"none","str":"see how you can build on this ","dir":"ltr","width":"147.52","height":"11.04","transform":["11.04","0.00","0.00","11.04","611.23","409.03"],"x":611.23,"y":409.03}
{"page":14,"change":"none","str":"am, adding on your ","dir":"ltr","width":"97.12","height":"11.04","transform":["11.04","0.00","0.00","11.04","664.54","394.39"],"x":664.54,"y":394.39}
{"page":14,"change":"none","str":"and your change ","dir":"ltr","width":"84.88","height":"11.04","transform":["11.04","0.00","0.00","11.04","665.86","365.47"],"x":665.86,"y":365.47}
{"page":14,"change":"none","str":"as you develop ","dir":"ltr","width":"76.86","height":"11.04","transform":["11.04","0.00","0.00","11.04","683.50","350.95"],"x":683.5,"y":350.95}
{"page":14,"change":"none","str":"Click here f","dir":"ltr","width":"54.99","height":"11.04","transform":["11.04","0.00","0.00","11.04","591.07","98.78"],"x":591.07,"y":98.784}
{"page":14,"change":"none","str":"or more ","dir":"ltr","width":"40.97","height":"11.04","transform":["11.04","0.00","0.00","11.04","646.18","98.78"],"x":646.18,"y":98.784}
{"page":14,"change":"none","str":"information about ","dir":"ltr","width":"87.98","height":"11.04","transform":["11.04","0.00","0.00","11.04","687.22","98.78"],"x":687.22,"y":98.784}
{"page":14,"change":"none","str":"in your ","dir":"ltr","width":"35.94","height":"11.04","transform":["11.04","0.00","0.00","11.04","699.46","84.24"],"x":699.46,"y":84.24}
{"page":14,"change":"none","str":"improvement work ","dir":"ltr","width":"92.91","height":"11.04","transform":["11.04","0.00","0.00","11.04","591.07","69.72"],"x":591.07,"y":69.72}
{"page":15,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":15,"change":"none","str":"What is the scale of your improvement","dir":"ltr","width":"293.20","height":"15.96","transform":["15.96","0.00","0.00","15.96","99.26","523.66"],"x":99.264,"y":523.66}
{"page":15,"change":"none","str":"You may be using this guide to make a small change in the way you manage transfers of care","dir":"ltr","width":"456.01","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","500.98"],"x":99.264,"y":500.98}
{"page":15,"change":"none","str":"or you might be trying to make a ","dir":"ltr","width":"160.05","height":"11.04","transform":["11.04","0.00","0.00","11.04","561.67","500.98"],"x":561.67,"y":500.98}
{"page":15,"change":"none","str":"change across your whole organisation, or even across ","dir":"ltr","width":"271.99","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","486.46"],"x":99.264,"y":486.46}
{"page":15,"change":"none","str":"local care community. Whatever level","dir":"ltr","width":"182.02","height":"11.04","transform":["11.04","0.00","0.00","11.04","389.81","486.46"],"x":389.81,"y":486.46}
{"page":15,"change":"none","str":"you are working at, you ne","dir":"ltr","width":"128.95","height":"11.04","transform":["11.04","0.00","0.00","11.04","574.99","486.46"],"x":574.99,"y":486.46}
{"page":15,"change":"none","str":"et the scope of your project ","dir":"ltr","width":"135.75","height":"11.04","transform":["11.04","0.00","0.00","11.04","104.78","471.94"],"x":104.78,"y":471.94}
{"page":15,"change":"none","str":"at the start","dir":"ltr","width":"51.88","height":"11.04","transform":["11.04","0.00","0.00","11.04","240.62","471.94"],"x":240.62,"y":471.94}
{"page":15,"change":"none","str":"to ensure it is manageable and achievable.","dir":"ltr","width":"209.04","height":"11.04","transform":["11.04","0.00","0.00","11.04","295.61","471.94"],"x":295.61,"y":471.94}
{"page":15,"change":"none","str":"Go where you think there is most need or where ","dir":"ltr","width":"237.12","height":"11.04","transform":["11.04","0.00","0.00","11.04","507.91","471.94"],"x":507.91,"y":471.94}
{"page":15,"change":"none","str":"there is most enthusiasm. A success early in the project is vital to help ","dir":"ltr","width":"344.18","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","457.42"],"x":99.264,"y":457.42}
{"page":15,"change":"none","str":"stimulate enthusiasm and ","dir":"ltr","width":"127.82","height":"11.04","transform":["11.04","0.00","0.00","11.04","443.57","457.42"],"x":443.57,"y":457.42}
{"page":15,"change":"none","str":"spread the good wo","dir":"ltr","width":"96.47","height":"11.04","transform":["11.04","0.00","0.00","11.04","571.51","457.42"],"x":571.51,"y":457.42}
{"page":15,"change":"none","str":"ngage staff, patients and users","dir":"ltr","width":"235.55","height":"15.96","transform":["15.96","0.00","0.00","15.96","109.94","432.22"],"x":109.94,"y":432.22}
{"page":15,"change":"none","str":"et up your project team ","dir":"ltr","width":"181.24","height":"15.96","transform":["15.96","0.00","0.00","15.96","391.85","432.22"],"x":391.85,"y":432.22}
{"page":15,"change":"none","str":"Think about different ways to engage ","dir":"ltr","width":"183.32","height":"11.04","transform":["11.04","0.00","0.00","11.04","109.58","337.87"],"x":109.58,"y":337.87}
{"page":15,"change":"none","str":"(staff, patients and service ","dir":"ltr","width":"131.41","height":"11.04","transform":["11.04","0.00","0.00","11.04","175.10","323.35"],"x":175.1,"y":323.35}
{"page":15,"change":"none","str":"and convince them of the ","dir":"ltr","width":"125.91","height":"11.04","transform":["11.04","0.00","0.00","11.04","143.30","308.81"],"x":143.3,"y":308.81}
{"page":15,"change":"none","str":"importance of improving transfers of care. ","dir":"ltr","width":"209.06","height":"11.04","transform":["11.04","0.00","0.00","11.04","109.58","294.17"],"x":109.58,"y":294.17}
{"page":15,"change":"none","str":"As well as patient stories, you can use ","dir":"ltr","width":"189.60","height":"11.04","transform":["11.04","0.00","0.00","11.04","109.58","269.69"],"x":109.58,"y":269.69}
{"page":15,"change":"none","str":"evidence and recommendations from the ","dir":"ltr","width":"202.45","height":"11.04","transform":["11.04","0.00","0.00","11.04","109.58","255.17"],"x":109.58,"y":255.17}
{"page":15,"change":"none","str":"transfer of care ","dir":"ltr","width":"77.06","height":"11.04","transform":["11.04","0.00","0.00","11.04","109.58","240.53"],"x":109.58,"y":240.53}
{"page":15,"change":"none","str":"at the ","dir":"ltr","width":"30.54","height":"11.04","transform":["11.04","0.00","0.00","11.04","277.25","240.53"],"x":277.25,"y":240.53}
{"page":15,"change":"none","str":"back of this guide. The ‘","dir":"ltr","width":"119.30","height":"11.04","transform":["11.04","0.00","0.00","11.04","109.58","226.01"],"fontName":"Arial","x":109.58,"y":226.01}
{"page":15,"change":"none","str":"’ page of the NHS Institute’s ","dir":"ltr","width":"139.19","height":"11.04","transform":["11.04","0.00","0.00","11.04","170.90","211.49"],"fontName":"Arial","x":170.9,"y":211.49}
{"page":15,"change":"none","str":"Quality and Service Improvement Tools ","dir":"ltr","width":"195.73","height":"11.04","transform":["11.04","0.00","0.00","11.04","109.58","196.94"],"x":109.58,"y":196.94}
{"page":15,"change":"none","str":"has further suggestions. ","dir":"ltr","width":"120.49","height":"11.04","transform":["11.04","0.00","0.00","11.04","109.58","182.30"],"x":109.58,"y":182.3}
{"page":15,"change":"none","str":"yone wants to deliver good care;","dir":"ltr","width":"158.42","height":"11.04","transform":["11.04","0.00","0.00","11.04","552.43","306.17"],"x":552.43,"y":306.17}
{"page":15,"change":"none","str":"(like the one at Appendix A)","dir":"ltr","width":"135.03","height":"11.04","transform":["11.04","0.00","0.00","11.04","601.51","291.65"],"x":601.51,"y":291.65}
{"page":15,"change":"none","str":"experiences can help teams commit ","dir":"ltr","width":"178.45","height":"11.04","transform":["11.04","0.00","0.00","11.04","566.71","277.13"],"x":566.71,"y":277.13}
{"page":15,"change":"none","str":"and improvement. The film: ","dir":"ltr","width":"136.23","height":"11.04","transform":["11.04","0.00","0.00","11.04","581.35","262.61"],"x":581.35,"y":262.61}
{"page":15,"change":"none","str":"trouble with handovers","dir":"ltr","width":"110.72","height":"11.04","transform":["11.04","0.00","0.00","11.04","529.87","247.97"],"x":529.87,"y":247.97}
{"page":15,"change":"none","str":"is a pow","dir":"ltr","width":"40.36","height":"11.04","transform":["11.04","0.00","0.00","11.04","643.78","247.97"],"x":643.78,"y":247.97}
{"page":15,"change":"none","str":"it is so important to ","dir":"ltr","width":"95.56","height":"11.04","transform":["11.04","0.00","0.00","11.04","629.47","233.45"],"x":629.47,"y":233.45}
{"page":15,"change":"none","str":"transfer the right information to","dir":"ltr","width":"149.87","height":"11.04","transform":["11.04","0.00","0.00","11.04","529.87","218.93"],"x":529.87,"y":218.93}
{"page":15,"change":"none","str":"the right ","dir":"ltr","width":"42.75","height":"11.04","transform":["11.04","0.00","0.00","11.04","682.90","218.93"],"x":682.9,"y":218.93}
{"page":15,"change":"none","str":"person at the right time","dir":"ltr","width":"112.63","height":"11.04","transform":["11.04","0.00","0.00","11.04","529.87","204.41"],"x":529.87,"y":204.41}
{"page":16,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":16,"change":"none","str":"Who to include in your team?","dir":"ltr","width":"223.84","height":"15.96","transform":["15.96","0.00","0.00","15.96","99.26","523.66"],"x":99.264,"y":523.66}
{"page":16,"change":"none","str":"Finding the right people to champion the project and drive it forward with insight and enthusiasm is crucial. ","dir":"ltr","width":"521.99","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","500.98"],"x":99.264,"y":500.98}
{"page":16,"change":"none","str":"Consider what each ","dir":"ltr","width":"100.24","height":"11.04","transform":["11.04","0.00","0.00","11.04","621.55","500.98"],"x":621.55,"y":500.98}
{"page":16,"change":"none","str":"team member can offer","dir":"ltr","width":"113.78","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","486.46"],"x":99.264,"y":486.46}
{"page":16,"change":"none","str":"do they have expert kn","dir":"ltr","width":"111.46","height":"11.04","transform":["11.04","0.00","0.00","11.04","219.14","486.46"],"x":219.14,"y":486.46}
{"page":16,"change":"none","str":"owledge and/or are they empowered to make decisions? This simple grid tool can ","dir":"ltr","width":"400.22","height":"11.04","transform":["11.04","0.00","0.00","11.04","330.65","486.46"],"x":330.65,"y":486.46}
{"page":16,"change":"none","str":"help you identify what each team member will be able to bring to the project.","dir":"ltr","width":"370.47","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","471.94"],"x":99.264,"y":471.94}
{"page":16,"change":"none","str":"Examples of the team selection grid for different ","dir":"ltr","width":"235.86","height":"11.04","transform":["11.04","0.00","0.00","11.04","476.11","471.94"],"x":476.11,"y":471.94}
{"page":16,"change":"none","str":"settings are at Appendix E","dir":"ltr","width":"128.40","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","457.42"],"x":99.264,"y":457.42}
{"page":16,"change":"none","str":"Project team ‘knowledge and ","dir":"ltr","width":"168.73","height":"12.00","transform":["12.00","0.00","0.00","12.00","99.26","431.86"],"fontName":"Arial,Bold","x":99.264,"y":431.86}
{"page":16,"change":"none","str":"dentify a clinical or ","dir":"ltr","width":"93.37","height":"11.04","transform":["11.04","0.00","0.00","11.04","659.02","400.99"],"x":659.02,"y":400.99}
{"page":16,"change":"none","str":"service champion who will be a visible and active ","dir":"ltr","width":"241.47","height":"11.04","transform":["11.04","0.00","0.00","11.04","506.59","386.47"],"x":506.59,"y":386.47}
{"page":16,"change":"none","str":"supporter of ","dir":"ltr","width":"61.82","height":"11.04","transform":["11.04","0.00","0.00","11.04","506.59","371.95"],"x":506.59,"y":371.95}
{"page":16,"change":"none","str":"nclude staff who are actually involved in the transfers ","dir":"ltr","width":"261.05","height":"11.04","transform":["11.04","0.00","0.00","11.04","509.71","356.59"],"x":509.71,"y":356.59}
{"page":16,"change":"none","str":"of care on a day","dir":"ltr","width":"79.04","height":"11.04","transform":["11.04","0.00","0.00","11.04","506.59","342.07"],"x":506.59,"y":342.07}
{"page":16,"change":"none","str":"those who ","dir":"ltr","width":"53.10","height":"11.04","transform":["11.04","0.00","0.00","11.04","682.78","342.07"],"x":682.78,"y":342.07}
{"page":16,"change":"none","str":"and receive the co","dir":"ltr","width":"90.00","height":"11.04","transform":["11.04","0.00","0.00","11.04","506.59","327.55"],"x":506.59,"y":327.55}
{"page":16,"change":"none","str":"might use the transfer of care ","dir":"ltr","width":"146.14","height":"11.04","transform":["11.04","0.00","0.00","11.04","600.19","312.19"],"x":600.19,"y":312.19}
{"page":16,"change":"none","str":"For example, might the physiotherapists ","dir":"ltr","width":"198.11","height":"11.04","transform":["11.04","0.00","0.00","11.04","567.19","297.65"],"x":567.19,"y":297.65}
{"page":16,"change":"none","str":"information about falls risk on the ","dir":"ltr","width":"164.35","height":"11.04","transform":["11.04","0.00","0.00","11.04","577.03","283.13"],"x":577.03,"y":283.13}
{"page":16,"change":"none","str":"ave you included someone from the IT team?","dir":"ltr","width":"220.88","height":"11.04","transform":["11.04","0.00","0.00","11.04","514.51","253.25"],"x":514.51,"y":253.25}
{"page":16,"change":"none","str":"e who can relate their experience of the ","dir":"ltr","width":"195.62","height":"11.04","transform":["11.04","0.00","0.00","11.04","572.11","238.01"],"x":572.11,"y":238.01}
{"page":16,"change":"none","str":"transfer of care, e","dir":"ltr","width":"86.24","height":"11.04","transform":["11.04","0.00","0.00","11.04","506.59","223.49"],"x":506.59,"y":223.49}
{"page":16,"change":"none","str":"the patient, resident or client","dir":"ltr","width":"138.24","height":"11.04","transform":["11.04","0.00","0.00","11.04","608.11","223.49"],"x":608.11,"y":223.49}
{"page":16,"change":"none","str":"minimum, consider how you will get their input to the ","dir":"ltr","width":"257.93","height":"11.04","transform":["11.04","0.00","0.00","11.04","506.59","208.85"],"x":506.59,"y":208.85}
{"page":16,"change":"none","str":"transfer of care process. Videoing people talking about ","dir":"ltr","width":"269.01","height":"11.04","transform":["11.04","0.00","0.00","11.04","506.59","194.30"],"x":506.59,"y":194.3}
{"page":16,"change":"none","str":"their experiences can be a particularly powe","dir":"ltr","width":"214.52","height":"11.04","transform":["11.04","0.00","0.00","11.04","506.59","179.78"],"x":506.59,"y":179.78}
{"page":16,"change":"none","str":"and is not difficult to set up","dir":"ltr","width":"130.19","height":"11.04","transform":["11.04","0.00","0.00","11.04","506.59","165.26"],"x":506.59,"y":165.26}
{"page":16,"change":"none","str":". The ","dir":"ltr","width":"31.27","height":"11.04","transform":["11.04","0.00","0.00","11.04","636.82","165.26"],"x":636.82,"y":165.26}
{"page":16,"change":"none","str":"experience based ","dir":"ltr","width":"89.82","height":"11.04","transform":["11.04","0.00","0.00","11.04","668.14","165.26"],"x":668.14,"y":165.26}
{"page":16,"change":"none","str":"provides further guidance on inter","dir":"ltr","width":"163.67","height":"11.04","transform":["11.04","0.00","0.00","11.04","574.03","150.74"],"x":574.03,"y":150.74}
{"page":17,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":17,"change":"none","str":"utting it all together","dir":"ltr","width":"149.07","height":"15.96","transform":["15.96","0.00","0.00","15.96","109.94","495.10"],"x":109.94,"y":495.1}
{"page":17,"change":"none","str":"this stage, you and your team ","dir":"ltr","width":"147.35","height":"11.04","transform":["11.04","0.00","0.00","11.04","115.10","481.30"],"x":115.1,"y":481.3}
{"page":17,"change":"none","str":"will have ","dir":"ltr","width":"45.07","height":"11.04","transform":["11.04","0.00","0.00","11.04","262.58","481.30"],"x":262.58,"y":481.3}
{"page":17,"change":"none","str":"the aim and scope of the improvement and how it fits with ","dir":"ltr","width":"282.91","height":"11.04","transform":["11.04","0.00","0.00","11.04","345.17","481.30"],"x":345.17,"y":481.3}
{"page":17,"change":"none","str":"c aims and targets. It is a","dir":"ltr","width":"122.21","height":"11.04","transform":["11.04","0.00","0.00","11.04","260.18","466.66"],"x":260.18,"y":466.66}
{"page":17,"change":"none","str":"good idea to capture this in one place, using a ","dir":"ltr","width":"227.47","height":"11.04","transform":["11.04","0.00","0.00","11.04","385.49","466.66"],"x":385.49,"y":466.66}
{"page":17,"change":"none","str":"template such a","dir":"ltr","width":"77.74","height":"11.04","transform":["11.04","0.00","0.00","11.04","134.18","452.14"],"x":134.18,"y":452.14}
{"page":17,"change":"none","str":"s the one ","dir":"ltr","width":"48.30","height":"11.04","transform":["11.04","0.00","0.00","11.04","211.82","452.14"],"x":211.82,"y":452.14}
{"page":17,"change":"none","str":"shown in Appendix ","dir":"ltr","width":"95.24","height":"11.04","transform":["11.04","0.00","0.00","11.04","260.18","452.14"],"x":260.18,"y":452.14}
{"page":17,"change":"none","str":"It will be a useful f","dir":"ltr","width":"87.39","height":"11.04","transform":["11.04","0.00","0.00","11.04","368.45","452.14"],"x":368.45,"y":452.14}
{"page":17,"change":"none","str":"ocus for further ","dir":"ltr","width":"77.07","height":"11.04","transform":["11.04","0.00","0.00","11.04","455.83","452.14"],"x":455.83,"y":452.14}
{"page":17,"change":"none","str":"ssions with ","dir":"ltr","width":"56.70","height":"11.04","transform":["11.04","0.00","0.00","11.04","558.67","452.14"],"x":558.67,"y":452.14}
{"page":17,"change":"none","str":"sponsors and others.","dir":"ltr","width":"102.76","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","437.62"],"x":99.264,"y":437.62}
{"page":17,"change":"none","str":"Sustaining your improvements should never be an afterthought. ","dir":"ltr","width":"312.44","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","395.11"],"x":99.264,"y":395.11}
{"page":17,"change":"none","str":"Sustainability is a crucial ","dir":"ltr","width":"122.67","height":"11.04","transform":["11.04","0.00","0.00","11.04","411.89","395.11"],"x":411.89,"y":395.11}
{"page":17,"change":"none","str":"and integral part of any successful improvement project. It is something you need to be ","dir":"ltr","width":"425.37","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","380.59"],"x":99.264,"y":380.59}
{"page":17,"change":"none","str":"planning for from the start and will run through every aspect of your improvement work; from ","dir":"ltr","width":"450.23","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","366.07"],"x":99.264,"y":366.07}
{"page":17,"change":"none","str":"how you engage leaders, staff, patients and cli","dir":"ltr","width":"226.25","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","351.55"],"x":99.264,"y":351.55}
{"page":17,"change":"none","str":"ents in developing, testing and implementing ","dir":"ltr","width":"220.08","height":"11.04","transform":["11.04","0.00","0.00","11.04","325.61","351.55"],"x":325.61,"y":351.55}
{"page":17,"change":"none","str":"changes, to celebrating success at the end of your project.","dir":"ltr","width":"284.35","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","337.03"],"x":99.264,"y":337.03}
{"page":17,"change":"none","str":"Step 6: Sustain and share","dir":"ltr","width":"134.46","height":"11.04","transform":["11.04","0.00","0.00","11.04","121.94","316.51"],"x":121.94,"y":316.51}
{"page":17,"change":"none","str":"more information about sustainability.","dir":"ltr","width":"181.99","height":"11.04","transform":["11.04","0.00","0.00","11.04","325.49","316.51"],"x":325.49,"y":316.51}
{"page":17,"change":"none","str":"OSSIE Guide to Clinical Handover Improvement","dir":"ltr","width":"234.70","height":"11.04","transform":["11.04","0.00","0.00","11.04","128.54","253.61"],"x":128.54,"y":253.61}
{"page":17,"change":"none","str":"and the ","dir":"ltr","width":"39.66","height":"11.04","transform":["11.04","0.00","0.00","11.04","366.53","253.61"],"x":366.53,"y":253.61}
{"page":17,"change":"none","str":"associated implementation toolkit are highly recommended for ","dir":"ltr","width":"305.10","height":"11.04","transform":["11.04","0.00","0.00","11.04","106.46","239.09"],"x":106.46,"y":239.09}
{"page":17,"change":"none","str":"anyone involved in improving handover or transfer of car","dir":"ltr","width":"274.52","height":"11.04","transform":["11.04","0.00","0.00","11.04","106.46","224.57"],"x":106.46,"y":224.57}
{"page":17,"change":"none","str":"e in ","dir":"ltr","width":"20.71","height":"11.04","transform":["11.04","0.00","0.00","11.04","381.17","224.57"],"x":381.17,"y":224.57}
{"page":17,"change":"none","str":"any care setting.","dir":"ltr","width":"80.77","height":"11.04","transform":["11.04","0.00","0.00","11.04","106.46","210.05"],"x":106.46,"y":210.05}
{"page":18,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":18,"change":"none","str":"Measure and understand","dir":"ltr","width":"284.04","height":"24.00","transform":["24.00","0.00","0.00","24.00","158.42","478.18"],"x":158.42,"y":478.18}
{"page":18,"change":"none","str":"Measurement for improvement ","dir":"ltr","width":"152.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","440.02"],"x":99.264,"y":440.02}
{"page":18,"change":"none","str":"does not have to be onerous","dir":"ltr","width":"139.56","height":"11.04","transform":["11.04","0.00","0.00","11.04","252.14","440.02"],"x":252.14,"y":440.02}
{"page":18,"change":"none","str":"; it is about using a few specific ","dir":"ltr","width":"154.65","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.61","440.02"],"x":391.61,"y":440.02}
{"page":18,"change":"none","str":"measures, linked to your projec","dir":"ltr","width":"152.94","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","425.50"],"x":99.264,"y":425.5}
{"page":18,"change":"none","str":"t aim to answer the question: ‘H","dir":"ltr","width":"154.06","height":"11.04","transform":["11.04","0.00","0.00","11.04","252.26","425.50"],"fontName":"Arial","x":252.26,"y":425.5}
{"page":18,"change":"none","str":"ow will I know that my","dir":"ltr","width":"106.36","height":"11.04","transform":["11.04","0.00","0.00","11.04","406.37","425.50"],"x":406.37,"y":425.5}
{"page":18,"change":"none","str":"have made an improvement?’","dir":"ltr","width":"145.00","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","410.95"],"fontName":"Arial","x":99.264,"y":410.95}
{"page":18,"change":"none","str":"You will want to use some process measures for your change ideas and also your improvement ","dir":"ltr","width":"467.65","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","386.35"],"x":99.264,"y":386.35}
{"page":18,"change":"none","str":"focus, and you will want to at least one outcome measure for your improvement project aim. ","dir":"ltr","width":"449.31","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","371.83"],"x":99.264,"y":371.83}
{"page":18,"change":"none","str":"For your overarching ","dir":"ltr","width":"104.56","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","347.35"],"x":99.264,"y":347.35}
{"page":18,"change":"none","str":"you might want to choose a process measure and an ","dir":"ltr","width":"261.02","height":"11.04","transform":["11.04","0.00","0.00","11.04","298.13","347.35"],"x":298.13,"y":347.35}
{"page":18,"change":"none","str":"outcome measure from the list below","dir":"ltr","width":"179.90","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","332.71"],"x":99.264,"y":332.71}
{"page":18,"change":"none","str":"No. of transfers right each time","dir":"ltr","width":"150.51","height":"11.04","transform":["11.04","0.00","0.00","11.04","153.26","311.45"],"x":153.26,"y":311.45}
{"page":18,"change":"none","str":"based on your definition of ‘right’ ","dir":"ltr","width":"161.34","height":"11.04","transform":["11.04","0.00","0.00","11.04","313.01","311.45"],"fontName":"Arial","x":313.01,"y":311.45}
{"page":18,"change":"none","str":"No. of staff who know which patients are at risk of fall ","dir":"ltr","width":"261.52","height":"11.04","transform":["11.04","0.00","0.00","11.04","153.26","296.21"],"x":153.26,"y":296.21}
{"page":18,"change":"none","str":"No of ","dir":"ltr","width":"29.44","height":"11.04","transform":["11.04","0.00","0.00","11.04","153.26","280.85"],"x":153.26,"y":280.85}
{"page":18,"change":"none","str":"who get ","dir":"ltr","width":"41.57","height":"11.04","transform":["11.04","0.00","0.00","11.04","224.30","280.85"],"x":224.3,"y":280.85}
{"page":18,"change":"none","str":"diagnostic tests when ","dir":"ltr","width":"108.07","height":"11.04","transform":["11.04","0.00","0.00","11.04","265.94","280.85"],"x":265.94,"y":280.85}
{"page":18,"change":"none","str":"No. of staff who ","dir":"ltr","width":"79.45","height":"11.04","transform":["11.04","0.00","0.00","11.04","153.26","265.61"],"x":153.26,"y":265.61}
{"page":18,"change":"none","str":"know who is in charge of handover","dir":"ltr","width":"169.38","height":"11.04","transform":["11.04","0.00","0.00","11.04","232.70","265.61"],"x":232.7,"y":265.61}
{"page":18,"change":"none","str":"get the information they require","dir":"ltr","width":"152.40","height":"11.04","transform":["11.04","0.00","0.00","11.04","426.53","265.61"],"x":426.53,"y":265.61}
{"page":18,"change":"none","str":"for their job ","dir":"ltr","width":"58.10","height":"11.04","transform":["11.04","0.00","0.00","11.04","153.26","250.97"],"x":153.26,"y":250.97}
{"page":18,"change":"none","str":"No. of times when number ","dir":"ltr","width":"131.40","height":"11.04","transform":["11.04","0.00","0.00","11.04","153.26","235.73"],"x":153.26,"y":235.73}
{"page":18,"change":"none","str":"in handover and time","dir":"ltr","width":"102.83","height":"11.04","transform":["11.04","0.00","0.00","11.04","364.13","235.73"],"x":364.13,"y":235.73}
{"page":18,"change":"none","str":"taken is within agreed limit ","dir":"ltr","width":"132.02","height":"11.04","transform":["11.04","0.00","0.00","11.04","469.99","235.73"],"x":469.99,"y":235.73}
{"page":18,"change":"none","str":"You will find some more on measures for the smaller pieces ","dir":"ltr","width":"294.02","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","215.21"],"x":99.264,"y":215.21}
{"page":18,"change":"none","str":"after we have described the 7 steps to measurement. ","dir":"ltr","width":"262.16","height":"11.04","transform":["11.04","0.00","0.00","11.04","402.77","215.21"],"x":402.77,"y":215.21}
{"page":19,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":19,"change":"none","str":"Whatever you choose to measure, there are seven basic steps ","dir":"ltr","width":"308.23","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","528.22"],"x":99.264,"y":528.22}
{"page":19,"change":"none","str":"The 7 steps to measu","dir":"ltr","width":"122.10","height":"12.00","transform":["12.00","0.00","0.00","12.00","99.26","506.62"],"x":99.264,"y":506.62}
{"page":19,"change":"none","str":"You will have already done this. ","dir":"ltr","width":"143.18","height":"9.96","transform":["9.96","0.00","0.00","9.96","206.18","483.22"],"x":206.18,"y":483.22}
{"page":19,"change":"none","str":"2: Choose your ","dir":"ltr","width":"75.42","height":"9.96","transform":["9.96","0.00","0.00","9.96","105.38","445.30"],"x":105.38,"y":445.3}
{"page":19,"change":"none","str":"You may have a long list of possible measures, so you need to narrow ","dir":"ltr","width":"313.17","height":"9.96","transform":["9.96","0.00","0.00","9.96","206.18","445.30"],"x":206.18,"y":445.3}
{"page":19,"change":"none","str":"these down to the most appropriate. ","dir":"ltr","width":"162.13","height":"9.96","transform":["9.96","0.00","0.00","9.96","206.18","433.78"],"x":206.18,"y":433.78}
{"page":19,"change":"none","str":"3: Define your ","dir":"ltr","width":"69.33","height":"9.96","transform":["9.96","0.00","0.00","9.96","105.38","407.35"],"x":105.38,"y":407.35}
{"page":19,"change":"none","str":"Be clear about exactly what you are measuring. ","dir":"ltr","width":"213.18","height":"9.96","transform":["9.96","0.00","0.00","9.96","206.18","407.35"],"x":206.18,"y":407.35}
{"page":19,"change":"none","str":"Think about ","dir":"ltr","width":"54.96","height":"9.96","transform":["9.96","0.00","0.00","9.96","206.18","369.55"],"x":206.18,"y":369.55}
{"page":19,"change":"none","str":"to measure and establish a ","dir":"ltr","width":"122.60","height":"9.96","transform":["9.96","0.00","0.00","9.96","385.85","369.55"],"x":385.85,"y":369.55}
{"page":19,"change":"none","str":"5: Analyse and ","dir":"ltr","width":"73.16","height":"9.96","transform":["9.96","0.00","0.00","9.96","105.38","344.71"],"x":105.38,"y":344.71}
{"page":19,"change":"none","str":"There are many tools to help you do this, including:","dir":"ltr","width":"225.89","height":"9.96","transform":["9.96","0.00","0.00","9.96","206.18","344.71"],"x":206.18,"y":344.71}
{"page":19,"change":"none","str":"bar charts to understand common problems","dir":"ltr","width":"193.34","height":"9.96","transform":["9.96","0.00","0.00","9.96","208.94","333.19"],"x":208.94,"y":333.19}
{"page":19,"change":"none","str":"run charts or statistical process control (SPC) charts to ","dir":"ltr","width":"244.21","height":"9.96","transform":["9.96","0.00","0.00","9.96","242.18","320.95"],"x":242.18,"y":320.95}
{"page":19,"change":"none","str":"demonstrate your progress","dir":"ltr","width":"119.35","height":"9.96","transform":["9.96","0.00","0.00","9.96","242.18","309.53"],"x":242.18,"y":309.53}
{"page":19,"change":"none","str":"photos, videos and stories.","dir":"ltr","width":"118.82","height":"9.96","transform":["9.96","0.00","0.00","9.96","242.18","297.29"],"x":242.18,"y":297.29}
{"page":19,"change":"none","str":"Look at the data regularly. What does it tell you? What should you do ","dir":"ltr","width":"313.09","height":"9.96","transform":["9.96","0.00","0.00","9.96","206.18","272.81"],"x":206.18,"y":272.81}
{"page":19,"change":"none","str":"7 steps to measurement video","dir":"ltr","width":"133.73","height":"9.96","transform":["9.96","0.00","0.00","9.96","109.10","159.02"],"x":109.1,"y":159.02}
{"page":19,"change":"none","str":"Measuring for improvement ","dir":"ltr","width":"124.40","height":"9.96","transform":["9.96","0.00","0.00","9.96","109.10","135.86"],"x":109.1,"y":135.86}
{"page":19,"change":"none","str":"Handover and tran","dir":"ltr","width":"82.67","height":"9.96","transform":["9.96","0.00","0.00","9.96","109.10","112.70"],"x":109.1,"y":112.7}
{"page":19,"change":"none","str":"sfers of Care ","dir":"ltr","width":"60.08","height":"9.96","transform":["9.96","0.00","0.00","9.96","191.78","112.70"],"x":191.78,"y":112.7}
{"page":20,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":20,"change":"none","str":"Choose your measures","dir":"ltr","width":"176.77","height":"15.96","transform":["15.96","0.00","0.00","15.96","99.26","523.66"],"x":99.264,"y":523.66}
{"page":20,"change":"none","str":"and start collecting your baseline data","dir":"ltr","width":"291.45","height":"15.96","transform":["15.96","0.00","0.00","15.96","280.61","523.66"],"x":280.61,"y":523.66}
{"page":20,"change":"none","str":"You should not be spending lots of time collecting data! From your long list of things you could measure","dir":"ltr","width":"503.17","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","500.98"],"x":99.264,"y":500.98}
{"page":20,"change":"none","str":"pick a few. ","dir":"ltr","width":"54.99","height":"11.04","transform":["11.04","0.00","0.00","11.04","628.99","500.98"],"x":628.99,"y":500.98}
{"page":20,"change":"none","str":"For your improvement project aim ","dir":"ltr","width":"181.55","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","480.58"],"x":99.264,"y":480.58}
{"page":20,"change":"none","str":"pick a process or outcome measure that","dir":"ltr","width":"195.51","height":"11.04","transform":["11.04","0.00","0.00","11.04","280.97","480.58"],"x":280.97,"y":480.58}
{"page":20,"change":"none","str":"tell you wheth","dir":"ltr","width":"67.20","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","465.94"],"x":99.264,"y":465.94}
{"page":20,"change":"none","str":"have achieved your aim. It should be something that is ","dir":"ltr","width":"268.43","height":"11.04","transform":["11.04","0.00","0.00","11.04","200.18","465.94"],"x":200.18,"y":465.94}
{"page":20,"change":"none","str":"meaningful to you and your team. Outcome measures are often more meaningful ","dir":"ltr","width":"396.78","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","451.42"],"x":99.264,"y":451.42}
{"page":20,"change":"none","str":"to patients, but are more frequently affected by changes that are beyond your ","dir":"ltr","width":"379.05","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","436.78"],"x":99.264,"y":436.78}
{"page":20,"change":"none","str":"control. Process measures can appeal to ","dir":"ltr","width":"202.33","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","422.23"],"x":99.264,"y":422.23}
{"page":20,"change":"none","str":"patients and carers too e.g. the number ","dir":"ltr","width":"194.86","height":"11.04","transform":["11.04","0.00","0.00","11.04","301.73","422.23"],"x":301.73,"y":422.23}
{"page":20,"change":"none","str":"of transfers of care in your weekly sample that are judged to be right ","dir":"ltr","width":"334.31","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","407.71"],"x":99.264,"y":407.71}
{"page":20,"change":"none","str":"have been involved in creating the definition of ‘right’","dir":"ltr","width":"255.51","height":"11.04","transform":["11.04","0.00","0.00","11.04","149.54","393.19"],"fontName":"Arial","x":149.54,"y":393.19}
{"page":20,"change":"none","str":"the community ","dir":"ltr","width":"74.54","height":"11.04","transform":["11.04","0.00","0.00","11.04","429.65","393.19"],"x":429.65,"y":393.19}
{"page":20,"change":"none","str":"rehabilitation therapists meet in the team","dir":"ltr","width":"198.13","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","378.55"],"x":99.264,"y":378.55}
{"page":20,"change":"none","str":"office at 4.30pm and handover all ","dir":"ltr","width":"165.46","height":"11.04","transform":["11.04","0.00","0.00","11.04","300.53","378.55"],"x":300.53,"y":378.55}
{"page":20,"change":"none","str":"planned actions for patients by completing ","dir":"ltr","width":"208.56","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","364.03"],"x":99.264,"y":364.03}
{"page":20,"change":"none","str":"So the choice on data collection is ","dir":"ltr","width":"169.38","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","343.51"],"x":99.264,"y":343.51}
{"page":20,"change":"none","str":"balance between ease and reliability of collection and ","dir":"ltr","width":"262.83","height":"11.04","transform":["11.04","0.00","0.00","11.04","277.97","343.51"],"x":277.97,"y":343.51}
{"page":20,"change":"none","str":"t can inform your next action. ","dir":"ltr","width":"144.22","height":"11.04","transform":["11.04","0.00","0.00","11.04","143.90","329.11"],"x":143.9,"y":329.11}
{"page":20,"change":"none","str":"ever you deci","dir":"ltr","width":"65.32","height":"11.04","transform":["11.04","0.00","0.00","11.04","313.97","329.11"],"x":313.97,"y":329.11}
{"page":20,"change":"none","str":"you should pick at least ","dir":"ltr","width":"127.58","height":"11.04","transform":["11.04","0.00","0.00","11.04","394.73","329.11"],"x":394.73,"y":329.11}
{"page":20,"change":"none","str":"one and start collecting this data now","dir":"ltr","width":"196.68","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","314.59"],"x":99.264,"y":314.59}
{"page":20,"change":"none","str":". This will give you ","dir":"ltr","width":"92.07","height":"11.04","transform":["11.04","0.00","0.00","11.04","296.21","314.59"],"x":296.21,"y":314.59}
{"page":20,"change":"none","str":"your baseline for the ","dir":"ltr","width":"102.75","height":"11.04","transform":["11.04","0.00","0.00","11.04","388.37","314.59"],"x":388.37,"y":314.59}
{"page":20,"change":"none","str":"If you don’t collect your baseline data now, it will be difficult to prove ","dir":"ltr","width":"332.58","height":"11.04","transform":["11.04","0.00","0.00","11.04","205.10","299.81"],"fontName":"Arial","x":205.1,"y":299.81}
{"page":20,"change":"none","str":"your changes have made an improvement later.","dir":"ltr","width":"232.89","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","285.29"],"x":99.264,"y":285.29}
{"page":20,"change":"none","str":"There are often lots of things that need fixing, and your next piece of work will help you ","dir":"ltr","width":"424.04","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","264.77"],"x":99.264,"y":264.77}
{"page":20,"change":"none","str":"decide where to start (your ","dir":"ltr","width":"133.34","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","250.37"],"x":99.264,"y":250.37}
{"page":20,"change":"none","str":". From all your change ideas you ","dir":"ltr","width":"162.60","height":"11.04","transform":["11.04","0.00","0.00","11.04","361.61","250.37"],"x":361.61,"y":250.37}
{"page":20,"change":"none","str":"will then need to select the ","dir":"ltr","width":"132.61","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","235.73"],"x":99.264,"y":235.73}
{"page":20,"change":"none","str":"In the box below and on ","dir":"ltr","width":"119.93","height":"11.04","transform":["11.04","0.00","0.00","11.04","366.41","235.73"],"x":366.41,"y":235.73}
{"page":20,"change":"none","str":"the next page ","dir":"ltr","width":"69.77","height":"11.04","transform":["11.04","0.00","0.00","11.04","486.31","235.73"],"x":486.31,"y":235.73}
{"page":20,"change":"none","str":"we have given some examples of ","dir":"ltr","width":"165.62","height":"11.04","transform":["11.04","0.00","0.00","11.04","556.15","235.73"],"x":556.15,"y":235.73}
{"page":20,"change":"none","str":"process and outcome measures that focus on frontline care. We have also included process measures with a management focus so ","dir":"ltr","width":"644.91","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","221.09"],"x":99.264,"y":221.09}
{"page":20,"change":"none","str":"that you can see the connection between your work and your organisation’s strategic ob","dir":"ltr","width":"427.42","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","206.57"],"fontName":"Arial","x":99.264,"y":206.57}
{"page":20,"change":"none","str":"Remember, you may not see ","dir":"ltr","width":"144.38","height":"11.04","transform":["11.04","0.00","0.00","11.04","563.59","384.67"],"x":563.59,"y":384.67}
{"page":20,"change":"none","str":"changes in these measures ","dir":"ltr","width":"137.68","height":"11.04","transform":["11.04","0.00","0.00","11.04","563.59","370.03"],"x":563.59,"y":370.03}
{"page":20,"change":"none","str":"until you have made and ","dir":"ltr","width":"122.92","height":"11.04","transform":["11.04","0.00","0.00","11.04","563.59","355.51"],"x":563.59,"y":355.51}
{"page":20,"change":"none","str":"sustained several smaller ","dir":"ltr","width":"127.22","height":"11.04","transform":["11.04","0.00","0.00","11.04","563.59","340.99"],"x":563.59,"y":340.99}
{"page":20,"change":"none","str":"changes, or even carried out ","dir":"ltr","width":"142.43","height":"11.04","transform":["11.04","0.00","0.00","11.04","563.59","326.47"],"x":563.59,"y":326.47}
{"page":21,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":21,"change":"none","str":"process and ","dir":"ltr","width":"74.11","height":"12.00","transform":["12.00","0.00","0.00","12.00","239.30","527.26"],"x":239.3,"y":527.26}
{"page":21,"change":"none","str":"from management and frontline care perspectives","dir":"ltr","width":"284.41","height":"12.00","transform":["12.00","0.00","0.00","12.00","426.17","527.26"],"x":426.17,"y":527.26}
{"page":21,"change":"none","str":"not be able to collect ","dir":"ltr","width":"103.80","height":"11.04","transform":["11.04","0.00","0.00","11.04","613.03","481.54"],"x":613.03,"y":481.54}
{"page":21,"change":"none","str":"data for all your project outcome","dir":"ltr","width":"157.24","height":"11.04","transform":["11.04","0.00","0.00","11.04","566.47","467.02"],"x":566.47,"y":467.02}
{"page":21,"change":"none","str":"measures yet, but you need to ","dir":"ltr","width":"150.99","height":"11.04","transform":["11.04","0.00","0.00","11.04","566.47","452.38"],"x":566.47,"y":452.38}
{"page":21,"change":"none","str":"start planning how and when you ","dir":"ltr","width":"163.83","height":"11.04","transform":["11.04","0.00","0.00","11.04","566.47","437.86"],"x":566.47,"y":437.86}
{"page":22,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":22,"change":"none","str":"Capture and display the data","dir":"ltr","width":"218.57","height":"15.96","transform":["15.96","0.00","0.00","15.96","99.26","523.66"],"x":99.264,"y":523.66}
{"page":22,"change":"none","str":"Plotting your data in a ","dir":"ltr","width":"109.46","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","503.86"],"x":99.264,"y":503.86}
{"page":22,"change":"none","str":"is a simple way to see the variation in the system and if any improvements have been made. You ","dir":"ltr","width":"475.07","height":"11.04","transform":["11.04","0.00","0.00","11.04","259.58","503.86"],"x":259.58,"y":503.86}
{"page":22,"change":"none","str":"need 25 data points before doing any analysis, so using more frequent data (weekly or daily","dir":"ltr","width":"446.36","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","489.22"],"x":99.264,"y":489.22}
{"page":22,"change":"none","str":"in favour of monthly or quarterly) is ","dir":"ltr","width":"172.16","height":"11.04","transform":["11.04","0.00","0.00","11.04","551.95","489.22"],"x":551.95,"y":489.22}
{"page":22,"change":"none","str":"better. You can look for a ","dir":"ltr","width":"125.91","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","474.70"],"x":99.264,"y":474.7}
{"page":22,"change":"none","str":"’ of seven","dir":"ltr","width":"47.04","height":"11.04","transform":["11.04","0.00","0.00","11.04","243.62","474.70"],"fontName":"Arial","x":243.62,"y":474.7}
{"page":22,"change":"none","str":"points or more","dir":"ltr","width":"70.29","height":"11.04","transform":["11.04","0.00","0.00","11.04","293.81","474.70"],"x":293.81,"y":474.7}
{"page":22,"change":"none","str":"all up, all down","dir":"ltr","width":"72.60","height":"11.04","transform":["11.04","0.00","0.00","11.04","373.97","474.70"],"x":373.97,"y":474.7}
{"page":22,"change":"none","str":"or all above or below the median value","dir":"ltr","width":"188.38","height":"11.04","transform":["11.04","0.00","0.00","11.04","452.71","474.70"],"x":452.71,"y":474.7}
{"page":22,"change":"none","str":". The run will tell you","dir":"ltr","width":"100.06","height":"11.04","transform":["11.04","0.00","0.00","11.04","641.14","474.70"],"x":641.14,"y":474.7}
{"page":22,"change":"none","str":"if an improvement has been made. ","dir":"ltr","width":"172.46","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","460.18"],"x":99.264,"y":460.18}
{"page":22,"change":"none","str":"Number of times standard format followed","dir":"ltr","width":"214.27","height":"12.00","transform":["12.00","0.00","0.00","12.00","163.54","398.57"],"fontName":"ABCDEE+Calibri,Bold","x":163.54,"y":398.57}
{"page":22,"change":"none","str":"Number of times standard format followed","dir":"ltr","width":"174.97","height":"9.96","transform":["9.96","0.00","0.00","9.96","158.09","379.32"],"fontName":"ABCDEE+Calibri","x":158.09,"y":379.32}
{"page":22,"change":"none","str":"Level of preparedness to deliver care","dir":"ltr","width":"182.66","height":"12.00","transform":["12.00","0.00","0.00","12.00","553.44","393.82"],"fontName":"ABCDEE+Calibri,Bold","x":553.44,"y":393.82}
{"page":22,"change":"none","str":"(1 = not prepared, 5 = prepared)","dir":"ltr","width":"159.26","height":"12.00","transform":["12.00","0.00","0.00","12.00","531.24","379.15"],"fontName":"ABCDEE+Calibri,Bold","x":531.24,"y":379.15}
{"page":22,"change":"none","str":"Click here for more about using ","dir":"ltr","width":"155.95","height":"11.04","transform":["11.04","0.00","0.00","11.04","512.35","153.62"],"x":512.35,"y":153.62}
{"page":22,"change":"none","str":"run charts and ","dir":"ltr","width":"73.37","height":"11.04","transform":["11.04","0.00","0.00","11.04","668.38","153.62"],"x":668.38,"y":153.62}
{"page":23,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":23,"change":"none","str":"Design and plan","dir":"ltr","width":"185.38","height":"24.00","transform":["24.00","0.00","0.00","24.00","154.82","484.18"],"x":154.82,"y":484.18}
{"page":23,"change":"none","str":"Once you have","dir":"ltr","width":"74.05","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","442.54"],"x":99.264,"y":442.54}
{"page":23,"change":"none","str":"mapped your current process and ","dir":"ltr","width":"167.52","height":"11.04","transform":["11.04","0.00","0.00","11.04","176.30","442.54"],"x":176.3,"y":442.54}
{"page":23,"change":"none","str":"data about your transfers ","dir":"ltr","width":"125.18","height":"11.04","transform":["11.04","0.00","0.00","11.04","396.05","442.54"],"x":396.05,"y":442.54}
{"page":23,"change":"none","str":"of care ","dir":"ltr","width":"36.76","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","428.02"],"x":99.264,"y":428.02}
{"page":23,"change":"none","str":"with best practice","dir":"ltr","width":"84.96","height":"11.04","transform":["11.04","0.00","0.00","11.04","136.10","428.02"],"x":136.1,"y":428.02}
{"page":23,"change":"none","str":"need to decide where to","dir":"ltr","width":"117.37","height":"11.04","transform":["11.04","0.00","0.00","11.04","247.94","428.02"],"x":247.94,"y":428.02}
{"page":23,"change":"none","str":"this will be ","dir":"ltr","width":"53.68","height":"11.04","transform":["11.04","0.00","0.00","11.04","402.05","428.02"],"x":402.05,"y":428.02}
{"page":23,"change":"none","str":"You may want to dig deeper into your ","dir":"ltr","width":"185.12","height":"11.04","transform":["11.04","0.00","0.00","11.04","207.02","413.59"],"x":207.02,"y":413.59}
{"page":23,"change":"none","str":"current transfer of care ","dir":"ltr","width":"114.24","height":"11.04","transform":["11.04","0.00","0.00","11.04","392.33","413.59"],"x":392.33,"y":413.59}
{"page":23,"change":"none","str":"root cause analysis","dir":"ltr","width":"93.94","height":"11.04","transform":["11.04","0.00","0.00","11.04","290.21","398.95"],"x":290.21,"y":398.95}
{"page":23,"change":"none","str":"to help you understand how your transfer fits into the bigger picture","dir":"ltr","width":"326.12","height":"11.04","transform":["11.04","0.00","0.00","11.04","156.02","384.43"],"x":156.02,"y":384.43}
{"page":23,"change":"none","str":"are drawn from the good practice checklist ","dir":"ltr","width":"209.62","height":"11.04","transform":["11.04","0.00","0.00","11.04","483.91","158.42"],"x":483.91,"y":158.42}
{"page":23,"change":"none","str":"earlier in the guide (","dir":"ltr","width":"97.12","height":"11.04","transform":["11.04","0.00","0.00","11.04","153.86","143.78"],"x":153.86,"y":143.78}
{"page":23,"change":"none","str":"for full list ","dir":"ltr","width":"49.57","height":"11.04","transform":["11.04","0.00","0.00","11.04","250.94","143.78"],"x":250.94,"y":143.78}
{"page":23,"change":"none","str":"in this list","dir":"ltr","width":"45.03","height":"11.04","transform":["11.04","0.00","0.00","11.04","320.81","123.26"],"x":320.81,"y":123.26}
{"page":23,"change":"none","str":"that you believe will ","dir":"ltr","width":"98.28","height":"11.04","transform":["11.04","0.00","0.00","11.04","369.05","123.26"],"x":369.05,"y":123.26}
{"page":23,"change":"none","str":"example, you predict that fi","dir":"ltr","width":"131.64","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","108.62"],"x":99.264,"y":108.62}
{"page":23,"change":"none","str":"nding a quiet place to communicate without interruptions will help speed up the handover or transfer of ","dir":"ltr","width":"500.47","height":"11.04","transform":["11.04","0.00","0.00","11.04","230.90","108.62"],"x":230.9,"y":108.62}
{"page":23,"change":"none","str":"Working with your project team,","dir":"ltr","width":"154.17","height":"11.04","transform":["11.04","0.00","0.00","11.04","171.26","94.22"],"x":171.26,"y":94.224}
{"page":23,"change":"none","str":"choose one ","dir":"ltr","width":"59.97","height":"11.04","transform":["11.04","0.00","0.00","11.04","328.73","94.22"],"x":328.73,"y":94.224}
{"page":23,"change":"none","str":"area as ","dir":"ltr","width":"39.64","height":"11.04","transform":["11.04","0.00","0.00","11.04","388.73","94.22"],"x":388.73,"y":94.224}
{"page":23,"change":"none","str":"your first improvement ","dir":"ltr","width":"122.78","height":"11.04","transform":["11.04","0.00","0.00","11.04","428.45","94.22"],"x":428.45,"y":94.224}
{"page":23,"change":"none","str":"There are different ways of ","dir":"ltr","width":"133.89","height":"11.04","transform":["11.04","0.00","0.00","11.04","586.63","94.22"],"x":586.63,"y":94.224}
{"page":23,"change":"none","str":"and you might choose to generate ","dir":"ltr","width":"169.20","height":"11.04","transform":["11.04","0.00","0.00","11.04","149.54","79.56"],"x":149.54,"y":79.56}
{"page":23,"change":"none","str":"deciding where to focus","dir":"ltr","width":"115.64","height":"11.04","transform":["11.04","0.00","0.00","11.04","473.47","79.56"],"x":473.47,"y":79.56}
{"page":24,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":24,"change":"none","str":"ll the ","dir":"ltr","width":"26.33","height":"11.04","transform":["11.04","0.00","0.00","11.04","106.58","528.22"],"x":106.58,"y":528.22}
{"page":24,"change":"none","str":"good practice elements","dir":"ltr","width":"113.82","height":"11.04","transform":["11.04","0.00","0.00","11.04","132.86","528.22"],"x":132.86,"y":528.22}
{"page":24,"change":"none","str":"are interlinked and ","dir":"ltr","width":"93.40","height":"11.04","transform":["11.04","0.00","0.00","11.04","249.74","528.22"],"x":249.74,"y":528.22}
{"page":24,"change":"none","str":"all need to be worked on at some point","dir":"ltr","width":"188.74","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.01","528.22"],"x":391.01,"y":528.22}
{"page":24,"change":"none","str":". Some changes ","dir":"ltr","width":"82.48","height":"11.04","transform":["11.04","0.00","0.00","11.04","579.91","528.22"],"x":579.91,"y":528.22}
{"page":24,"change":"none","str":"developed very quickly (e","dir":"ltr","width":"124.05","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","513.58"],"x":99.264,"y":513.58}
{"page":24,"change":"none","str":"moving the location of handover); others may take a longer (e","dir":"ltr","width":"299.48","height":"11.04","transform":["11.04","0.00","0.00","11.04","238.70","513.58"],"x":238.7,"y":513.58}
{"page":24,"change":"none","str":"changing the culture to ","dir":"ltr","width":"114.24","height":"11.04","transform":["11.04","0.00","0.00","11.04","553.75","513.58"],"x":553.75,"y":513.58}
{"page":24,"change":"none","str":"place a higher ","dir":"ltr","width":"72.18","height":"11.04","transform":["11.04","0.00","0.00","11.04","668.14","513.58"],"x":668.14,"y":513.58}
{"page":24,"change":"none","str":"transfers of care ","dir":"ltr","width":"82.47","height":"11.04","transform":["11.04","0.00","0.00","11.04","143.90","499.06"],"x":143.9,"y":499.06}
{"page":24,"change":"none","str":"and give them ","dir":"ltr","width":"72.16","height":"11.04","transform":["11.04","0.00","0.00","11.04","226.46","499.06"],"x":226.46,"y":499.06}
{"page":24,"change":"none","str":"over other tasks","dir":"ltr","width":"78.33","height":"11.04","transform":["11.04","0.00","0.00","11.04","334.61","499.06"],"x":334.61,"y":499.06}
{"page":24,"change":"none","str":"Where to s","dir":"ltr","width":"81.68","height":"15.96","transform":["15.96","0.00","0.00","15.96","99.26","453.46"],"x":99.264,"y":453.46}
{"page":24,"change":"none","str":"Look at your current process map ","dir":"ltr","width":"166.90","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","430.78"],"x":99.264,"y":430.78}
{"page":24,"change":"none","str":"hich aspects of the process need improving first?","dir":"ltr","width":"238.27","height":"11.04","transform":["11.04","0.00","0.00","11.04","325.73","430.78"],"x":325.73,"y":430.78}
{"page":24,"change":"none","str":"You could use a bar chart to display ","dir":"ltr","width":"177.88","height":"11.04","transform":["11.04","0.00","0.00","11.04","567.07","430.78"],"x":567.07,"y":430.78}
{"page":24,"change":"none","str":"results from a staff survey ","dir":"ltr","width":"128.75","height":"11.04","transform":["11.04","0.00","0.00","11.04","117.62","416.23"],"x":117.62,"y":416.23}
{"page":24,"change":"none","str":"and then focus your initial improvement on the most commonly","dir":"ltr","width":"305.16","height":"11.04","transform":["11.04","0.00","0.00","11.04","246.50","416.23"],"x":246.5,"y":416.23}
{"page":24,"change":"none","str":"is a simple technique that helps ","dir":"ltr","width":"156.50","height":"11.04","transform":["11.04","0.00","0.00","11.04","587.95","339.67"],"x":587.95,"y":339.67}
{"page":24,"change":"none","str":"you to focus efforts on the problems that offer the ","dir":"ltr","width":"242.67","height":"11.04","transform":["11.04","0.00","0.00","11.04","509.59","327.07"],"x":509.59,"y":327.07}
{"page":24,"change":"none","str":"greatest potential for improvement by showing ","dir":"ltr","width":"228.06","height":"11.04","transform":["11.04","0.00","0.00","11.04","509.59","314.35"],"x":509.59,"y":314.35}
{"page":24,"change":"none","str":"uency or size in a ","dir":"ltr","width":"88.61","height":"11.04","transform":["11.04","0.00","0.00","11.04","591.67","301.85"],"x":591.67,"y":301.85}
{"page":24,"change":"none","str":", the ‘80/20’ rule","dir":"ltr","width":"78.34","height":"11.04","transform":["11.04","0.00","0.00","11.04","601.51","262.49"],"fontName":"Arial","x":601.51,"y":262.49}
{"page":24,"change":"none","str":"asserts that ","dir":"ltr","width":"59.81","height":"11.04","transform":["11.04","0.00","0.00","11.04","686.02","262.49"],"x":686.02,"y":262.49}
{"page":24,"change":"none","str":"for many events, roughly 80% of the effects come ","dir":"ltr","width":"244.46","height":"11.04","transform":["11.04","0.00","0.00","11.04","509.59","249.77"],"x":509.59,"y":249.77}
{"page":24,"change":"none","str":"from 20% of the causes.","dir":"ltr","width":"118.71","height":"11.04","transform":["11.04","0.00","0.00","11.04","509.59","237.17"],"x":509.59,"y":237.17}
{"page":24,"change":"none","str":"For example, if ","dir":"ltr","width":"75.87","height":"11.04","transform":["11.04","0.00","0.00","11.04","631.30","237.17"],"x":631.3,"y":237.17}
{"page":24,"change":"none","str":"documentation is not completed, the process ","dir":"ltr","width":"221.26","height":"11.04","transform":["11.04","0.00","0.00","11.04","509.59","224.45"],"x":509.59,"y":224.45}
{"page":24,"change":"none","str":"takes longer and information ","dir":"ltr","width":"141.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","509.59","211.85"],"x":509.59,"y":211.85}
{"page":24,"change":"none","str":"may be missed or ","dir":"ltr","width":"89.78","height":"11.04","transform":["11.04","0.00","0.00","11.04","651.58","211.85"],"x":651.58,"y":211.85}
{"page":24,"change":"none","str":"Number of staff who highlighted problem","dir":"ltr","width":"172.75","height":"9.96","transform":["-0.00","9.96","-9.96","-0.00","115.34","183.19"],"fontName":"ABCDEE+Calibri,Bold","x":115.34,"y":183.19}
{"page":24,"change":"none","str":"Problems with handover identfied by staff","dir":"ltr","width":"209.64","height":"12.00","transform":["12.00","0.00","0.00","12.00","173.21","348.29"],"fontName":"ABCDEE+Calibri,Bold","x":173.21,"y":348.29}
{"page":25,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":25,"change":"none","str":"You could u","dir":"ltr","width":"58.18","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","528.22"],"x":99.264,"y":528.22}
{"page":25,"change":"none","str":"se a ","dir":"ltr","width":"23.84","height":"11.04","transform":["11.04","0.00","0.00","11.04","157.46","528.22"],"x":157.46,"y":528.22}
{"page":25,"change":"none","str":"to categorise your improvement ideas. Quick wins can be tested and","dir":"ltr","width":"336.23","height":"11.04","transform":["11.04","0.00","0.00","11.04","250.22","528.22"],"x":250.22,"y":528.22}
{"page":25,"change":"none","str":"take more planning and resources to achieve.","dir":"ltr","width":"222.48","height":"11.04","transform":["11.04","0.00","0.00","11.04","230.06","513.58"],"x":230.06,"y":513.58}
{"page":25,"change":"none","str":"Likely impact on project aim","dir":"ltr","width":"115.48","height":"10.02","transform":["9.99","0.00","0.00","10.02","259.86","182.53"],"fontName":"ABCDEE+Calibri,Bold","x":259.86360252916995,"y":182.527980289072}
{"page":25,"change":"none","str":"Ease of testing and ","dir":"ltr","width":"81.55","height":"9.99","transform":["-0.00","10.02","-9.99","-0.00","164.06","285.94"],"fontName":"ABCDEE+Calibri,Bold","x":164.056111440224,"y":285.94428777568}
{"page":25,"change":"none","str":"Just do it!","dir":"ltr","width":"40.06","height":"10.04","transform":["10.01","0.00","0.00","10.04","359.85","368.15"],"fontName":"ABCDEE+Calibri,Bold","x":359.85189045233,"y":368.15034869824}
{"page":25,"change":"none","str":"Record the idea ","dir":"ltr","width":"66.58","height":"10.02","transform":["9.99","0.00","0.00","10.02","216.11","282.88"],"fontName":"ABCDEE+Calibri,Bold","x":216.114790901432,"y":282.880735889488}
{"page":25,"change":"none","str":"whether it is worth ","dir":"ltr","width":"79.28","height":"10.04","transform":["10.01","0.00","0.00","10.04","216.11","259.03"],"fontName":"ABCDEE+Calibri","x":216.114790901432,"y":259.03105213336}
{"page":25,"change":"none","str":"Nice to have","dir":"ltr","width":"51.02","height":"10.02","transform":["9.99","0.00","0.00","10.02","216.11","392.63"],"fontName":"ABCDEE+Calibri,Bold","x":216.114790901432,"y":392.62718077863997}
{"page":25,"change":"none","str":"Test and implement ","dir":"ltr","width":"82.10","height":"10.02","transform":["9.99","0.00","0.00","10.02","216.11","380.72"],"fontName":"ABCDEE+Calibri","x":216.114790901432,"y":380.71587447592}
{"page":25,"change":"none","str":"have been achieved","dir":"ltr","width":"79.93","height":"10.02","transform":["9.99","0.00","0.00","10.02","216.11","356.87"],"fontName":"ABCDEE+Calibri","x":216.114790901432,"y":356.87070257823996}
{"page":25,"change":"none","str":"Plan with your team ","dir":"ltr","width":"83.36","height":"10.02","transform":["9.99","0.00","0.00","10.02","350.49","277.22"],"fontName":"ABCDEE+Calibri","x":350.48501642623995,"y":277.222865395696}
{"page":25,"change":"none","str":"how you will test and ","dir":"ltr","width":"87.92","height":"10.02","transform":["9.99","0.00","0.00","10.02","350.49","265.31"],"fontName":"ABCDEE+Calibri","x":350.48501642623995,"y":265.311559092976}
{"page":25,"change":"none","str":"implement these ","dir":"ltr","width":"70.93","height":"10.02","transform":["9.99","0.00","0.00","10.02","350.49","253.40"],"fontName":"ABCDEE+Calibri","x":350.48501642623995,"y":253.400252790256}
{"page":25,"change":"none","str":"Royal College of Physicians, ","dir":"ltr","width":"142.44","height":"11.04","transform":["11.04","0.00","0.00","11.04","600.67","178.46"],"x":600.67,"y":178.46}
{"page":25,"change":"none","str":"Acute Care Toolkit: 1 ","dir":"ltr","width":"105.75","height":"11.04","transform":["11.04","0.00","0.00","11.04","600.67","163.94"],"x":600.67,"y":163.94}
{"page":26,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":26,"change":"none","str":"and using all the data and observations you already have, ","dir":"ltr","width":"284.27","height":"11.04","transform":["11.04","0.00","0.00","11.04","217.22","494.98"],"x":217.22,"y":494.98}
{"page":26,"change":"none","str":"you can now focus more fully on generating","dir":"ltr","width":"212.24","height":"11.04","transform":["11.04","0.00","0.00","11.04","501.67","494.98"],"x":501.67,"y":494.98}
{"page":26,"change":"none","str":"help you select your ","dir":"ltr","width":"100.85","height":"11.04","transform":["11.04","0.00","0.00","11.04","225.86","480.46"],"x":225.86,"y":480.46}
{"page":26,"change":"none","str":". There are lots of examples ","dir":"ltr","width":"139.34","height":"11.04","transform":["11.04","0.00","0.00","11.04","433.13","480.46"],"x":433.13,"y":480.46}
{"page":26,"change":"none","str":"in the ","dir":"ltr","width":"29.94","height":"11.04","transform":["11.04","0.00","0.00","11.04","689.38","480.46"],"x":689.38,"y":480.46}
{"page":26,"change":"none","str":"seful resources on ","dir":"ltr","width":"93.01","height":"11.04","transform":["11.04","0.00","0.00","11.04","348.17","465.94"],"x":348.17,"y":465.94}
{"page":26,"change":"none","str":"these to stimulate discussion about what is ","dir":"ltr","width":"211.54","height":"11.04","transform":["11.04","0.00","0.00","11.04","514.63","465.94"],"x":514.63,"y":465.94}
{"page":26,"change":"none","str":"possible in your setting","dir":"ltr","width":"111.97","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","451.42"],"x":99.264,"y":451.42}
{"page":26,"change":"none","str":". Remember improvement is context specific, so solutions that work for one ","dir":"ltr","width":"368.55","height":"11.04","transform":["11.04","0.00","0.00","11.04","211.22","451.42"],"x":211.22,"y":451.42}
{"page":26,"change":"none","str":"team in one place don’t easily ","dir":"ltr","width":"147.77","height":"11.04","transform":["11.04","0.00","0.00","11.04","579.91","451.42"],"fontName":"Arial","x":579.91,"y":451.42}
{"page":26,"change":"none","str":"transplant to another team in another place. Some adaption is often required in order for adoption to follow. The approach de","dir":"ltr","width":"605.89","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","436.78"],"x":99.264,"y":436.78}
{"page":26,"change":"none","str":"in this guide can be used to ‘check out’ of test a proven intervention and optimise its effe","dir":"ltr","width":"428.57","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","422.23"],"fontName":"Arial","x":99.264,"y":422.23}
{"page":26,"change":"none","str":"ct in a different place.","dir":"ltr","width":"104.55","height":"11.04","transform":["11.04","0.00","0.00","11.04","528.07","422.23"],"x":528.07,"y":422.23}
{"page":26,"change":"none","str":"we have used the development of a ","dir":"ltr","width":"176.66","height":"11.04","transform":["11.04","0.00","0.00","11.04","178.22","401.83"],"x":178.22,"y":401.83}
{"page":26,"change":"none","str":"to illustrate how you could ","dir":"ltr","width":"129.51","height":"11.04","transform":["11.04","0.00","0.00","11.04","471.79","401.83"],"x":471.79,"y":401.83}
{"page":26,"change":"none","str":"develop and ","dir":"ltr","width":"62.97","height":"11.04","transform":["11.04","0.00","0.00","11.04","601.39","401.83"],"x":601.39,"y":401.83}
{"page":26,"change":"none","str":"test some ","dir":"ltr","width":"50.82","height":"11.04","transform":["11.04","0.00","0.00","11.04","664.42","401.83"],"x":664.42,"y":401.83}
{"page":26,"change":"none","str":"Is the right information shared at transfer ","dir":"ltr","width":"198.68","height":"9.96","transform":["9.96","0.00","0.00","9.96","495.55","335.83"],"x":495.55,"y":335.83}
{"page":26,"change":"none","str":"Identify the pieces of information that ","dir":"ltr","width":"165.96","height":"9.96","transform":["9.96","0.00","0.00","9.96","537.19","322.63"],"x":537.19,"y":322.63}
{"page":26,"change":"none","str":"should be included in transfers of care. This is ","dir":"ltr","width":"208.86","height":"9.96","transform":["9.96","0.00","0.00","9.96","495.55","309.29"],"x":495.55,"y":309.29}
{"page":26,"change":"none","str":"the information ","dir":"ltr","width":"68.85","height":"9.96","transform":["9.96","0.00","0.00","9.96","495.55","295.97"],"x":495.55,"y":295.97}
{"page":26,"change":"none","str":"you need to","dir":"ltr","width":"52.08","height":"9.96","transform":["9.96","0.00","0.00","9.96","564.55","295.97"],"x":564.55,"y":295.97}
{"page":26,"change":"none","str":"include in your ","dir":"ltr","width":"67.12","height":"9.96","transform":["9.96","0.00","0.00","9.96","619.51","295.97"],"x":619.51,"y":295.97}
{"page":26,"change":"none","str":"standard information template","dir":"ltr","width":"143.75","height":"9.96","transform":["9.96","0.00","0.00","9.96","495.55","282.89"],"x":495.55,"y":282.89}
{"page":26,"change":"none","str":"examples below and in Appendix K).","dir":"ltr","width":"161.52","height":"9.96","transform":["9.96","0.00","0.00","9.96","495.55","269.57"],"x":495.55,"y":269.57}
{"page":26,"change":"none","str":"Is communication structured in a ","dir":"ltr","width":"159.85","height":"9.96","transform":["9.96","0.00","0.00","9.96","495.43","240.29"],"x":495.43,"y":240.29}
{"page":26,"change":"none","str":"You will need to agree ","dir":"ltr","width":"101.60","height":"9.96","transform":["9.96","0.00","0.00","9.96","588.19","227.09"],"x":588.19,"y":227.09}
{"page":26,"change":"none","str":"the way in which you want to standardise ","dir":"ltr","width":"184.29","height":"9.96","transform":["9.96","0.00","0.00","9.96","495.43","213.65"],"x":495.43,"y":213.65}
{"page":26,"change":"none","str":"transfer of ","dir":"ltr","width":"47.84","height":"9.96","transform":["9.96","0.00","0.00","9.96","495.43","200.42"],"x":495.43,"y":200.42}
{"page":26,"change":"none","str":"Work with your team to design a structured ","dir":"ltr","width":"192.70","height":"9.96","transform":["9.96","0.00","0.00","9.96","495.43","187.22"],"x":495.43,"y":187.22}
{"page":26,"change":"none","str":"will your new ","dir":"ltr","width":"59.96","height":"9.96","transform":["9.96","0.00","0.00","9.96","626.14","170.90"],"x":626.14,"y":170.9}
{"page":26,"change":"none","str":"be documented and ","dir":"ltr","width":"91.17","height":"9.96","transform":["9.96","0.00","0.00","9.96","593.35","157.58"],"x":593.35,"y":157.58}
{"page":26,"change":"none","str":"shared with new members of the team and the ","dir":"ltr","width":"208.17","height":"9.96","transform":["9.96","0.00","0.00","9.96","495.55","144.38"],"x":495.55,"y":144.38}
{"page":27,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":27,"change":"none","str":"Design your change intervention","dir":"ltr","width":"248.67","height":"15.96","transform":["15.96","0.00","0.00","15.96","99.26","523.66"],"x":99.264,"y":523.66}
{"page":27,"change":"none","str":"Design your own ","dir":"ltr","width":"100.02","height":"12.00","transform":["12.00","0.00","0.00","12.00","99.26","500.02"],"x":99.264,"y":500.02}
{"page":27,"change":"none","str":"standard transfer of care","dir":"ltr","width":"141.24","height":"12.00","transform":["12.00","0.00","0.00","12.00","202.70","500.02"],"x":202.7,"y":500.02}
{"page":27,"change":"none","str":"Let’s take one of these change interventions ","dir":"ltr","width":"218.37","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","479.26"],"fontName":"Arial","x":99.264,"y":479.26}
{"page":27,"change":"none","str":"standard transfer of care template","dir":"ltr","width":"177.78","height":"11.04","transform":["11.04","0.00","0.00","11.04","324.53","479.26"],"x":324.53,"y":479.26}
{"page":27,"change":"none","str":"and look at how you might go about ","dir":"ltr","width":"176.63","height":"11.04","transform":["11.04","0.00","0.00","11.04","514.63","479.26"],"x":514.63,"y":479.26}
{"page":27,"change":"none","str":"developing, testing and implementing it. ","dir":"ltr","width":"196.31","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","464.62"],"x":99.264,"y":464.62}
{"page":27,"change":"none","str":"Below is an example of an information template sheet that ","dir":"ltr","width":"285.32","height":"11.04","transform":["11.04","0.00","0.00","11.04","295.73","464.62"],"x":295.73,"y":464.62}
{"page":27,"change":"none","str":"be used in a hospital ward ","dir":"ltr","width":"130.71","height":"11.04","transform":["11.04","0.00","0.00","11.04","610.63","464.62"],"x":610.63,"y":464.62}
{"page":27,"change":"none","str":"for a transfer of care","dir":"ltr","width":"99.05","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","450.10"],"x":99.264,"y":450.1}
{"page":27,"change":"none","str":"ou may ","dir":"ltr","width":"39.05","height":"11.04","transform":["11.04","0.00","0.00","11.04","211.82","450.10"],"x":211.82,"y":450.1}
{"page":27,"change":"none","str":"want to trial this one,","dir":"ltr","width":"100.70","height":"11.04","transform":["11.04","0.00","0.00","11.04","250.94","450.10"],"x":250.94,"y":450.1}
{"page":27,"change":"none","str":"but it is better if your transf","dir":"ltr","width":"129.46","height":"11.04","transform":["11.04","0.00","0.00","11.04","354.89","450.10"],"x":354.89,"y":450.1}
{"page":27,"change":"none","str":"er of care ","dir":"ltr","width":"49.48","height":"11.04","transform":["11.04","0.00","0.00","11.04","484.51","450.10"],"x":484.51,"y":450.1}
{"page":27,"change":"none","str":"includes information which is ","dir":"ltr","width":"143.08","height":"11.04","transform":["11.04","0.00","0.00","11.04","579.19","450.10"],"x":579.19,"y":450.1}
{"page":27,"change":"none","str":"specific and relevant ","dir":"ltr","width":"103.36","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","435.46"],"x":99.264,"y":435.46}
{"page":27,"change":"none","str":"your own care environment. ","dir":"ltr","width":"138.61","height":"11.04","transform":["11.04","0.00","0.00","11.04","214.94","435.46"],"x":214.94,"y":435.46}
{"page":27,"change":"none","str":"A similar approach may be used in general practice for referral letters.","dir":"ltr","width":"339.74","height":"11.04","transform":["11.04","0.00","0.00","11.04","353.69","435.46"],"x":353.69,"y":435.46}
{"page":27,"change":"none","str":"Example information template","dir":"ltr","width":"171.37","height":"12.00","transform":["12.00","0.00","0.00","12.00","99.26","413.95"],"x":99.264,"y":413.95}
{"page":27,"change":"none","str":"Example from the George Eliot Hospital","dir":"ltr","width":"193.32","height":"11.04","transform":["11.04","0.00","0.00","11.04","532.63","387.91"],"x":532.63,"y":387.91}
{"page":28,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":28,"change":"none","str":"Make it your own","dir":"ltr","width":"129.68","height":"15.96","transform":["15.96","0.00","0.00","15.96","99.26","523.66"],"x":99.264,"y":523.66}
{"page":28,"change":"none","str":"standard information template.","dir":"ltr","width":"148.54","height":"11.04","transform":["11.04","0.00","0.00","11.04","205.70","500.98"],"x":205.7,"y":500.98}
{"page":28,"change":"none","str":"The quality of care you give is reflected in the quality of communicat","dir":"ltr","width":"330.15","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","480.46"],"x":99.264,"y":480.46}
{"page":28,"change":"none","str":"you use every day. The documentation needs to reflect this by including ","dir":"ltr","width":"352.12","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","465.94"],"x":99.264,"y":465.94}
{"page":28,"change":"none","str":"the right information. ","dir":"ltr","width":"106.41","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","451.54"],"x":99.264,"y":451.54}
{"page":28,"change":"none","str":"minimum data set","dir":"ltr","width":"93.51","height":"11.04","transform":["11.04","0.00","0.00","11.04","348.17","451.54"],"x":348.17,"y":451.54}
{"page":28,"change":"none","str":"During the planning stage of ","dir":"ltr","width":"140.66","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","430.78"],"x":99.264,"y":430.78}
{"page":28,"change":"none","str":"you will have chosen your ","dir":"ltr","width":"128.90","height":"11.04","transform":["11.04","0.00","0.00","11.04","300.65","430.78"],"x":300.65,"y":430.78}
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{"page":31,"change":"none","str":"protocols in the ","dir":"ltr","width":"77.68","height":"11.04","transform":["11.04","0.00","0.00","11.04","551.35","388.27"],"x":551.35,"y":388.27}
{"page":31,"change":"none","str":"OSSIE Guide to Clinical ","dir":"ltr","width":"119.78","height":"11.04","transform":["11.04","0.00","0.00","11.04","628.99","388.27"],"x":628.99,"y":388.27}
{"page":31,"change":"none","str":"ABC of handover","dir":"ltr","width":"83.71","height":"11.04","transform":["11.04","0.00","0.00","11.04","573.43","349.15"],"x":573.43,"y":349.15}
{"page":31,"change":"none","str":"is another model ","dir":"ltr","width":"84.42","height":"11.04","transform":["11.04","0.00","0.00","11.04","660.34","349.15"],"x":660.34,"y":349.15}
{"page":31,"change":"none","str":"which prompts the communication of clinical ","dir":"ltr","width":"217.55","height":"11.04","transform":["11.04","0.00","0.00","11.04","551.35","334.63"],"x":551.35,"y":334.63}
{"page":31,"change":"none","str":"and operational issues between shifts","dir":"ltr","width":"183.56","height":"11.04","transform":["11.04","0.00","0.00","11.04","551.35","320.11"],"x":551.35,"y":320.11}
{"page":31,"change":"none","str":"is a similar structured communication ","dir":"ltr","width":"184.10","height":"11.04","transform":["11.04","0.00","0.00","11.04","584.35","295.49"],"x":584.35,"y":295.49}
{"page":31,"change":"none","str":"tool developed by Portsmouth Hospitals. ","dir":"ltr","width":"199.92","height":"11.04","transform":["11.04","0.00","0.00","11.04","551.35","280.97"],"x":551.35,"y":280.97}
{"page":31,"change":"none","str":"data for ","dir":"ltr","width":"40.35","height":"11.04","transform":["11.04","0.00","0.00","11.04","463.27","127.10"],"x":463.27,"y":127.1}
{"page":31,"change":"none","str":"each letter of the tool you have ","dir":"ltr","width":"153.38","height":"11.04","transform":["11.04","0.00","0.00","11.04","337.85","112.58"],"x":337.85,"y":112.58}
{"page":32,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":32,"change":"none","str":"to design your template based on these ","dir":"ltr","width":"195.72","height":"11.04","transform":["11.04","0.00","0.00","11.04","180.02","528.22"],"x":180.02,"y":528.22}
{"page":32,"change":"none","str":"Decide how you will indicate which patients ","dir":"ltr","width":"213.35","height":"11.04","transform":["11.04","0.00","0.00","11.04","135.26","506.86"],"x":135.26,"y":506.86}
{"page":32,"change":"none","str":"and add this to your template. ","dir":"ltr","width":"150.99","height":"11.04","transform":["11.04","0.00","0.00","11.04","412.37","506.86"],"x":412.37,"y":506.86}
{"page":32,"change":"none","str":"Prompt the person receiving the transfer of care to clarify and ","dir":"ltr","width":"301.37","height":"11.04","transform":["11.04","0.00","0.00","11.04","135.26","491.74"],"x":135.26,"y":491.74}
{"page":32,"change":"none","str":"confirm they are taking over ","dir":"ltr","width":"138.57","height":"11.04","transform":["11.04","0.00","0.00","11.04","588.55","491.74"],"x":588.55,"y":491.74}
{"page":32,"change":"none","str":"responsibility for care from this point.","dir":"ltr","width":"179.10","height":"11.04","transform":["11.04","0.00","0.00","11.04","135.26","476.98"],"x":135.26,"y":476.98}
{"page":32,"change":"none","str":"Don’t worry about getting too technical with document","dir":"ltr","width":"261.08","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","456.46"],"fontName":"Arial","x":99.264,"y":456.46}
{"page":32,"change":"none","str":"ng of the template. Try finding ","dir":"ltr","width":"148.43","height":"11.04","transform":["11.04","0.00","0.00","11.04","547.63","456.46"],"x":547.63,"y":456.46}
{"page":32,"change":"none","str":"someone in your team or organisation with some spreadshe","dir":"ltr","width":"291.75","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","441.94"],"x":99.264,"y":441.94}
{"page":32,"change":"none","str":"et or word processing skills to mock one up for you.","dir":"ltr","width":"249.90","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.13","441.94"],"x":391.13,"y":441.94}
{"page":32,"change":"none","str":"one by hand for your initial testing.","dir":"ltr","width":"167.54","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","427.42"],"x":99.264,"y":427.42}
{"page":32,"change":"none","str":"As well as standardising","dir":"ltr","width":"117.95","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","379.63"],"x":99.264,"y":379.63}
{"page":32,"change":"none","str":"you are going to communicate, you need to also standardise the process for ","dir":"ltr","width":"372.94","height":"11.04","transform":["11.04","0.00","0.00","11.04","296.33","379.63"],"x":296.33,"y":379.63}
{"page":32,"change":"none","str":"communication. You will develop this process ","dir":"ltr","width":"227.51","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","365.11"],"x":99.264,"y":365.11}
{"page":32,"change":"none","str":"test your change interventions for","dir":"ltr","width":"162.59","height":"11.04","transform":["11.04","0.00","0.00","11.04","348.29","365.11"],"x":348.29,"y":365.11}
{"page":32,"change":"none","str":"the other areas of good practice","dir":"ltr","width":"155.20","height":"11.04","transform":["11.04","0.00","0.00","11.04","514.03","365.11"],"x":514.03,"y":365.11}
{"page":32,"change":"none","str":". You will ","dir":"ltr","width":"49.96","height":"11.04","transform":["11.04","0.00","0.00","11.04","669.34","365.11"],"x":669.34,"y":365.11}
{"page":32,"change":"none","str":"need to ","dir":"ltr","width":"39.78","height":"11.04","transform":["11.04","0.00","0.00","11.04","122.54","350.59"],"x":122.54,"y":350.59}
{"page":32,"change":"none","str":"test the best way to document your sta","dir":"ltr","width":"188.33","height":"11.04","transform":["11.04","0.00","0.00","11.04","162.26","350.59"],"x":162.26,"y":350.59}
{"page":32,"change":"none","str":"ndard process and communicate it","dir":"ltr","width":"168.15","height":"11.04","transform":["11.04","0.00","0.00","11.04","350.69","350.59"],"x":350.69,"y":350.59}
{"page":32,"change":"none","str":"to everyone involved. An example of ","dir":"ltr","width":"183.35","height":"11.04","transform":["11.04","0.00","0.00","11.04","521.95","350.59"],"x":521.95,"y":350.59}
{"page":32,"change":"none","str":"rocess is attached ","dir":"ltr","width":"91.58","height":"11.04","transform":["11.04","0.00","0.00","11.04","169.10","336.07"],"x":169.1,"y":336.07}
{"page":32,"change":"none","str":"Once you have developed your change interventions, y","dir":"ltr","width":"268.48","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","288.29"],"x":99.264,"y":288.29}
{"page":32,"change":"none","str":"need to decide","dir":"ltr","width":"72.27","height":"11.04","transform":["11.04","0.00","0.00","11.04","401.21","288.29"],"x":401.21,"y":288.29}
{"page":32,"change":"none","str":"which measures will be most helpful","dir":"ltr","width":"175.55","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","273.77"],"x":99.264,"y":273.77}
{"page":32,"change":"none","str":"Choose just a couple of measures that you ","dir":"ltr","width":"211.32","height":"11.04","transform":["11.04","0.00","0.00","11.04","284.09","273.77"],"x":284.09,"y":273.77}
{"page":32,"change":"none","str":"think give the best feedback about the impact of your change intervention. ","dir":"ltr","width":"362.56","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","259.25"],"x":99.264,"y":259.25}
{"page":32,"change":"none","str":"make sure the data can be","dir":"ltr","width":"130.31","height":"11.04","transform":["11.04","0.00","0.00","11.04","211.82","244.61"],"x":211.82,"y":244.61}
{"page":32,"change":"none","str":"quickly and easily","dir":"ltr","width":"86.12","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.61","244.61"],"x":391.61,"y":244.61}
{"page":32,"change":"none","str":"choose to measure whether or not something happens in a particular ","dir":"ltr","width":"337.98","height":"11.04","transform":["11.04","0.00","0.00","11.04","128.66","230.09"],"x":128.66,"y":230.09}
{"page":32,"change":"none","str":"the answer can be ","dir":"ltr","width":"93.06","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","215.57"],"x":99.264,"y":215.57}
{"page":32,"change":"none","str":"the ‘good practice checklist’ and","dir":"ltr","width":"155.82","height":"11.04","transform":["11.04","0.00","0.00","11.04","551.59","165.86"],"fontName":"Arial","x":551.59,"y":165.86}
{"page":32,"change":"none","str":"that you might want to ","dir":"ltr","width":"110.52","height":"11.04","transform":["11.04","0.00","0.00","11.04","600.55","151.34"],"x":600.55,"y":151.34}
{"page":32,"change":"none","str":"consider for ","dir":"ltr","width":"60.53","height":"11.04","transform":["11.04","0.00","0.00","11.04","465.31","136.82"],"x":465.31,"y":136.82}
{"page":32,"change":"none","str":"You will ","dir":"ltr","width":"40.74","height":"11.04","transform":["11.04","0.00","0.00","11.04","682.54","136.82"],"x":682.54,"y":136.82}
{"page":32,"change":"none","str":"that these often overlap.","dir":"ltr","width":"117.87","height":"11.04","transform":["11.04","0.00","0.00","11.04","497.83","122.30"],"x":497.83,"y":122.3}
{"page":32,"change":"none","str":"Developing your measures for improvement is an ","dir":"ltr","width":"242.73","height":"11.04","transform":["11.04","0.00","0.00","11.04","114.98","146.90"],"x":114.98,"y":146.9}
{"page":32,"change":"none","str":"ocess. In s","dir":"ltr","width":"52.54","height":"11.04","transform":["11.04","0.00","0.00","11.04","166.46","132.38"],"x":166.46,"y":132.38}
{"page":32,"change":"none","str":"ome cases, you will only be able ","dir":"ltr","width":"160.71","height":"11.04","transform":["11.04","0.00","0.00","11.04","219.02","132.38"],"x":219.02,"y":132.38}
{"page":32,"change":"none","str":"to refine your measures ","dir":"ltr","width":"118.55","height":"11.04","transform":["11.04","0.00","0.00","11.04","114.98","117.86"],"x":114.98,"y":117.86}
{"page":32,"change":"none","str":"once you have designed your ","dir":"ltr","width":"146.69","height":"11.04","transform":["11.04","0.00","0.00","11.04","233.54","117.86"],"x":233.54,"y":117.86}
{"page":32,"change":"none","str":"For example, you can’t measure ","dir":"ltr","width":"160.10","height":"11.04","transform":["11.04","0.00","0.00","11.04","190.34","103.34"],"fontName":"Arial","x":190.34,"y":103.34}
{"page":32,"change":"none","str":"whether the new process is followed until you have ","dir":"ltr","width":"250.69","height":"11.04","transform":["11.04","0.00","0.00","11.04","114.98","88.70"],"x":114.98,"y":88.704}
{"page":32,"change":"none","str":"defined what the new process is.","dir":"ltr","width":"159.62","height":"11.04","transform":["11.04","0.00","0.00","11.04","114.98","74.16"],"x":114.98,"y":74.16}
{"page":32,"change":"none","str":"Think of measurement ","dir":"ltr","width":"112.56","height":"11.04","transform":["11.04","0.00","0.00","11.04","572.95","291.53"],"x":572.95,"y":291.53}
{"page":32,"change":"none","str":"providing a ‘before’ and ‘after’ ","dir":"ltr","width":"147.33","height":"11.04","transform":["11.04","0.00","0.00","11.04","572.95","262.37"],"fontName":"Arial","x":572.95,"y":262.37}
{"page":32,"change":"none","str":"snapshot of each test","dir":"ltr","width":"104.57","height":"11.04","transform":["11.04","0.00","0.00","11.04","572.95","247.85"],"x":572.95,"y":247.85}
{"page":33,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":33,"change":"none","str":"Pilot and implement","dir":"ltr","width":"228.10","height":"24.00","transform":["24.00","0.00","0.00","24.00","155.18","488.50"],"x":155.18,"y":488.5}
{"page":33,"change":"none","str":"This is where you use ","dir":"ltr","width":"109.48","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","440.74"],"x":99.264,"y":440.74}
{"page":33,"change":"none","str":"cycles in the Model for Improvement. ","dir":"ltr","width":"182.76","height":"11.04","transform":["11.04","0.00","0.00","11.04","367.73","440.74"],"x":367.73,"y":440.74}
{"page":33,"change":"none","str":"The tests are repeated until a reliable change has been established","dir":"ltr","width":"327.74","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","426.22"],"x":99.264,"y":426.22}
{"page":33,"change":"none","str":"(see Appendix I & J for worked ","dir":"ltr","width":"152.76","height":"11.04","transform":["11.04","0.00","0.00","11.04","430.25","426.22"],"x":430.25,"y":426.22}
{"page":33,"change":"none","str":"you will test","dir":"ltr","width":"56.70","height":"11.04","transform":["11.04","0.00","0.00","11.04","284.09","387.19"],"x":284.09,"y":387.19}
{"page":33,"change":"none","str":"structured transfer of care sheets","dir":"ltr","width":"161.42","height":"11.04","transform":["11.04","0.00","0.00","11.04","369.05","387.19"],"x":369.05,"y":387.19}
{"page":33,"change":"none","str":"you will test them, who will support you and how you will train and inform all staff","dir":"ltr","width":"390.55","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","372.55"],"x":99.264,"y":372.55}
{"page":33,"change":"none","str":"ain your test team and start using the tools. Experience has shown that implementation ","dir":"ltr","width":"426.02","height":"11.04","transform":["11.04","0.00","0.00","11.04","130.58","348.07"],"x":130.58,"y":348.07}
{"page":33,"change":"none","str":"works best when staff ","dir":"ltr","width":"108.88","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","333.43"],"x":99.264,"y":333.43}
{"page":33,"change":"none","str":"are fully involved and encouraged to develop or ","dir":"ltr","width":"233.98","height":"11.04","transform":["11.04","0.00","0.00","11.04","208.22","333.43"],"x":208.22,"y":333.43}
{"page":33,"change":"none","str":"modify their own version of ","dir":"ltr","width":"133.80","height":"11.04","transform":["11.04","0.00","0.00","11.04","442.37","333.43"],"x":442.37,"y":333.43}
{"page":33,"change":"none","str":"(see ‘Flexible standardisation’ on p","dir":"ltr","width":"169.40","height":"11.04","transform":["11.04","0.00","0.00","11.04","222.86","318.91"],"fontName":"Arial","x":222.86,"y":318.91}
{"page":33,"change":"none","str":"ssess the impact of the intervention using the measures you ","dir":"ltr","width":"295.13","height":"11.04","transform":["11.04","0.00","0.00","11.04","143.30","294.41"],"x":143.3,"y":294.41}
{"page":33,"change":"none","str":". One ","dir":"ltr","width":"29.84","height":"11.04","transform":["11.04","0.00","0.00","11.04","557.95","294.41"],"x":557.95,"y":294.41}
{"page":33,"change":"none","str":"of the most useful measures of success will come from staff feedback. ","dir":"ltr","width":"344.03","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","279.77"],"x":99.264,"y":279.77}
{"page":33,"change":"none","str":"Is your intervention ready to be implemented? If not you will ","dir":"ltr","width":"292.62","height":"11.04","transform":["11.04","0.00","0.00","11.04","123.14","255.41"],"x":123.14,"y":255.41}
{"page":33,"change":"none","str":"to run the ","dir":"ltr","width":"49.61","height":"11.04","transform":["11.04","0.00","0.00","11.04","443.57","255.41"],"x":443.57,"y":255.41}
{"page":33,"change":"none","str":"again. If it is","dir":"ltr","width":"58.77","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","240.65"],"x":99.264,"y":240.65}
{"page":33,"change":"none","str":"ready for implementation,","dir":"ltr","width":"124.09","height":"11.04","transform":["11.04","0.00","0.00","11.04","161.06","240.65"],"x":161.06,"y":240.65}
{"page":33,"change":"none","str":"you will need to plan how you will rol","dir":"ltr","width":"177.10","height":"11.04","transform":["11.04","0.00","0.00","11.04","288.41","240.65"],"x":288.41,"y":240.65}
{"page":33,"change":"none","str":"l it out to the wider ","dir":"ltr","width":"92.28","height":"11.04","transform":["11.04","0.00","0.00","11.04","465.55","240.65"],"x":465.55,"y":240.65}
{"page":33,"change":"none","str":"department or organisation and, crucially, how you will sustain the ","dir":"ltr","width":"323.45","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","226.13"],"x":99.264,"y":226.13}
{"page":33,"change":"none","str":"the long term.","dir":"ltr","width":"67.22","height":"11.04","transform":["11.04","0.00","0.00","11.04","501.19","226.13"],"x":501.19,"y":226.13}
{"page":33,"change":"none","str":"Click here for ","dir":"ltr","width":"67.82","height":"11.04","transform":["11.04","0.00","0.00","11.04","525.91","120.74"],"x":525.91,"y":120.74}
{"page":33,"change":"none","str":"more on the ","dir":"ltr","width":"61.72","height":"11.04","transform":["11.04","0.00","0.00","11.04","593.83","120.74"],"x":593.83,"y":120.74}
{"page":33,"change":"none","str":"Model for ","dir":"ltr","width":"48.89","height":"11.04","transform":["11.04","0.00","0.00","11.04","655.66","120.74"],"x":655.66,"y":120.74}
{"page":33,"change":"none","str":"Improvement and PDSA","dir":"ltr","width":"118.68","height":"11.04","transform":["11.04","0.00","0.00","11.04","525.91","106.22"],"x":525.91,"y":106.22}
{"page":34,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":34,"change":"none","str":"PDSA cycle to test ","dir":"ltr","width":"109.37","height":"12.00","transform":["12.00","0.00","0.00","12.00","156.02","527.26"],"x":156.02,"y":527.26}
{"page":34,"change":"none","str":"ndard transfer of care template","dir":"ltr","width":"176.54","height":"12.00","transform":["12.00","0.00","0.00","12.00","292.85","527.26"],"x":292.85,"y":527.26}
{"page":34,"change":"none","str":"one patient, resident or client","dir":"ltr","width":"141.15","height":"11.04","transform":["11.04","0.00","0.00","11.04","140.90","461.74"],"x":140.9,"y":461.74}
{"page":34,"change":"none","str":"one bay or unit","dir":"ltr","width":"72.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","140.90","448.30"],"x":140.9,"y":448.3}
{"page":34,"change":"none","str":"half a ward, or a floor","dir":"ltr","width":"103.33","height":"11.04","transform":["11.04","0.00","0.00","11.04","140.90","434.98"],"x":140.9,"y":434.98}
{"page":34,"change":"none","str":"variety of transfers of care (","dir":"ltr","width":"133.87","height":"11.04","transform":["11.04","0.00","0.00","11.04","140.90","408.19"],"x":140.9,"y":408.19}
{"page":34,"change":"none","str":"early / late shift / nights).","dir":"ltr","width":"119.13","height":"11.04","transform":["11.04","0.00","0.00","11.04","274.97","408.19"],"x":274.97,"y":408.19}
{"page":34,"change":"none","str":"TIP: Use the test documentation for handover or transfer of ","dir":"ltr","width":"312.88","height":"11.04","transform":["11.04","0.00","0.00","11.04","104.90","389.59"],"x":104.9,"y":389.59}
{"page":34,"change":"none","str":"care alongside the old format during testing to minimise risk ","dir":"ltr","width":"319.61","height":"11.04","transform":["11.04","0.00","0.00","11.04","104.90","376.99"],"x":104.9,"y":376.99}
{"page":34,"change":"none","str":"and ensure continuity of care.","dir":"ltr","width":"156.51","height":"11.04","transform":["11.04","0.00","0.00","11.04","104.90","364.27"],"x":104.9,"y":364.27}
{"page":34,"change":"none","str":"Continue the testing for as long as you need; it may ","dir":"ltr","width":"253.53","height":"11.04","transform":["11.04","0.00","0.00","11.04","435.89","481.06"],"x":435.89,"y":481.06}
{"page":34,"change":"none","str":"be a few days, weeks or even longer, depending on ","dir":"ltr","width":"254.38","height":"11.04","transform":["11.04","0.00","0.00","11.04","435.89","468.46"],"x":435.89,"y":468.46}
{"page":34,"change":"none","str":"You may find that the same information might not be ","dir":"ltr","width":"258.05","height":"11.04","transform":["11.04","0.00","0.00","11.04","435.89","437.14"],"x":435.89,"y":437.14}
{"page":34,"change":"none","str":"relevant for all types of transfers. ","dir":"ltr","width":"165.69","height":"11.04","transform":["11.04","0.00","0.00","11.04","435.89","424.51"],"x":435.89,"y":424.51}
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{"page":34,"change":"none","str":"times to find the transfer of care documentation ","dir":"ltr","width":"252.90","height":"11.04","transform":["11.04","0.00","0.00","11.04","435.89","393.31"],"x":435.89,"y":393.31}
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{"page":34,"change":"none","str":". From this da","dir":"ltr","width":"67.33","height":"11.04","transform":["11.04","0.00","0.00","11.04","206.42","287.45"],"x":206.42,"y":287.45}
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{"page":34,"change":"none","str":"Consider these questions:","dir":"ltr","width":"127.11","height":"11.04","transform":["11.04","0.00","0.00","11.04","278.69","274.85"],"x":278.69,"y":274.85}
{"page":34,"change":"none","str":"Are the fields on the documentation ","dir":"ltr","width":"176.17","height":"11.04","transform":["11.04","0.00","0.00","11.04","140.90","255.53"],"x":140.9,"y":255.53}
{"page":34,"change":"none","str":"adding value for ","dir":"ltr","width":"81.29","height":"11.04","transform":["11.04","0.00","0.00","11.04","331.25","255.53"],"x":331.25,"y":255.53}
{"page":34,"change":"none","str":"Has everyone been involved?","dir":"ltr","width":"144.82","height":"11.04","transform":["11.04","0.00","0.00","11.04","140.90","229.49"],"x":140.9,"y":229.49}
{"page":34,"change":"none","str":"How will information be updated in the templ","dir":"ltr","width":"215.83","height":"11.04","transform":["11.04","0.00","0.00","11.04","140.90","216.05"],"x":140.9,"y":216.05}
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{"page":34,"change":"none","str":"whose responsibility will it be?","dir":"ltr","width":"146.82","height":"11.04","transform":["11.04","0.00","0.00","11.04","140.90","203.33"],"x":140.9,"y":203.33}
{"page":34,"change":"none","str":"Do those people have the appropriate technical skills to ","dir":"ltr","width":"272.74","height":"11.04","transform":["11.04","0.00","0.00","11.04","140.90","189.98"],"x":140.9,"y":189.98}
{"page":34,"change":"none","str":"What training is needed to roll this out further?","dir":"ltr","width":"225.03","height":"11.04","transform":["11.04","0.00","0.00","11.04","140.90","163.94"],"x":140.9,"y":163.94}
{"page":34,"change":"none","str":"Does the layout help staff find information easily?","dir":"ltr","width":"239.51","height":"11.04","transform":["11.04","0.00","0.00","11.04","140.90","150.50"],"x":140.9,"y":150.5}
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{"page":34,"change":"none","str":"record and if so how?","dir":"ltr","width":"105.09","height":"11.04","transform":["11.04","0.00","0.00","11.04","140.90","124.46"],"x":140.9,"y":124.46}
{"page":34,"change":"none","str":"TIP: When observing tests it is important to note the factors ","dir":"ltr","width":"315.98","height":"11.04","transform":["11.04","0.00","0.00","11.04","104.90","105.98"],"x":104.9,"y":105.98}
{"page":34,"change":"none","str":"that may lead to variability (eg what information gets ","dir":"ltr","width":"277.98","height":"11.04","transform":["11.04","0.00","0.00","11.04","104.90","93.26"],"x":104.9,"y":93.264}
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{"page":34,"change":"none","str":"in the new transfer of care design. Keep going until ","dir":"ltr","width":"250.49","height":"11.04","transform":["11.04","0.00","0.00","11.04","435.89","298.13"],"x":435.89,"y":298.13}
{"page":34,"change":"none","str":"you are happy that the format is suitable to be tested ","dir":"ltr","width":"259.15","height":"11.04","transform":["11.04","0.00","0.00","11.04","435.89","285.41"],"x":435.89,"y":285.41}
{"page":34,"change":"none","str":"for a long","dir":"ltr","width":"45.84","height":"11.04","transform":["11.04","0.00","0.00","11.04","435.89","272.81"],"x":435.89,"y":272.81}
{"page":34,"change":"none","str":"er period on its own and not alongside the ","dir":"ltr","width":"207.14","height":"11.04","transform":["11.04","0.00","0.00","11.04","481.87","272.81"],"x":481.87,"y":272.81}
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{"page":35,"change":"none","str":"want to look at other ","dir":"ltr","width":"102.04","height":"11.04","transform":["11.04","0.00","0.00","11.04","515.83","457.42"],"x":515.83,"y":457.42}
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{"page":37,"change":"none","str":"ustaining your improvements should ","dir":"ltr","width":"179.06","height":"11.04","transform":["11.04","0.00","0.00","11.04","352.61","355.27"],"x":352.61,"y":355.27}
{"page":37,"change":"none","str":"never be an afterthought","dir":"ltr","width":"119.89","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","340.75"],"x":99.264,"y":340.75}
{"page":37,"change":"none","str":", but something to consider at the very beginning of your ","dir":"ltr","width":"276.97","height":"11.04","transform":["11.04","0.00","0.00","11.04","219.14","340.75"],"x":219.14,"y":340.75}
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{"page":37,"change":"none","str":"as you roll out and share the new p","dir":"ltr","width":"171.06","height":"11.04","transform":["11.04","0.00","0.00","11.04","144.02","311.71"],"x":144.02,"y":311.71}
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{"page":37,"change":"none","str":"are valuable resources which will ","dir":"ltr","width":"163.60","height":"11.04","transform":["11.04","0.00","0.00","11.04","361.01","229.61"],"x":361.01,"y":229.61}
{"page":37,"change":"none","str":"help you build sustainability into the fabric of your improvement work.","dir":"ltr","width":"335.57","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","214.97"],"x":99.264,"y":214.97}
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{"page":37,"change":"none","str":"and weaknesses in your implementation plan and predict the likelihood of ","dir":"ltr","width":"359.58","height":"11.04","transform":["11.04","0.00","0.00","11.04","135.26","179.06"],"x":135.26,"y":179.06}
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{"page":37,"change":"none","str":"provides practical advice on how you might increase ","dir":"ltr","width":"257.30","height":"11.04","transform":["11.04","0.00","0.00","11.04","266.18","143.42"],"x":266.18,"y":143.42}
{"page":37,"change":"none","str":"the likelihood of sustainabil","dir":"ltr","width":"131.42","height":"11.04","transform":["11.04","0.00","0.00","11.04","135.26","128.78"],"x":135.26,"y":128.78}
{"page":37,"change":"none","str":"ity for your improvement initiative.","dir":"ltr","width":"163.88","height":"11.04","transform":["11.04","0.00","0.00","11.04","266.66","128.78"],"x":266.66,"y":128.78}
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{"page":37,"change":"none","str":"engagement in your project are ","dir":"ltr","width":"169.37","height":"12.00","transform":["12.00","0.00","0.00","12.00","548.23","337.39"],"x":548.23,"y":337.39}
{"page":37,"change":"none","str":"two of the key factors in ","dir":"ltr","width":"129.35","height":"12.02","transform":["12.02","0.00","0.00","12.02","548.23","321.55"],"x":548.23,"y":321.55}
{"page":38,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":38,"change":"none","str":"Tell people how well the new handov","dir":"ltr","width":"179.75","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","500.98"],"x":99.264,"y":500.98}
{"page":38,"change":"none","str":"er or transfer of care is working. Not only do those doing it need ","dir":"ltr","width":"312.50","height":"11.04","transform":["11.04","0.00","0.00","11.04","278.93","500.98"],"x":278.93,"y":500.98}
{"page":38,"change":"none","str":"to know, but tell other wards","dir":"ltr","width":"136.98","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","486.46"],"x":99.264,"y":486.46}
{"page":38,"change":"none","str":"the whole organisation to spread the ","dir":"ltr","width":"180.39","height":"11.04","transform":["11.04","0.00","0.00","11.04","412.37","486.46"],"x":412.37,"y":486.46}
{"page":38,"change":"none","str":"good practice and gain recognition for the hard work ","dir":"ltr","width":"256.87","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","471.94"],"x":99.264,"y":471.94}
{"page":38,"change":"none","str":"team and all the staff ","dir":"ltr","width":"105.26","height":"11.04","transform":["11.04","0.00","0.00","11.04","374.57","471.94"],"x":374.57,"y":471.94}
{"page":38,"change":"none","str":"how you ","dir":"ltr","width":"43.87","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","457.42"],"x":99.264,"y":457.42}
{"page":38,"change":"none","str":"can spread the word ","dir":"ltr","width":"102.78","height":"11.04","transform":["11.04","0.00","0.00","11.04","143.18","457.42"],"x":143.18,"y":457.42}
{"page":38,"change":"none","str":"team meetings and existing transfer of care meetings","dir":"ltr","width":"258.67","height":"11.04","transform":["11.04","0.00","0.00","11.04","135.26","436.06"],"x":135.26,"y":436.06}
{"page":38,"change":"none","str":"Agree to measure processes and outcomes periodically to ensure you are sustaining ","dir":"ltr","width":"415.02","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","309.53"],"x":99.264,"y":309.53}
{"page":38,"change":"none","str":"improvements and that staff aren’t tempted to return to old ways of working. ","dir":"ltr","width":"370.37","height":"11.04","transform":["11.04","0.00","0.00","11.04","99.26","295.01"],"fontName":"Arial","x":99.264,"y":295.01}
{"page":39,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":39,"change":"none","str":"Reports and standards","dir":"ltr","width":"130.61","height":"12.00","transform":["12.00","0.00","0.00","12.00","53.88","476.14"],"x":53.88,"y":476.14}
{"page":39,"change":"none","str":"Communication During Patient Hand","dir":"ltr","width":"178.64","height":"11.04","transform":["11.04","0.00","0.00","11.04","89.88","398.35"],"x":89.88,"y":398.35}
{"page":39,"change":"none","str":", World Health Organisation Collaborating Centre for Patient Safety Solutions ","dir":"ltr","width":"377.80","height":"11.04","transform":["11.04","0.00","0.00","11.04","301.49","398.35"],"x":301.49,"y":398.35}
{"page":39,"change":"none","str":"Guidance on clinical handover for clinicians and managers,","dir":"ltr","width":"287.38","height":"11.04","transform":["11.04","0.00","0.00","11.04","239.78","368.59"],"x":239.78,"y":368.59}
{"page":39,"change":"none","str":"Acute Care Toolkit: 1 Handover, Royal College of Physicians","dir":"ltr","width":"295.81","height":"11.04","transform":["11.04","0.00","0.00","11.04","89.28","353.23"],"x":89.28,"y":353.23}
{"page":39,"change":"none","str":"A Clinician’s Guide to Record ","dir":"ltr","width":"146.18","height":"11.04","transform":["11.04","0.00","0.00","11.04","89.88","337.99"],"fontName":"Arial","x":89.88,"y":337.99}
{"page":39,"change":"none","str":"Standards for the stru","dir":"ltr","width":"105.91","height":"11.04","transform":["11.04","0.00","0.00","11.04","333.89","337.99"],"x":333.89,"y":337.99}
{"page":39,"change":"none","str":"cture and content of medical records and communications when ","dir":"ltr","width":"314.11","height":"11.04","transform":["11.04","0.00","0.00","11.04","439.73","337.99"],"x":439.73,"y":337.99}
{"page":39,"change":"none","str":"patients are admitted to hospital","dir":"ltr","width":"156.02","height":"11.04","transform":["11.04","0.00","0.00","11.04","89.88","325.27"],"x":89.88,"y":325.27}
{"page":39,"change":"none","str":"Academy of Medical Royal Colleges (2008)","dir":"ltr","width":"210.82","height":"11.04","transform":["11.04","0.00","0.00","11.04","252.14","325.27"],"x":252.14,"y":325.27}
{"page":39,"change":"none","str":"'Passing the Baton ","dir":"ltr","width":"94.49","height":"11.04","transform":["11.04","0.00","0.00","11.04","89.88","299.21"],"x":89.88,"y":299.21}
{"page":39,"change":"none","str":"National Leadership and Innovation Agency for Healthcare ","dir":"ltr","width":"287.99","height":"11.04","transform":["11.04","0.00","0.00","11.04","440.33","299.21"],"x":440.33,"y":299.21}
{"page":39,"change":"none","str":"Clinical Handover Literature Review","dir":"ltr","width":"174.93","height":"11.04","transform":["11.04","0.00","0.00","11.04","89.88","273.29"],"x":89.88,"y":273.29}
{"page":39,"change":"none","str":"The eHealth Services Research Group, University of Tasmania for the: Australian Commission on Safety ","dir":"ltr","width":"512.18","height":"11.04","transform":["11.04","0.00","0.00","11.04","270.89","273.29"],"x":270.89,"y":273.29}
{"page":39,"change":"none","str":"and Quality in Health Care (ACSQHC)","dir":"ltr","width":"186.47","height":"11.04","transform":["11.04","0.00","0.00","11.04","89.88","260.57"],"x":89.88,"y":260.57}
{"page":39,"change":"none","str":"A resource for transferring care from General Practice to Hospitals and Hospitals to General Practice","dir":"ltr","width":"489.49","height":"11.04","transform":["11.04","0.00","0.00","11.04","210.98","234.53"],"x":210.98,"y":234.53}
{"page":39,"change":"none","str":"Tools and guides","dir":"ltr","width":"98.69","height":"12.00","transform":["12.00","0.00","0.00","12.00","53.88","157.70"],"x":53.88,"y":157.7}
{"page":39,"change":"none","str":"The trouble with handovers video","dir":"ltr","width":"161.97","height":"11.04","transform":["11.04","0.00","0.00","11.04","89.88","108.26"],"x":89.88,"y":108.26}
{"page":39,"change":"none","str":"NSW [New South Wales] Health","dir":"ltr","width":"157.14","height":"11.04","transform":["11.04","0.00","0.00","11.04","89.88","92.90"],"x":89.88,"y":92.904}
{"page":39,"change":"none","str":"Implementation Toolkit, Standard Key Principles for Clinical Handover ","dir":"ltr","width":"342.13","height":"11.04","transform":["11.04","0.00","0.00","11.04","250.10","92.90"],"x":250.1,"y":92.904}
{"page":39,"change":"none","str":"Quality and service improvement tools ","dir":"ltr","width":"189.48","height":"11.04","transform":["11.04","0.00","0.00","11.04","89.88","63.12"],"x":89.88,"y":63.12}
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{"page":40,"change":"none","str":"The Productive Mental Health ","dir":"ltr","width":"147.98","height":"11.04","transform":["11.04","0.00","0.00","11.04","125.90","480.94"],"x":125.9,"y":480.94}
{"page":40,"change":"none","str":"Productive Community Hospital (handover module)","dir":"ltr","width":"248.65","height":"11.04","transform":["11.04","0.00","0.00","11.04","147.98","451.78"],"x":147.98,"y":451.78}
{"page":40,"change":"none","str":"Care Homes Wellbeing Programme","dir":"ltr","width":"173.63","height":"11.04","transform":["11.04","0.00","0.00","11.04","111.98","436.54"],"x":111.98,"y":436.54}
{"page":40,"change":"none","str":"Experience Based Design ","dir":"ltr","width":"129.66","height":"11.04","transform":["11.04","0.00","0.00","11.04","89.88","421.27"],"x":89.88,"y":421.27}
{"page":40,"change":"none","str":"Analysis and Redesign","dir":"ltr","width":"111.97","height":"11.04","transform":["11.04","0.00","0.00","11.04","217.10","376.15"],"x":217.1,"y":376.15}
{"page":40,"change":"none","str":"Measuring for improvement","dir":"ltr","width":"133.78","height":"11.04","transform":["11.04","0.00","0.00","11.04","125.90","361.51"],"x":125.9,"y":361.51}
{"page":40,"change":"none","str":"The 7 steps to measurement","dir":"ltr","width":"140.03","height":"11.04","transform":["11.04","0.00","0.00","11.04","89.88","331.75"],"x":89.88,"y":331.75}
{"page":40,"change":"none","str":"un charts and simple statistical measures","dir":"ltr","width":"201.31","height":"11.04","transform":["11.04","0.00","0.00","11.04","97.82","316.51"],"x":97.824,"y":316.51}
{"page":40,"change":"none","str":"(including a video guide) ","dir":"ltr","width":"122.18","height":"11.04","transform":["11.04","0.00","0.00","11.04","302.21","316.51"],"x":302.21,"y":316.51}
{"page":40,"change":"none","str":"Root cause analysis","dir":"ltr","width":"98.38","height":"11.04","transform":["11.04","0.00","0.00","11.04","89.88","301.13"],"x":89.88,"y":301.13}
{"page":40,"change":"none","str":"(including the ‘Five whys’) ","dir":"ltr","width":"128.88","height":"11.04","transform":["11.04","0.00","0.00","11.04","191.42","301.13"],"fontName":"Arial","x":191.42,"y":301.13}
{"page":40,"change":"none","str":"ABC of handover","dir":"ltr","width":"83.71","height":"11.04","transform":["11.04","0.00","0.00","11.04","147.98","241.49"],"x":147.98,"y":241.49}
{"page":40,"change":"none","str":"HAND ME AN ISOBAR","dir":"ltr","width":"113.75","height":"11.04","transform":["11.04","0.00","0.00","11.04","125.90","226.97"],"x":125.9,"y":226.97}
{"page":40,"change":"none","str":"Sustainability Model and Guide ","dir":"ltr","width":"154.73","height":"11.04","transform":["11.04","0.00","0.00","11.04","89.88","197.06"],"x":89.88,"y":197.06}
{"page":40,"change":"none","str":"Accelerating the Spread of Good Practice: A Workbook for Healthcare","dir":"ltr","width":"340.57","height":"11.04","transform":["11.04","0.00","0.00","11.04","89.88","181.82"],"x":89.88,"y":181.82}
{"page":40,"change":"none","str":"Sarah W Fraser, (2002)","dir":"ltr","width":"115.48","height":"11.04","transform":["11.04","0.00","0.00","11.04","433.61","181.82"],"x":433.61,"y":181.82}
{"page":40,"change":"none","str":". Via Amazon","dir":"ltr","width":"65.42","height":"11.04","transform":["11.04","0.00","0.00","11.04","549.19","181.82"],"x":549.19,"y":181.82}
{"page":40,"change":"none","str":"Using a communication framework at handover to boost patient outcomes, Christie, P and Robinson, R","dir":"ltr","width":"500.84","height":"11.04","transform":["11.04","0.00","0.00","11.04","89.52","134.66"],"x":89.52,"y":134.66}
{"page":40,"change":"none","str":"centered, standardised approach Mehra A and Henein C. ","dir":"ltr","width":"281.72","height":"11.04","transform":["11.04","0.00","0.00","11.04","315.65","104.78"],"x":315.65,"y":104.78}
{"page":40,"change":"none","str":"Improving the safety of patient transfer from AMU using a written checklist, Hindmarsh D, Lees L, Acute Med. 2012;11(1):13","dir":"ltr","width":"602.22","height":"11.04","transform":["11.04","0.00","0.00","11.04","89.88","78.72"],"x":89.88,"y":78.72}
{"page":41,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":41,"change":"none","str":"Appendix B: Good practice checklist ","dir":"ltr","width":"179.17","height":"11.04","transform":["11.04","0.00","0.00","11.04","53.88","388.75"],"x":53.88,"y":388.75}
{"page":41,"change":"none","str":"examples of questions to prompt discussion and generate ideas","dir":"ltr","width":"310.46","height":"11.04","transform":["11.04","0.00","0.00","11.04","242.42","388.75"],"x":242.42,"y":388.75}
{"page":41,"change":"none","str":"Appendix C: The Model for Improvement","dir":"ltr","width":"198.12","height":"11.04","transform":["11.04","0.00","0.00","11.04","53.88","364.87"],"x":53.88,"y":364.87}
{"page":41,"change":"none","str":"Appendix F: Example project template","dir":"ltr","width":"185.94","height":"11.04","transform":["11.04","0.00","0.00","11.04","53.88","292.85"],"x":53.88,"y":292.85}
{"page":41,"change":"none","str":"ix H: Good practice checklist ","dir":"ltr","width":"141.83","height":"11.04","transform":["11.04","0.00","0.00","11.04","91.82","244.97"],"x":91.824,"y":244.97}
{"page":41,"change":"none","str":"Appendix I: Example PDSA for testing a new handover template","dir":"ltr","width":"311.88","height":"11.04","transform":["11.04","0.00","0.00","11.04","53.88","220.97"],"x":53.88,"y":220.97}
{"page":41,"change":"none","str":"Appendix J: Example PDSA for testing new transfer of care process","dir":"ltr","width":"329.60","height":"11.04","transform":["11.04","0.00","0.00","11.04","53.88","196.94"],"x":53.88,"y":196.94}
{"page":41,"change":"none","str":"Appendix K: Examples of standardised communication templates","dir":"ltr","width":"316.83","height":"11.04","transform":["11.04","0.00","0.00","11.04","53.88","172.94"],"x":53.88,"y":172.94}
{"page":41,"change":"none","str":"Appendix L: Example of how a poster can be used to spread the word about new processes","dir":"ltr","width":"446.40","height":"11.04","transform":["11.04","0.00","0.00","11.04","53.88","149.06"],"x":53.88,"y":149.06}
{"page":41,"change":"none","str":"M: Summary of the six step improvement process for transfer of care","dir":"ltr","width":"334.34","height":"11.04","transform":["11.04","0.00","0.00","11.04","102.86","125.06"],"x":102.86,"y":125.06}
{"page":42,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":42,"change":"none","str":"This case study tells the story of a real NHS patient. The patient ","dir":"ltr","width":"335.54","height":"11.04","transform":["11.04","0.00","0.00","11.04","53.88","481.78"],"x":53.88,"y":481.78}
{"page":42,"change":"none","str":"did not die ","dir":"ltr","width":"58.61","height":"11.04","transform":["11.04","0.00","0.00","11.04","389.69","481.78"],"x":389.69,"y":481.78}
{"page":42,"change":"none","str":"as a result of ","dir":"ltr","width":"70.84","height":"11.04","transform":["11.04","0.00","0.00","11.04","448.37","481.78"],"x":448.37,"y":481.78}
{"page":42,"change":"none","str":"a series of errors ","dir":"ltr","width":"92.34","height":"11.04","transform":["11.04","0.00","0.00","11.04","53.88","467.26"],"x":53.88,"y":467.26}
{"page":42,"change":"none","str":"and was ","dir":"ltr","width":"46.50","height":"11.04","transform":["11.04","0.00","0.00","11.04","146.30","467.26"],"x":146.3,"y":467.26}
{"page":42,"change":"none","str":"not ‘clinically harmed’. But ","dir":"ltr","width":"143.13","height":"11.04","transform":["11.04","0.00","0.00","11.04","247.70","467.26"],"fontName":"Arial,Bold","x":247.7,"y":467.26}
{"page":42,"change":"none","str":"could have been, as ","dir":"ltr","width":"107.70","height":"11.04","transform":["11.04","0.00","0.00","11.04","406.73","467.26"],"x":406.73,"y":467.26}
{"page":42,"change":"none","str":"his care was compromised more than once through poor handover practices","dir":"ltr","width":"401.64","height":"11.04","transform":["11.04","0.00","0.00","11.04","53.88","452.62"],"x":53.88,"y":452.62}
{"page":42,"change":"none","str":"Overview of situation:","dir":"ltr","width":"114.96","height":"11.04","transform":["11.04","0.00","0.00","11.04","53.88","428.14"],"x":53.88,"y":428.14}
{"page":42,"change":"none","str":"Over a one year period Ollie, as ","dir":"ltr","width":"158.41","height":"11.04","transform":["11.04","0.00","0.00","11.04","53.88","403.39"],"x":53.88,"y":403.39}
{"page":42,"change":"none","str":"he was known to his friends, ","dir":"ltr","width":"141.06","height":"11.04","transform":["11.04","0.00","0.00","11.04","212.42","403.39"],"x":212.42,"y":403.39}
{"page":42,"change":"none","str":"was admitted to hospital at least 3 ","dir":"ltr","width":"168.60","height":"11.04","transform":["11.04","0.00","0.00","11.04","353.57","403.39"],"x":353.57,"y":403.39}
{"page":42,"change":"none","str":"well as the condition he was admitted for, Ollie had epilepsy which was well controlled ","dir":"ltr","width":"420.54","height":"11.04","transform":["11.04","0.00","0.00","11.04","102.26","388.87"],"x":102.26,"y":388.87}
{"page":42,"change":"none","str":"After the first ","dir":"ltr","width":"65.41","height":"11.04","transform":["11.04","0.00","0.00","11.04","126.74","374.35"],"x":126.74,"y":374.35}
{"page":42,"change":"none","str":"e and his wife","dir":"ltr","width":"67.31","height":"11.04","transform":["11.04","0.00","0.00","11.04","253.94","374.35"],"x":253.94,"y":374.35}
{"page":42,"change":"none","str":"to know the routine","dir":"ltr","width":"92.99","height":"11.04","transform":["11.04","0.00","0.00","11.04","400.73","374.35"],"x":400.73,"y":374.35}
{"page":42,"change":"none","str":"Georgette would ","dir":"ltr","width":"83.68","height":"11.04","transform":["11.04","0.00","0.00","11.04","53.88","359.83"],"x":53.88,"y":359.83}
{"page":42,"change":"none","str":"a copy of ","dir":"ltr","width":"47.67","height":"11.04","transform":["11.04","0.00","0.00","11.04","165.26","359.83"],"x":165.26,"y":359.83}
{"page":42,"change":"none","str":"current prescription record to th","dir":"ltr","width":"152.93","height":"11.04","transform":["11.04","0.00","0.00","11.04","245.90","359.83"],"x":245.9,"y":359.83}
{"page":42,"change":"none","str":"would take notes and hand it back to her. ","dir":"ltr","width":"203.64","height":"11.04","transform":["11.04","0.00","0.00","11.04","53.88","345.19"],"x":53.88,"y":345.19}
{"page":42,"change":"none","str":"By the time she met up with ","dir":"ltr","width":"138.02","height":"11.04","transform":["11.04","0.00","0.00","11.04","257.66","345.19"],"x":257.66,"y":345.19}
{"page":42,"change":"none","str":"Ollie in A&E","dir":"ltr","width":"58.70","height":"11.04","transform":["11.04","0.00","0.00","11.04","395.81","345.19"],"x":395.81,"y":345.19}
{"page":42,"change":"none","str":", his ","dir":"ltr","width":"23.22","height":"11.04","transform":["11.04","0.00","0.00","11.04","454.51","345.19"],"x":454.51,"y":345.19}
{"page":42,"change":"none","str":"prescription record would have disappeared, and so she went armed with a","dir":"ltr","width":"365.55","height":"11.04","transform":["11.04","0.00","0.00","11.04","53.88","330.67"],"x":53.88,"y":330.67}
{"page":42,"change":"none","str":"copy to hand ","dir":"ltr","width":"66.05","height":"11.04","transform":["11.04","0.00","0.00","11.04","453.91","330.67"],"x":453.91,"y":330.67}
{"page":42,"change":"none","str":"in. Within 24 hours he would have passed through the Medical Admissions Unit and be on a ","dir":"ltr","width":"449.46","height":"11.04","transform":["11.04","0.00","0.00","11.04","53.88","316.15"],"x":53.88,"y":316.15}
{"page":42,"change":"none","str":"ward, and his prescription record would once again ","dir":"ltr","width":"251.27","height":"11.04","transform":["11.04","0.00","0.00","11.04","53.88","301.61"],"x":53.88,"y":301.61}
{"page":42,"change":"none","str":"be incomplete. So Georgette would provide ","dir":"ltr","width":"213.81","height":"11.04","transform":["11.04","0.00","0.00","11.04","305.33","301.61"],"x":305.33,"y":301.61}
{"page":42,"change":"none","str":"of his current prescription","dir":"ltr","width":"123.34","height":"11.04","transform":["11.04","0.00","0.00","11.04","124.34","287.09"],"x":124.34,"y":287.09}
{"page":42,"change":"none","str":"On one occasion","dir":"ltr","width":"82.70","height":"11.04","transform":["11.04","0.00","0.00","11.04","53.88","237.89"],"x":53.88,"y":237.89}
{"page":42,"change":"none","str":", the prescription was wri","dir":"ltr","width":"120.97","height":"11.04","transform":["11.04","0.00","0.00","11.04","136.46","237.89"],"x":136.46,"y":237.89}
{"page":42,"change":"none","str":"tten, but Georgette and Ollie knew that the dose of his epilepsy medication was wrong. They pointed this out ","dir":"ltr","width":"529.40","height":"11.04","transform":["11.04","0.00","0.00","11.04","257.42","237.89"],"x":257.42,"y":237.89}
{"page":42,"change":"none","str":"twice on the first day, and again on ","dir":"ltr","width":"173.15","height":"11.04","transform":["11.04","0.00","0.00","11.04","53.88","223.37"],"x":53.88,"y":223.37}
{"page":42,"change":"none","str":"the second day","dir":"ltr","width":"74.65","height":"11.04","transform":["11.04","0.00","0.00","11.04","227.06","223.37"],"x":227.06,"y":223.37}
{"page":42,"change":"none","str":". It was eventually corrected. ","dir":"ltr","width":"142.57","height":"11.04","transform":["11.04","0.00","0.00","11.04","301.61","223.37"],"x":301.61,"y":223.37}
{"page":42,"change":"none","str":"Georgette is clear that t","dir":"ltr","width":"114.36","height":"11.04","transform":["11.04","0.00","0.00","11.04","53.88","198.89"],"x":53.88,"y":198.89}
{"page":42,"change":"none","str":"hese poor practices were not the result","dir":"ltr","width":"189.50","height":"11.04","transform":["11.04","0.00","0.00","11.04","168.38","198.89"],"x":168.38,"y":198.89}
{"page":42,"change":"none","str":"of bad clinicians, but on gaps ","dir":"ltr","width":"144.99","height":"11.04","transform":["11.04","0.00","0.00","11.04","361.01","198.89"],"x":361.01,"y":198.89}
{"page":42,"change":"none","str":"in information transfer and lack of clarity and/feasibility for task completion","dir":"ltr","width":"359.43","height":"11.04","transform":["11.04","0.00","0.00","11.04","53.88","184.22"],"x":53.88,"y":184.22}
{"page":42,"change":"none","str":"amongst team ","dir":"ltr","width":"72.76","height":"11.04","transform":["11.04","0.00","0.00","11.04","416.57","184.22"],"x":416.57,"y":184.22}
{"page":42,"change":"none","str":"Georgette continues to share this story and hopes that one day there will be no ","dir":"ltr","width":"386.92","height":"11.04","transform":["11.04","0.00","0.00","11.04","105.86","169.70"],"x":105.86,"y":169.7}
{"page":42,"change":"none","str":"In the last year of his life Ollie was ","dir":"ltr","width":"226.24","height":"14.04","transform":["14.04","0.00","0.00","14.04","539.71","443.74"],"x":539.71,"y":443.74}
{"page":42,"change":"none","str":"admitted to hospital several times. ","dir":"ltr","width":"228.32","height":"14.04","transform":["14.04","0.00","0.00","14.04","539.71","425.14"],"x":539.71,"y":425.14}
{"page":42,"change":"none","str":"Even though his wife, Georgette, ","dir":"ltr","width":"216.89","height":"14.04","transform":["14.04","0.00","0.00","14.04","539.71","406.63"],"x":539.71,"y":406.63}
{"page":42,"change":"none","str":"developed an ‘A&E survival pack’ to ","dir":"ltr","width":"239.10","height":"14.04","transform":["14.04","0.00","0.00","14.04","539.71","388.15"],"fontName":"Arial,Bold","x":539.71,"y":388.15}
{"page":42,"change":"none","str":"keep him safe, her planned ","dir":"ltr","width":"179.87","height":"14.04","transform":["14.04","0.00","0.00","14.04","539.71","369.55"],"x":539.71,"y":369.55}
{"page":42,"change":"none","str":"‘information handovers’ failed to ","dir":"ltr","width":"216.09","height":"14.04","transform":["14.04","0.00","0.00","14.04","539.71","351.07"],"fontName":"Arial,Bold","x":539.71,"y":351.07}
{"page":42,"change":"none","str":"result in an accurate prescription ","dir":"ltr","width":"219.80","height":"14.04","transform":["14.04","0.00","0.00","14.04","539.71","332.59"],"x":539.71,"y":332.59}
{"page":42,"change":"none","str":"for his regular ","dir":"ltr","width":"95.84","height":"14.04","transform":["14.04","0.00","0.00","14.04","539.71","314.11"],"x":539.71,"y":314.11}
{"page":42,"change":"none","str":"When his prescription was wrong, ","dir":"ltr","width":"226.23","height":"14.04","transform":["14.04","0.00","0.00","14.04","539.71","256.97"],"x":539.71,"y":256.97}
{"page":42,"change":"none","str":"no one seemed to take ","dir":"ltr","width":"151.73","height":"14.04","transform":["14.04","0.00","0.00","14.04","539.71","238.49"],"x":539.71,"y":238.49}
{"page":42,"change":"none","str":"responsibility to get it put right. ","dir":"ltr","width":"208.62","height":"14.04","transform":["14.04","0.00","0.00","14.04","539.71","220.01"],"x":539.71,"y":220.01}
{"page":42,"change":"none","str":"lie understood that going one day ","dir":"ltr","width":"180.65","height":"12.00","transform":["12.00","0.00","0.00","12.00","601.75","198.14"],"x":601.75,"y":198.14}
{"page":42,"change":"none","str":"without his epilepsy medicine was unlikely to ","dir":"ltr","width":"240.00","height":"12.00","transform":["12.00","0.00","0.00","12.00","542.35","182.30"],"x":542.35,"y":182.3}
{"page":42,"change":"none","str":"trigger a seizure, he still got anxious ","dir":"ltr","width":"194.70","height":"12.00","transform":["12.00","0.00","0.00","12.00","537.67","166.34"],"x":537.67,"y":166.34}
{"page":42,"change":"none","str":"and he ","dir":"ltr","width":"39.90","height":"12.00","transform":["12.00","0.00","0.00","12.00","742.66","166.34"],"x":742.66,"y":166.34}
{"page":42,"change":"none","str":"knew that ","dir":"ltr","width":"54.73","height":"12.00","transform":["12.00","0.00","0.00","12.00","534.43","150.50"],"x":534.43,"y":150.5}
{"page":42,"change":"none","str":"COULD make a seizure ","dir":"ltr","width":"129.97","height":"12.00","transform":["12.00","0.00","0.00","12.00","652.54","150.50"],"x":652.54,"y":150.5}
{"page":43,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":43,"change":"none","str":"ie and Georgette were reassured by staff that they had been heard and that the error would be corrected. But when it remained","dir":"ltr","width":"617.38","height":"11.04","transform":["11.04","0.00","0.00","11.04","93.02","496.18"],"x":93.024,"y":496.18}
{"page":43,"change":"none","str":"unchanged for ","dir":"ltr","width":"73.24","height":"11.04","transform":["11.04","0.00","0.00","11.04","713.86","496.18"],"x":713.86,"y":496.18}
{"page":43,"change":"none","str":"a second day Georgette felt she had to stay, all day as it turned out, until it was put right. Whilst they both kne","dir":"ltr","width":"534.94","height":"11.04","transform":["11.04","0.00","0.00","11.04","53.88","481.66"],"x":53.88,"y":481.66}
{"page":43,"change":"none","str":"w and understood that a small delay ","dir":"ltr","width":"179.07","height":"11.04","transform":["11.04","0.00","0.00","11.04","589.15","481.66"],"x":589.15,"y":481.66}
{"page":43,"change":"none","str":"would not ","dir":"ltr","width":"50.21","height":"11.04","transform":["11.04","0.00","0.00","11.04","53.88","467.14"],"x":53.88,"y":467.14}
{"page":43,"change":"none","str":"trigger a seizure, their confidence was dented, and they remained anxious throughout the hospital stay. ","dir":"ltr","width":"504.46","height":"11.04","transform":["11.04","0.00","0.00","11.04","104.06","467.14"],"x":104.06,"y":467.14}
{"page":43,"change":"none","str":"For many staff this story will not be unusual","dir":"ltr","width":"211.03","height":"11.04","transform":["11.04","0.00","0.00","11.04","53.88","408.91"],"x":53.88,"y":408.91}
{"page":43,"change":"none","str":". It may even be common place. But ","dir":"ltr","width":"178.44","height":"11.04","transform":["11.04","0.00","0.00","11.04","264.98","408.91"],"x":264.98,"y":408.91}
{"page":43,"change":"none","str":"it is unlikely ","dir":"ltr","width":"59.20","height":"11.04","transform":["11.04","0.00","0.00","11.04","443.57","408.91"],"x":443.57,"y":408.91}
{"page":43,"change":"none","str":"be reported or counted ","dir":"ltr","width":"114.39","height":"11.04","transform":["11.04","0.00","0.00","11.04","173.18","394.39"],"x":173.18,"y":394.39}
{"page":43,"change":"none","str":"service failures as the ","dir":"ltr","width":"109.34","height":"11.04","transform":["11.04","0.00","0.00","11.04","302.33","394.39"],"x":302.33,"y":394.39}
{"page":43,"change":"none","str":"classified as ","dir":"ltr","width":"63.07","height":"11.04","transform":["11.04","0.00","0.00","11.04","53.88","379.87"],"x":53.88,"y":379.87}
{"page":43,"change":"none","str":"‘patient received medicine and no ad","dir":"ltr","width":"178.99","height":"11.04","transform":["11.04","0.00","0.00","11.04","117.02","379.87"],"fontName":"Arial","x":117.02,"y":379.87}
{"page":43,"change":"none","str":"Negative impacts on patients ","dir":"ltr","width":"144.27","height":"11.04","transform":["11.04","0.00","0.00","11.04","361.61","379.87"],"x":361.61,"y":379.87}
{"page":43,"change":"none","str":"such as ‘anxiety’ are rarely captured, and it is usually only when a catastrophe occurs that the ","dir":"ltr","width":"457.94","height":"11.04","transform":["11.04","0.00","0.00","11.04","53.88","365.23"],"fontName":"Arial","x":53.88,"y":365.23}
{"page":43,"change":"none","str":"effect of serial failures become visible to the staff who have been involved along the way. ","dir":"ltr","width":"435.11","height":"11.04","transform":["11.04","0.00","0.00","11.04","53.88","350.71"],"x":53.88,"y":350.71}
{"page":43,"change":"none","str":"We can ","dir":"ltr","width":"40.37","height":"11.04","transform":["11.04","0.00","0.00","11.04","53.88","321.67"],"x":53.88,"y":321.67}
{"page":43,"change":"none","str":"ed to ","dir":"ltr","width":"27.57","height":"11.04","transform":["11.04","0.00","0.00","11.04","183.62","321.67"],"x":183.62,"y":321.67}
{"page":43,"change":"none","str":"the way things are","dir":"ltr","width":"89.26","height":"11.04","transform":["11.04","0.00","0.00","11.04","211.10","321.67"],"x":211.1,"y":321.67}
{"page":43,"change":"none","str":"accommodate shortcomings by ‘working around’ the barrier","dir":"ltr","width":"288.48","height":"11.04","transform":["11.04","0.00","0.00","11.04","379.37","321.67"],"fontName":"Arial","x":379.37,"y":321.67}
{"page":43,"change":"none","str":"what is ","dir":"ltr","width":"37.26","height":"11.04","transform":["11.04","0.00","0.00","11.04","724.30","321.67"],"x":724.3,"y":321.67}
{"page":43,"change":"none","str":"Although evidence shows that the human brain has a limited memory capacity, meaning that an existing task must be dr","dir":"ltr","width":"583.07","height":"11.04","transform":["11.04","0.00","0.00","11.04","138.98","307.01"],"x":138.98,"y":307.01}
{"page":43,"change":"none","str":"opped to ","dir":"ltr","width":"45.93","height":"11.04","transform":["11.04","0.00","0.00","11.04","722.38","307.01"],"x":722.38,"y":307.01}
{"page":43,"change":"none","str":"make way for a new one when the ‘list is full’, the way we work doesn’t reflect this knowledge.","dir":"ltr","width":"454.17","height":"11.04","transform":["11.04","0.00","0.00","11.04","53.88","292.49"],"fontName":"Arial","x":53.88,"y":292.49}
{"page":43,"change":"none","str":"you haven’t already done so, ","dir":"ltr","width":"143.67","height":"11.04","transform":["11.04","0.00","0.00","11.04","63.12","263.45"],"fontName":"Arial","x":63.12,"y":263.45}
{"page":43,"change":"none","str":"you could ","dir":"ltr","width":"50.12","height":"11.04","transform":["11.04","0.00","0.00","11.04","206.90","263.45"],"x":206.9,"y":263.45}
{"page":43,"change":"none","str":"start thinking about what you might change and how you will know if this results in an improvement! ","dir":"ltr","width":"485.31","height":"11.04","transform":["11.04","0.00","0.00","11.04","257.06","263.45"],"x":257.06,"y":263.45}
{"page":43,"change":"none","str":"Insanity: doing the same thing over and over ","dir":"ltr","width":"239.33","height":"12.00","transform":["12.00","0.00","0.00","12.00","543.67","399.07"],"x":543.67,"y":399.07}
{"page":43,"change":"none","str":"again and expecting different ","dir":"ltr","width":"157.38","height":"12.00","transform":["12.00","0.00","0.00","12.00","583.63","383.11"],"x":583.63,"y":383.11}
{"page":44,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":44,"change":"none","str":": Good practice c","dir":"ltr","width":"98.15","height":"12.00","transform":["12.00","0.00","0.00","12.00","120.50","524.38"],"x":120.5,"y":524.38}
{"page":44,"change":"none","str":"examples of questions to prompt discussion and generate ideas ","dir":"ltr","width":"369.86","height":"12.00","transform":["12.00","0.00","0.00","12.00","276.77","524.38"],"x":276.77,"y":524.38}
{"page":44,"change":"none","str":"What do we need?","dir":"ltr","width":"105.44","height":"12.00","transform":["12.00","0.00","0.00","12.00","124.34","479.98"],"x":124.34,"y":479.98}
{"page":44,"change":"none","str":"What does it mean?","dir":"ltr","width":"113.38","height":"12.00","transform":["12.00","0.00","0.00","12.00","243.14","479.98"],"x":243.14,"y":479.98}
{"page":44,"change":"none","str":"There is a nominated leader ","dir":"ltr","width":"127.20","height":"9.96","transform":["9.96","0.00","0.00","9.96","243.14","442.18"],"x":243.14,"y":442.18}
{"page":44,"change":"none","str":"for each transfer of ","dir":"ltr","width":"86.69","height":"9.96","transform":["9.96","0.00","0.00","9.96","243.14","428.98"],"x":243.14,"y":428.98}
{"page":44,"change":"none","str":"Who should have overall ","dir":"ltr","width":"112.13","height":"9.96","transform":["9.96","0.00","0.00","9.96","420.89","442.78"],"x":420.89,"y":442.78}
{"page":44,"change":"none","str":"responsibility for the transfer of care? This would ","dir":"ltr","width":"217.74","height":"9.96","transform":["9.96","0.00","0.00","9.96","533.11","442.78"],"x":533.11,"y":442.78}
{"page":44,"change":"none","str":"involve ensuring participants attend; introducing and orientating new team ","dir":"ltr","width":"328.87","height":"9.96","transform":["9.96","0.00","0.00","9.96","420.89","429.58"],"x":420.89,"y":429.58}
{"page":44,"change":"none","str":"prioritising urgent elements of transfer of care.","dir":"ltr","width":"203.75","height":"9.96","transform":["9.96","0.00","0.00","9.96","468.19","416.23"],"x":468.19,"y":416.23}
{"page":44,"change":"none","str":"Transfer and handovers are ","dir":"ltr","width":"126.07","height":"9.96","transform":["9.96","0.00","0.00","9.96","243.14","375.55"],"x":243.14,"y":375.55}
{"page":44,"change":"none","str":"valued as an essential part of ","dir":"ltr","width":"132.85","height":"9.96","transform":["9.96","0.00","0.00","9.96","243.14","362.35"],"x":243.14,"y":362.35}
{"page":44,"change":"none","str":"and preparation for ","dir":"ltr","width":"87.17","height":"9.96","transform":["9.96","0.00","0.00","9.96","265.34","349.15"],"x":265.34,"y":349.15}
{"page":44,"change":"none","str":"handover is a priority.","dir":"ltr","width":"95.47","height":"9.96","transform":["9.96","0.00","0.00","9.96","243.14","335.83"],"x":243.14,"y":335.83}
{"page":44,"change":"none","str":"How can we ensure information transfer is confidential and non","dir":"ltr","width":"278.77","height":"9.96","transform":["9.96","0.00","0.00","9.96","420.89","376.15"],"x":420.89,"y":376.15}
{"page":44,"change":"none","str":"How is the importance of transfer of care reinforced in the","dir":"ltr","width":"254.26","height":"9.96","transform":["9.96","0.00","0.00","9.96","420.89","362.23"],"x":420.89,"y":362.23}
{"page":44,"change":"none","str":"What training is required to ensure","dir":"ltr","width":"152.60","height":"9.96","transform":["9.96","0.00","0.00","9.96","420.89","335.11"],"x":420.89,"y":335.11}
{"page":44,"change":"none","str":"staff understand their accountability in ","dir":"ltr","width":"170.56","height":"9.96","transform":["9.96","0.00","0.00","9.96","576.43","335.11"],"x":576.43,"y":335.11}
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{"page":44,"change":"none","str":"clients understand their role in transfer of care?","dir":"ltr","width":"208.83","height":"9.96","transform":["9.96","0.00","0.00","9.96","509.71","294.77"],"x":509.71,"y":294.77}
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{"page":44,"change":"none","str":"clients have guidelines on transfer of care?","dir":"ltr","width":"190.04","height":"9.96","transform":["9.96","0.00","0.00","9.96","526.99","280.73"],"x":526.99,"y":280.73}
{"page":44,"change":"none","str":"The appropriate people are ","dir":"ltr","width":"123.30","height":"9.96","transform":["9.96","0.00","0.00","9.96","243.14","243.89"],"x":243.14,"y":243.89}
{"page":44,"change":"none","str":"Who needs to attend the transfer of care","dir":"ltr","width":"178.90","height":"9.96","transform":["9.96","0.00","0.00","9.96","420.89","244.49"],"x":420.89,"y":244.49}
{"page":44,"change":"none","str":"(think about multidisciplinary ","dir":"ltr","width":"128.07","height":"9.96","transform":["9.96","0.00","0.00","9.96","602.71","244.49"],"x":602.71,"y":244.49}
{"page":44,"change":"none","str":"? Do they need to be present for whole ","dir":"ltr","width":"177.73","height":"9.96","transform":["9.96","0.00","0.00","9.96","465.91","231.17"],"x":465.91,"y":231.17}
{"page":44,"change":"none","str":"part of ","dir":"ltr","width":"31.06","height":"9.96","transform":["9.96","0.00","0.00","9.96","710.62","231.17"],"x":710.62,"y":231.17}
{"page":44,"change":"none","str":"At what points","dir":"ltr","width":"62.68","height":"9.96","transform":["9.96","0.00","0.00","9.96","420.89","217.37"],"x":420.89,"y":217.37}
{"page":44,"change":"none","str":"carers want to be involved in the ","dir":"ltr","width":"145.92","height":"9.96","transform":["9.96","0.00","0.00","9.96","591.55","217.37"],"x":591.55,"y":217.37}
{"page":44,"change":"none","str":"transfer of care process?","dir":"ltr","width":"110.57","height":"9.96","transform":["9.96","0.00","0.00","9.96","420.89","204.05"],"x":420.89,"y":204.05}
{"page":44,"change":"none","str":"How will students and junior staff get the mos","dir":"ltr","width":"200.55","height":"9.96","transform":["9.96","0.00","0.00","9.96","420.89","190.22"],"x":420.89,"y":190.22}
{"page":44,"change":"none","str":"t learning opportunities from ","dir":"ltr","width":"126.60","height":"9.96","transform":["9.96","0.00","0.00","9.96","621.67","190.22"],"x":621.67,"y":190.22}
{"page":44,"change":"none","str":"Who will cover the unit while transfer of care occurs? ","dir":"ltr","width":"235.99","height":"9.96","transform":["9.96","0.00","0.00","9.96","420.89","163.10"],"x":420.89,"y":163.1}
{"page":44,"change":"none","str":"What happens in emergencies?","dir":"ltr","width":"140.45","height":"9.96","transform":["9.96","0.00","0.00","9.96","420.89","149.18"],"x":420.89,"y":149.18}
{"page":44,"change":"none","str":"can interruptions be prevented?","dir":"ltr","width":"140.56","height":"9.96","transform":["9.96","0.00","0.00","9.96","443.57","135.26"],"x":443.57,"y":135.26}
{"page":44,"change":"none","str":"Who will be involved in regular review and audit of transfer of care ","dir":"ltr","width":"294.45","height":"9.96","transform":["9.96","0.00","0.00","9.96","420.89","121.46"],"x":420.89,"y":121.46}
{"page":44,"change":"none","str":"Who will prepar","dir":"ltr","width":"68.81","height":"9.96","transform":["9.96","0.00","0.00","9.96","420.89","94.22"],"x":420.89,"y":94.224}
{"page":44,"change":"none","str":"e information and documentation for ","dir":"ltr","width":"162.83","height":"9.96","transform":["9.96","0.00","0.00","9.96","489.79","94.22"],"x":489.79,"y":94.224}
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{"page":45,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":45,"change":"none","str":"What do we need?","dir":"ltr","width":"105.44","height":"12.00","transform":["12.00","0.00","0.00","12.00","124.34","511.90"],"x":124.34,"y":511.9}
{"page":45,"change":"none","str":"What does it mean?","dir":"ltr","width":"113.38","height":"12.00","transform":["12.00","0.00","0.00","12.00","243.14","511.90"],"x":243.14,"y":511.9}
{"page":45,"change":"none","str":"Specified time and ","dir":"ltr","width":"109.37","height":"12.00","transform":["12.00","0.00","0.00","12.00","124.34","468.82"],"x":124.34,"y":468.82}
{"page":45,"change":"none","str":"A specific setting or place ","dir":"ltr","width":"115.96","height":"9.96","transform":["9.96","0.00","0.00","9.96","243.14","469.42"],"x":243.14,"y":469.42}
{"page":45,"change":"none","str":"has been agreed where ","dir":"ltr","width":"107.69","height":"9.96","transform":["9.96","0.00","0.00","9.96","243.14","456.10"],"x":243.14,"y":456.1}
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{"page":45,"change":"none","str":"place without interruption or ","dir":"ltr","width":"125.53","height":"9.96","transform":["9.96","0.00","0.00","9.96","243.14","429.70"],"x":243.14,"y":429.7}
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{"page":45,"change":"none","str":"How does this relate to time of shift change?","dir":"ltr","width":"196.53","height":"9.96","transform":["9.96","0.00","0.00","9.96","420.89","456.10"],"x":420.89,"y":456.1}
{"page":45,"change":"none","str":"How long should the transfer of care take? ","dir":"ltr","width":"190.53","height":"9.96","transform":["9.96","0.00","0.00","9.96","420.89","442.18"],"x":420.89,"y":442.18}
{"page":45,"change":"none","str":"How can ","dir":"ltr","width":"41.50","height":"9.96","transform":["9.96","0.00","0.00","9.96","420.89","428.26"],"x":420.89,"y":428.26}
{"page":45,"change":"none","str":"ensure it starts on time?","dir":"ltr","width":"106.76","height":"9.96","transform":["9.96","0.00","0.00","9.96","478.03","428.26"],"x":478.03,"y":428.26}
{"page":45,"change":"none","str":"Does the transfer of care process need to be different depending on the time ","dir":"ltr","width":"341.03","height":"9.96","transform":["9.96","0.00","0.00","9.96","420.89","414.43"],"x":420.89,"y":414.43}
{"page":45,"change":"none","str":"Where should the transfer of care happen?","dir":"ltr","width":"189.85","height":"9.96","transform":["9.96","0.00","0.00","9.96","420.89","387.31"],"x":420.89,"y":387.31}
{"page":45,"change":"none","str":"Is the environment quiet with no interruptions? If not, how can interruptions","dir":"ltr","width":"332.51","height":"9.96","transform":["9.96","0.00","0.00","9.96","420.89","373.39"],"x":420.89,"y":373.39}
{"page":45,"change":"none","str":"Does any part of ","dir":"ltr","width":"76.02","height":"9.96","transform":["9.96","0.00","0.00","9.96","420.89","346.27"],"x":420.89,"y":346.27}
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{"page":45,"change":"none","str":"happen with the patient or in a public area? ","dir":"ltr","width":"196.64","height":"9.96","transform":["9.96","0.00","0.00","9.96","567.07","346.27"],"x":567.07,"y":346.27}
{"page":45,"change":"none","str":"How and where is","dir":"ltr","width":"79.33","height":"9.96","transform":["9.96","0.00","0.00","9.96","420.89","332.35"],"x":420.89,"y":332.35}
{"page":45,"change":"none","str":"There is an agreed process ","dir":"ltr","width":"124.47","height":"9.96","transform":["9.96","0.00","0.00","9.96","243.14","292.13"],"x":243.14,"y":292.13}
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{"page":45,"change":"none","str":"This includes an agreed set ","dir":"ltr","width":"124.93","height":"9.96","transform":["9.96","0.00","0.00","9.96","243.14","265.61"],"x":243.14,"y":265.61}
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{"page":45,"change":"none","str":"in transfers (minimum data ","dir":"ltr","width":"121.01","height":"9.96","transform":["9.96","0.00","0.00","9.96","243.14","239.21"],"x":243.14,"y":239.21}
{"page":45,"change":"none","str":"set). This is communicated in ","dir":"ltr","width":"132.05","height":"9.96","transform":["9.96","0.00","0.00","9.96","243.14","226.01"],"x":243.14,"y":226.01}
{"page":45,"change":"none","str":", is action","dir":"ltr","width":"42.23","height":"9.96","transform":["9.96","0.00","0.00","9.96","316.37","212.69"],"x":316.37,"y":212.69}
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{"page":45,"change":"none","str":"What information ","dir":"ltr","width":"78.21","height":"9.96","transform":["9.96","0.00","0.00","9.96","420.89","292.73"],"x":420.89,"y":292.73}
{"page":45,"change":"none","str":"would be included","dir":"ltr","width":"79.88","height":"9.96","transform":["9.96","0.00","0.00","9.96","499.27","292.73"],"x":499.27,"y":292.73}
{"page":45,"change":"none","str":"in a standard transfer of care template","dir":"ltr","width":"168.89","height":"9.96","transform":["9.96","0.00","0.00","9.96","582.07","292.73"],"x":582.07,"y":292.73}
{"page":45,"change":"none","str":"he minimum data set","dir":"ltr","width":"92.61","height":"9.96","transform":["9.96","0.00","0.00","9.96","557.23","279.41"],"x":557.23,"y":279.41}
{"page":45,"change":"none","str":"How much of this information overlaps with other disciplines?","dir":"ltr","width":"269.82","height":"9.96","transform":["9.96","0.00","0.00","9.96","420.89","265.61"],"x":420.89,"y":265.61}
{"page":45,"change":"none","str":"How could ","dir":"ltr","width":"49.42","height":"9.96","transform":["9.96","0.00","0.00","9.96","696.58","265.61"],"x":696.58,"y":265.61}
{"page":45,"change":"none","str":"multidisciplinary transfer of care be most effective?","dir":"ltr","width":"224.38","height":"9.96","transform":["9.96","0.00","0.00","9.96","420.89","252.29"],"x":420.89,"y":252.29}
{"page":45,"change":"none","str":"How and ","dir":"ltr","width":"42.10","height":"9.96","transform":["9.96","0.00","0.00","9.96","420.89","238.49"],"x":420.89,"y":238.49}
{"page":45,"change":"none","str":"when in the process will the person receiving the transfer of care ","dir":"ltr","width":"287.75","height":"9.96","transform":["9.96","0.00","0.00","9.96","463.15","238.49"],"x":463.15,"y":238.49}
{"page":45,"change":"none","str":"ask questions, confirm understanding and accept responsibility for the ","dir":"ltr","width":"311.41","height":"9.96","transform":["9.96","0.00","0.00","9.96","420.89","225.17"],"x":420.89,"y":225.17}
{"page":45,"change":"none","str":"Do you want to use","dir":"ltr","width":"85.39","height":"9.96","transform":["9.96","0.00","0.00","9.96","420.89","198.14"],"x":420.89,"y":198.14}
{"page":45,"change":"none","str":"d communication tool","dir":"ltr","width":"94.42","height":"9.96","transform":["9.96","0.00","0.00","9.96","548.11","198.14"],"x":548.11,"y":198.14}
{"page":45,"change":"none","str":"or develop your own?","dir":"ltr","width":"95.48","height":"9.96","transform":["9.96","0.00","0.00","9.96","473.11","184.82"],"x":473.11,"y":184.82}
{"page":45,"change":"none","str":"What happens to documentation following the transfer of care? How could it ","dir":"ltr","width":"340.40","height":"9.96","transform":["9.96","0.00","0.00","9.96","420.89","170.90"],"x":420.89,"y":170.9}
{"page":45,"change":"none","str":"be designed to go directly into patient notes?","dir":"ltr","width":"198.19","height":"9.96","transform":["9.96","0.00","0.00","9.96","420.89","157.70"],"x":420.89,"y":157.7}
{"page":45,"change":"none","str":"How is the agreed transfer of care process documented? How d","dir":"ltr","width":"285.40","height":"9.96","transform":["9.96","0.00","0.00","9.96","420.89","143.78"],"x":420.89,"y":143.78}
{"page":45,"change":"none","str":"o new staff ","dir":"ltr","width":"51.20","height":"9.96","transform":["9.96","0.00","0.00","9.96","706.66","143.78"],"x":706.66,"y":143.78}
{"page":45,"change":"none","str":"and patients/clients find out about the process?","dir":"ltr","width":"208.73","height":"9.96","transform":["9.96","0.00","0.00","9.96","420.89","130.58"],"x":420.89,"y":130.58}
{"page":46,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":46,"change":"none","str":": The Model for Improvement","dir":"ltr","width":"164.72","height":"12.00","transform":["12.00","0.00","0.00","12.00","120.50","524.38"],"x":120.5,"y":524.38}
{"page":46,"change":"none","str":"he Model for Improvement ","dir":"ltr","width":"131.40","height":"11.04","transform":["11.04","0.00","0.00","11.04","60.72","481.42"],"x":60.72,"y":481.42}
{"page":46,"change":"none","str":"you a simple, adaptable and ","dir":"ltr","width":"140.70","height":"11.04","transform":["11.04","0.00","0.00","11.04","220.94","481.42"],"x":220.94,"y":481.42}
{"page":46,"change":"none","str":"framework for ","dir":"ltr","width":"70.35","height":"11.04","transform":["11.04","0.00","0.00","11.04","408.05","481.42"],"x":408.05,"y":481.42}
{"page":46,"change":"none","str":"developing, testing and implementing changes","dir":"ltr","width":"226.25","height":"11.04","transform":["11.04","0.00","0.00","11.04","478.51","481.42"],"x":478.51,"y":481.42}
{"page":46,"change":"none","str":". Using the ","dir":"ltr","width":"55.60","height":"11.04","transform":["11.04","0.00","0.00","11.04","704.86","481.42"],"x":704.86,"y":481.42}
{"page":46,"change":"none","str":"Model for ","dir":"ltr","width":"48.97","height":"11.04","transform":["11.04","0.00","0.00","11.04","53.88","466.90"],"x":53.88,"y":466.9}
{"page":46,"change":"none","str":"Improvement means your changes are more likely to lead to the improvement you set out to make","dir":"ltr","width":"476.23","height":"11.04","transform":["11.04","0.00","0.00","11.04","102.86","466.90"],"x":102.86,"y":466.9}
{"page":46,"change":"none","str":"The first thing you need to do when using the model is answer ","dir":"ltr","width":"277.09","height":"9.96","transform":["9.96","0.00","0.00","9.96","404.21","382.03"],"x":404.21,"y":382.03}
{"page":46,"change":"none","str":"these three key questions","dir":"ltr","width":"113.73","height":"9.96","transform":["9.96","0.00","0.00","9.96","404.21","369.07"],"x":404.21,"y":369.07}
{"page":46,"change":"none","str":"Then you carry out the ‘plan, do, study, act’ (PDSA) cycles. ","dir":"ltr","width":"263.76","height":"9.96","transform":["9.96","0.00","0.00","9.96","404.09","304.01"],"fontName":"Arial","x":404.09,"y":304.01}
{"page":46,"change":"none","str":"These cycles are used to test an idea by trialling a change and ","dir":"ltr","width":"279.25","height":"9.96","transform":["9.96","0.00","0.00","9.96","404.09","290.81"],"x":404.09,"y":290.81}
{"page":46,"change":"none","str":"assessing its impact.","dir":"ltr","width":"92.20","height":"9.96","transform":["9.96","0.00","0.00","9.96","404.09","277.61"],"x":404.09,"y":277.61}
{"page":46,"change":"none","str":"PDSA cycles is to repeat them; ","dir":"ltr","width":"140.64","height":"9.96","transform":["9.96","0.00","0.00","9.96","548.47","277.61"],"x":548.47,"y":277.61}
{"page":46,"change":"none","str":"keep testing small changes until they deliver the sustainable ","dir":"ltr","width":"268.11","height":"9.96","transform":["9.96","0.00","0.00","9.96","404.09","264.41"],"x":404.09,"y":264.41}
{"page":46,"change":"none","str":"improvement you are looking for.","dir":"ltr","width":"145.46","height":"9.96","transform":["9.96","0.00","0.00","9.96","404.09","251.21"],"x":404.09,"y":251.21}
{"page":46,"change":"none","str":"the change and how you will test it","dir":"ltr","width":"152.27","height":"9.96","transform":["9.96","0.00","0.00","9.96","463.87","227.45"],"x":463.87,"y":227.45}
{"page":46,"change":"none","str":"the change and tests","dir":"ltr","width":"92.76","height":"9.96","transform":["9.96","0.00","0.00","9.96","456.19","213.53"],"x":456.19,"y":213.53}
{"page":46,"change":"none","str":"the data before and after the change and learn ","dir":"ltr","width":"208.88","height":"9.96","transform":["9.96","0.00","0.00","9.96","470.59","199.61"],"x":470.59,"y":199.61}
{"page":46,"change":"none","str":"on the learning by refining the change and planning ","dir":"ltr","width":"229.98","height":"9.96","transform":["9.96","0.00","0.00","9.96","458.95","172.46"],"x":458.95,"y":172.46}
{"page":46,"change":"none","str":"another PDSA cycle to test it.","dir":"ltr","width":"129.86","height":"9.96","transform":["9.96","0.00","0.00","9.96","440.09","159.14"],"x":440.09,"y":159.14}
{"page":46,"change":"none","str":"For more ","dir":"ltr","width":"43.42","height":"9.96","transform":["9.96","0.00","0.00","9.96","404.09","122.66"],"x":404.09,"y":122.66}
{"page":46,"change":"none","str":"Langley GL, Nolan KM, Nolan TW, Norman CL, Provost LP, ","dir":"ltr","width":"240.51","height":"9.00","transform":["9.00","0.00","0.00","9.00","53.88","152.78"],"x":53.88,"y":152.78}
{"page":46,"change":"none","str":"Improvement Guide: A Practical Approach to Enhancing ","dir":"ltr","width":"225.48","height":"9.00","transform":["9.00","0.00","0.00","9.00","53.88","142.46"],"x":53.88,"y":142.46}
{"page":46,"change":"none","str":"For more on the Model for Improvement see: ","dir":"ltr","width":"201.01","height":"9.96","transform":["9.96","0.00","0.00","9.96","446.69","117.62"],"x":446.69,"y":117.62}
{"page":46,"change":"none","str":"Quality and service improvement tools","dir":"ltr","width":"169.26","height":"9.96","transform":["9.96","0.00","0.00","9.96","482.71","93.74"],"x":482.71,"y":93.744}
{"page":46,"change":"none","str":"Analysis and ","dir":"ltr","width":"59.38","height":"9.96","transform":["9.96","0.00","0.00","9.96","710.62","80.04"],"x":710.62,"y":80.04}
{"page":47,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":47,"change":"none","str":"SMART aims are a good way to ","dir":"ltr","width":"158.28","height":"11.04","transform":["11.04","0.00","0.00","11.04","53.88","481.42"],"x":53.88,"y":481.42}
{"page":47,"change":"none","str":"ensure your project aim is clearly defined","dir":"ltr","width":"199.86","height":"11.04","transform":["11.04","0.00","0.00","11.04","212.30","481.42"],"x":212.3,"y":481.42}
{"page":47,"change":"none","str":"Have a clear and specific improvement aim","dir":"ltr","width":"210.12","height":"11.04","transform":["11.04","0.00","0.00","11.04","127.34","415.87"],"x":127.34,"y":415.87}
{"page":47,"change":"none","str":"structured transfer of care, right each time","dir":"ltr","width":"204.22","height":"11.04","transform":["11.04","0.00","0.00","11.04","80.64","401.11"],"x":80.64,"y":401.11}
{"page":47,"change":"none","str":"Ensure data is available to measure the scale of the ","dir":"ltr","width":"255.59","height":"11.04","transform":["11.04","0.00","0.00","11.04","145.58","380.71"],"x":145.58,"y":380.71}
{"page":47,"change":"none","str":"problem and your success in addressing it","dir":"ltr","width":"205.41","height":"11.04","transform":["11.04","0.00","0.00","11.04","78.24","366.07"],"x":78.24,"y":366.07}
{"page":47,"change":"none","str":"Set a suitable challenge","dir":"ltr","width":"116.75","height":"11.04","transform":["11.04","0.00","0.00","11.04","143.18","345.67"],"x":143.18,"y":345.67}
{"page":47,"change":"none","str":"on’t be afraid to set ","dir":"ltr","width":"96.49","height":"11.04","transform":["11.04","0.00","0.00","11.04","290.57","345.67"],"fontName":"Arial","x":290.57,"y":345.67}
{"page":47,"change":"none","str":". Resist setting your aim too low","dir":"ltr","width":"155.29","height":"11.04","transform":["11.04","0.00","0.00","11.04","144.38","331.03"],"x":144.38,"y":331.03}
{"page":47,"change":"none","str":"just to improve your ","dir":"ltr","width":"99.13","height":"11.04","transform":["11.04","0.00","0.00","11.04","302.69","331.03"],"x":302.69,"y":331.03}
{"page":47,"change":"none","str":"chances of succeeding","dir":"ltr","width":"111.98","height":"11.04","transform":["11.04","0.00","0.00","11.04","78.24","316.39"],"x":78.24,"y":316.39}
{"page":47,"change":"none","str":"Consider the factors beyond your control which may limit ","dir":"ltr","width":"278.61","height":"11.04","transform":["11.04","0.00","0.00","11.04","130.34","295.97"],"x":130.34,"y":295.97}
{"page":47,"change":"none","str":"the impact of the project, ","dir":"ltr","width":"123.47","height":"11.04","transform":["11.04","0.00","0.00","11.04","78.24","281.33"],"x":78.24,"y":281.33}
{"page":47,"change":"none","str":"e.g. closure of a unit for refurbishment;","dir":"ltr","width":"188.22","height":"11.04","transform":["11.04","0.00","0.00","11.04","201.86","281.33"],"x":201.86,"y":281.33}
{"page":47,"change":"none","str":"availability of sponsor. ","dir":"ltr","width":"114.25","height":"11.04","transform":["11.04","0.00","0.00","11.04","180.50","266.81"],"x":180.5,"y":266.81}
{"page":47,"change":"none","str":"Set a deadline and stick to it","dir":"ltr","width":"137.53","height":"11.04","transform":["11.04","0.00","0.00","11.04","110.78","246.29"],"x":110.78,"y":246.29}
{"page":47,"change":"none","str":", e.g. by December 2015.","dir":"ltr","width":"123.50","height":"11.04","transform":["11.04","0.00","0.00","11.04","248.42","246.29"],"x":248.42,"y":246.29}
{"page":48,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":48,"change":"none","str":"Appendix E: Team ","dir":"ltr","width":"108.01","height":"12.00","transform":["12.00","0.00","0.00","12.00","53.88","524.38"],"x":53.88,"y":524.38}
{"page":48,"change":"none","str":"Authority to make changes","dir":"ltr","width":"87.40","height":"8.01","transform":["8.03","0.00","0.00","8.01","468.21","463.33"],"fontName":"ABCDEE+Calibri","x":468.20900137420006,"y":463.32671200000004}
{"page":48,"change":"none","str":"Knowledge [of the process]","dir":"ltr","width":"88.77","height":"8.03","transform":["-0.00","8.01","-8.03","-0.00","408.67","360.38"],"fontName":"ABCDEE+Calibri","x":408.67320752867204,"y":360.37663}
{"page":48,"change":"none","str":"Authority to make changes","dir":"ltr","width":"87.02","height":"7.90","transform":["7.97","0.00","0.00","7.90","157.30","252.58"],"fontName":"ABCDEE+Calibri","x":157.30436901152,"y":252.57682397199997}
{"page":48,"change":"none","str":"Residential home example","dir":"ltr","width":"153.36","height":"14.29","transform":["14.41","0.00","0.00","14.29","91.89","267.69"],"fontName":"ABCDEE+Calibri","x":91.887591363584,"y":267.6885559315}
{"page":48,"change":"none","str":"Care home staff","dir":"ltr","width":"40.91","height":"6.37","transform":["6.43","0.00","0.00","6.37","226.44","211.42"],"fontName":"ABCDEE+Calibri","x":226.43520988256,"y":211.41995062375}
{"page":49,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":49,"change":"none","str":": Example ","dir":"ltr","width":"60.06","height":"12.00","transform":["12.00","0.00","0.00","12.00","119.18","524.50"],"x":119.18,"y":524.5}
{"page":49,"change":"none","str":"Adapted from outline in the ","dir":"ltr","width":"134.53","height":"11.04","transform":["11.04","0.00","0.00","11.04","373.61","455.62"],"x":373.61,"y":455.62}
{"page":49,"change":"none","str":"OSSIE Guide to Clinical ","dir":"ltr","width":"119.66","height":"11.04","transform":["11.04","0.00","0.00","11.04","508.27","455.62"],"x":508.27,"y":455.62}
{"page":49,"change":"none","str":"t. Available on Slide Share at ","dir":"ltr","width":"144.26","height":"11.04","transform":["11.04","0.00","0.00","11.04","485.59","441.10"],"x":485.59,"y":441.1}
{"page":50,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":50,"change":"none","str":"Dot voting is a simple way to collect input from the whole team about ","dir":"ltr","width":"336.90","height":"11.04","transform":["11.04","0.00","0.00","11.04","53.88","484.90"],"x":53.88,"y":484.9}
{"page":50,"change":"none","str":"the information that should be included ","dir":"ltr","width":"191.92","height":"11.04","transform":["11.04","0.00","0.00","11.04","390.89","484.90"],"x":390.89,"y":484.9}
{"page":50,"change":"none","str":"in your communication tool.","dir":"ltr","width":"133.83","height":"11.04","transform":["11.04","0.00","0.00","11.04","53.88","472.18"],"x":53.88,"y":472.18}
{"page":50,"change":"none","str":"Using your ","dir":"ltr","width":"55.72","height":"11.04","transform":["11.04","0.00","0.00","11.04","89.88","446.14"],"x":89.88,"y":446.14}
{"page":50,"change":"none","str":"observation of the current transfer of care process, create a list of all the information which ","dir":"ltr","width":"441.77","height":"11.04","transform":["11.04","0.00","0.00","11.04","145.70","446.14"],"x":145.7,"y":446.14}
{"page":50,"change":"none","str":"is currently discussed.","dir":"ltr","width":"108.29","height":"11.04","transform":["11.04","0.00","0.00","11.04","89.88","433.54"],"x":89.88,"y":433.54}
{"page":50,"change":"none","str":"Add any additional information ","dir":"ltr","width":"151.13","height":"11.04","transform":["11.04","0.00","0.00","11.04","89.88","420.07"],"x":89.88,"y":420.07}
{"page":50,"change":"none","str":"should perhaps be included","dir":"ltr","width":"134.54","height":"11.04","transform":["11.04","0.00","0.00","11.04","262.46","420.07"],"x":262.46,"y":420.07}
{"page":50,"change":"none","str":"either because it is recommended ","dir":"ltr","width":"168.01","height":"11.04","transform":["11.04","0.00","0.00","11.04","403.13","420.07"],"x":403.13,"y":420.07}
{"page":50,"change":"none","str":"best practice or becaus","dir":"ltr","width":"113.84","height":"11.04","transform":["11.04","0.00","0.00","11.04","89.88","405.55"],"x":89.88,"y":405.55}
{"page":50,"change":"none","str":"e staff/patients/clients want to see ","dir":"ltr","width":"168.00","height":"11.04","transform":["11.04","0.00","0.00","11.04","203.78","405.55"],"x":203.78,"y":405.55}
{"page":50,"change":"none","str":"Let all staff have the opportunity to vote ","dir":"ltr","width":"195.07","height":"11.04","transform":["11.04","0.00","0.00","11.04","89.88","390.31"],"x":89.88,"y":390.31}
{"page":50,"change":"none","str":"by sticking or drawing ","dir":"ltr","width":"108.72","height":"11.04","transform":["11.04","0.00","0.00","11.04","285.17","390.31"],"x":285.17,"y":390.31}
{"page":50,"change":"none","str":"the information they feel is ","dir":"ltr","width":"131.38","height":"11.04","transform":["11.04","0.00","0.00","11.04","457.63","390.31"],"x":457.63,"y":390.31}
{"page":50,"change":"none","str":"most important ","dir":"ltr","width":"75.86","height":"11.04","transform":["11.04","0.00","0.00","11.04","89.88","375.67"],"x":89.88,"y":375.67}
{"page":50,"change":"none","str":"them to provide good quality care.","dir":"ltr","width":"165.58","height":"11.04","transform":["11.04","0.00","0.00","11.04","222.02","375.67"],"x":222.02,"y":375.67}
{"page":50,"change":"none","str":"Remember to include both the staff ","dir":"ltr","width":"174.37","height":"11.04","transform":["11.04","0.00","0.00","11.04","89.88","360.55"],"x":89.88,"y":360.55}
{"page":50,"change":"none","str":"who are ","dir":"ltr","width":"42.07","height":"11.04","transform":["11.04","0.00","0.00","11.04","264.38","360.55"],"x":264.38,"y":360.55}
{"page":50,"change":"none","str":"the transfer of care. This might ","dir":"ltr","width":"155.16","height":"11.04","transform":["11.04","0.00","0.00","11.04","434.33","360.55"],"x":434.33,"y":360.55}
{"page":50,"change":"none","str":"mean involving individuals from outside your immediate team if you are transferring patients between ","dir":"ltr","width":"493.20","height":"11.04","transform":["11.04","0.00","0.00","11.04","89.88","345.91"],"x":89.88,"y":345.91}
{"page":50,"change":"none","str":"Use different colour pens to identify different roles","dir":"ltr","width":"242.15","height":"11.04","transform":["11.04","0.00","0.00","11.04","89.88","316.03"],"x":89.88,"y":316.03}
{"page":50,"change":"none","str":"colours for trained and untrained ","dir":"ltr","width":"161.31","height":"11.04","transform":["11.04","0.00","0.00","11.04","402.53","316.03"],"x":402.53,"y":316.03}
{"page":50,"change":"none","str":"After everyone has voted, the information with the most dots is the information you need to focus on.","dir":"ltr","width":"487.71","height":"11.04","transform":["11.04","0.00","0.00","11.04","53.88","272.45"],"x":53.88,"y":272.45}
{"page":51,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":51,"change":"none","str":"Good practice checklist ","dir":"ltr","width":"138.77","height":"12.00","transform":["12.00","0.00","0.00","12.00","127.94","524.38"],"x":127.94,"y":524.38}
{"page":51,"change":"none","str":"What do we ","dir":"ltr","width":"70.02","height":"12.00","transform":["12.00","0.00","0.00","12.00","74.76","479.98"],"x":74.76,"y":479.98}
{"page":51,"change":"none","str":"What does it mean?","dir":"ltr","width":"113.38","height":"12.00","transform":["12.00","0.00","0.00","12.00","166.70","479.98"],"x":166.7,"y":479.98}
{"page":51,"change":"none","str":"There is a nominated leader for each ","dir":"ltr","width":"166.07","height":"9.96","transform":["9.96","0.00","0.00","9.96","166.70","426.34"],"x":166.7,"y":426.34}
{"page":51,"change":"none","str":"transfer of care/handover.","dir":"ltr","width":"114.26","height":"9.96","transform":["9.96","0.00","0.00","9.96","166.70","413.11"],"x":166.7,"y":413.11}
{"page":51,"change":"none","str":"is leadership clear and does leader fulfil role?","dir":"ltr","width":"200.43","height":"9.96","transform":["9.96","0.00","0.00","9.96","443.69","432.94"],"x":443.69,"y":432.94}
{"page":51,"change":"none","str":"Do new team members understand the process?","dir":"ltr","width":"215.98","height":"9.96","transform":["9.96","0.00","0.00","9.96","379.85","420.79"],"x":379.85,"y":420.79}
{"page":51,"change":"none","str":"Is leader indicated on transfer of care process checklist (if ","dir":"ltr","width":"257.78","height":"9.96","transform":["9.96","0.00","0.00","9.96","379.85","408.55"],"x":379.85,"y":408.55}
{"page":51,"change":"none","str":"Transfer and handovers are valued ","dir":"ltr","width":"158.18","height":"9.96","transform":["9.96","0.00","0.00","9.96","166.70","380.83"],"x":166.7,"y":380.83}
{"page":51,"change":"none","str":"as an essential part of care.","dir":"ltr","width":"122.79","height":"9.96","transform":["9.96","0.00","0.00","9.96","166.70","367.63"],"x":166.7,"y":367.63}
{"page":51,"change":"none","str":"Number of interruptions","dir":"ltr","width":"104.26","height":"9.96","transform":["9.96","0.00","0.00","9.96","379.49","387.43"],"x":379.49,"y":387.43}
{"page":51,"change":"none","str":"do individuals value &","dir":"ltr","width":"96.55","height":"9.96","transform":["9.96","0.00","0.00","9.96","500.11","375.31"],"x":500.11,"y":375.31}
{"page":51,"change":"none","str":"understand the transfer of care process?","dir":"ltr","width":"179.98","height":"9.96","transform":["9.96","0.00","0.00","9.96","599.59","375.31"],"x":599.59,"y":375.31}
{"page":51,"change":"none","str":"How many patients/clients know who is in charge of their ","dir":"ltr","width":"253.07","height":"9.96","transform":["9.96","0.00","0.00","9.96","379.49","363.07"],"x":379.49,"y":363.07}
{"page":51,"change":"none","str":"Do transfer of care guidelines exist","dir":"ltr","width":"153.84","height":"9.96","transform":["9.96","0.00","0.00","9.96","379.49","350.95"],"x":379.49,"y":350.95}
{"page":51,"change":"none","str":"and are they visible?","dir":"ltr","width":"91.64","height":"9.96","transform":["9.96","0.00","0.00","9.96","536.23","350.95"],"x":536.23,"y":350.95}
{"page":51,"change":"none","str":"Number of staff trained in transfer of care process","dir":"ltr","width":"219.98","height":"9.96","transform":["9.96","0.00","0.00","9.96","379.49","338.71"],"x":379.49,"y":338.71}
{"page":51,"change":"none","str":"The appropriate people are involved.","dir":"ltr","width":"162.63","height":"9.96","transform":["9.96","0.00","0.00","9.96","166.70","295.25"],"x":166.7,"y":295.25}
{"page":51,"change":"none","str":"Staff time invested in transfer of care (including ","dir":"ltr","width":"210.89","height":"9.96","transform":["9.96","0.00","0.00","9.96","379.85","301.85"],"x":379.85,"y":301.85}
{"page":51,"change":"none","str":"Staff/patient/client satisfaction with transfer of care process","dir":"ltr","width":"260.46","height":"9.96","transform":["9.96","0.00","0.00","9.96","379.85","289.73"],"x":379.85,"y":289.73}
{"page":51,"change":"none","str":"Number of incidents in unit/on floor during transfer of care","dir":"ltr","width":"254.88","height":"9.96","transform":["9.96","0.00","0.00","9.96","379.85","277.49"],"x":379.85,"y":277.49}
{"page":51,"change":"none","str":"time and ","dir":"ltr","width":"52.78","height":"12.00","transform":["12.00","0.00","0.00","12.00","74.76","217.01"],"x":74.76,"y":217.01}
{"page":51,"change":"none","str":"A specific setting or place has been ","dir":"ltr","width":"159.86","height":"9.96","transform":["9.96","0.00","0.00","9.96","166.70","233.45"],"x":166.7,"y":233.45}
{"page":51,"change":"none","str":"agreed where ","dir":"ltr","width":"63.78","height":"9.96","transform":["9.96","0.00","0.00","9.96","166.70","220.25"],"x":166.7,"y":220.25}
{"page":51,"change":"none","str":"transfers of care can ","dir":"ltr","width":"93.77","height":"9.96","transform":["9.96","0.00","0.00","9.96","230.54","220.25"],"x":230.54,"y":220.25}
{"page":51,"change":"none","str":"take place without interruption or ","dir":"ltr","width":"147.12","height":"9.96","transform":["9.96","0.00","0.00","9.96","166.70","207.05"],"x":166.7,"y":207.05}
{"page":51,"change":"none","str":"Number of interruptions","dir":"ltr","width":"104.26","height":"9.96","transform":["9.96","0.00","0.00","9.96","379.85","240.05"],"x":379.85,"y":240.05}
{"page":51,"change":"none","str":"are timing and location appropriate?","dir":"ltr","width":"159.47","height":"9.96","transform":["9.96","0.00","0.00","9.96","505.39","227.93"],"x":505.39,"y":227.93}
{"page":51,"change":"none","str":"Time transfer of care ","dir":"ltr","width":"94.96","height":"9.96","transform":["9.96","0.00","0.00","9.96","379.85","215.69"],"x":379.85,"y":215.69}
{"page":51,"change":"none","str":"does it start on time","dir":"ltr","width":"87.19","height":"9.96","transform":["9.96","0.00","0.00","9.96","481.03","215.69"],"x":481.03,"y":215.69}
{"page":51,"change":"none","str":"ow long does it take?","dir":"ltr","width":"93.91","height":"9.96","transform":["9.96","0.00","0.00","9.96","595.99","215.69"],"x":595.99,"y":215.69}
{"page":51,"change":"none","str":"Staff time invested i","dir":"ltr","width":"87.13","height":"9.96","transform":["9.96","0.00","0.00","9.96","379.85","203.57"],"x":379.85,"y":203.57}
{"page":51,"change":"none","str":"n transfer of care","dir":"ltr","width":"75.53","height":"9.96","transform":["9.96","0.00","0.00","9.96","467.11","203.57"],"x":467.11,"y":203.57}
{"page":51,"change":"none","str":"There is an agreed process for ","dir":"ltr","width":"138.95","height":"9.96","transform":["9.96","0.00","0.00","9.96","166.70","166.82"],"x":166.7,"y":166.82}
{"page":51,"change":"none","str":"transfers of care","dir":"ltr","width":"72.28","height":"9.96","transform":["9.96","0.00","0.00","9.96","166.70","153.62"],"x":166.7,"y":153.62}
{"page":51,"change":"none","str":"This includes an ","dir":"ltr","width":"74.85","height":"9.96","transform":["9.96","0.00","0.00","9.96","247.34","153.62"],"x":247.34,"y":153.62}
{"page":51,"change":"none","str":"agreed set of information to be ","dir":"ltr","width":"138.24","height":"9.96","transform":["9.96","0.00","0.00","9.96","166.70","140.30"],"x":166.7,"y":140.3}
{"page":51,"change":"none","str":"covered in transfers (minimum data ","dir":"ltr","width":"159.40","height":"9.96","transform":["9.96","0.00","0.00","9.96","166.70","127.10"],"x":166.7,"y":127.1}
{"page":51,"change":"none","str":"set). This is communicated in a ","dir":"ltr","width":"140.43","height":"9.96","transform":["9.96","0.00","0.00","9.96","166.70","113.90"],"x":166.7,"y":113.9}
{"page":51,"change":"none","str":"structured way, is action","dir":"ltr","width":"107.09","height":"9.96","transform":["9.96","0.00","0.00","9.96","166.70","100.70"],"x":166.7,"y":100.7}
{"page":51,"change":"none","str":"responsibility for actions and ","dir":"ltr","width":"128.77","height":"9.96","transform":["9.96","0.00","0.00","9.96","203.30","87.50"],"x":203.3,"y":87.504}
{"page":51,"change":"none","str":"supported by clear documentation.","dir":"ltr","width":"153.14","height":"9.96","transform":["9.96","0.00","0.00","9.96","166.70","74.16"],"x":166.7,"y":74.16}
{"page":51,"change":"none","str":"Length of time for transfer of care","dir":"ltr","width":"147.71","height":"9.96","transform":["9.96","0.00","0.00","9.96","379.85","161.30"],"x":379.85,"y":161.3}
{"page":51,"change":"none","str":"is appropriate information included in transfer of care? Is ","dir":"ltr","width":"254.92","height":"9.96","transform":["9.96","0.00","0.00","9.96","502.75","149.06"],"x":502.75,"y":149.06}
{"page":51,"change":"none","str":"anything missing or not required?","dir":"ltr","width":"147.71","height":"9.96","transform":["9.96","0.00","0.00","9.96","379.85","137.66"],"x":379.85,"y":137.66}
{"page":51,"change":"none","str":"Audit of transfer of care ","dir":"ltr","width":"106.61","height":"9.96","transform":["9.96","0.00","0.00","9.96","379.85","125.42"],"x":379.85,"y":125.42}
{"page":51,"change":"none","str":"is standard communication process followed each ","dir":"ltr","width":"223.25","height":"9.96","transform":["9.96","0.00","0.00","9.96","494.83","125.42"],"x":494.83,"y":125.42}
{"page":51,"change":"none","str":"Number of pieces of information in minimum data set which are communicated","dir":"ltr","width":"347.05","height":"9.96","transform":["9.96","0.00","0.00","9.96","379.85","113.18"],"x":379.85,"y":113.18}
{"page":51,"change":"none","str":"Number of pieces of documentation filed in patient notes (or wherever process says they ","dir":"ltr","width":"393.50","height":"9.96","transform":["9.96","0.00","0.00","9.96","379.85","101.06"],"x":379.85,"y":101.06}
{"page":51,"change":"none","str":"Number of outstanding actions not completed at end of shift.","dir":"ltr","width":"266.69","height":"9.96","transform":["9.96","0.00","0.00","9.96","379.85","77.40"],"x":379.85,"y":77.4}
{"page":52,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":52,"change":"none","str":"Example PDSA for testing a new handover template","dir":"ltr","width":"294.55","height":"12.00","transform":["12.00","0.00","0.00","12.00","126.02","524.50"],"x":126.02,"y":524.5}
{"page":52,"change":"none","str":"We plan to.... ","dir":"ltr","width":"56.22","height":"8.58","transform":["8.58","0.00","0.00","8.58","174.33","481.11"],"fontName":"Arial,Bold","x":174.329911705504,"y":481.11385157773}
{"page":52,"change":"none","str":"order to (aim)","dir":"ltr","width":"55.01","height":"8.58","transform":["8.58","0.00","0.00","8.58","240.05","481.11"],"x":240.04516476621995,"y":481.11385157773}
{"page":52,"change":"none","str":"Get staff input to ","dir":"ltr","width":"64.43","height":"8.58","transform":["8.58","0.00","0.00","8.58","193.50","470.89"],"x":193.497747914704,"y":470.89406268204993}
{"page":52,"change":"none","str":"improve the design of the ","dir":"ltr","width":"97.69","height":"8.58","transform":["8.58","0.00","0.00","8.58","257.94","470.89"],"x":257.93514522813996,"y":470.89406268204993}
{"page":52,"change":"none","str":"Use the new ISOBAR handover template for 1 bay of patients at afternoon shift handover.","dir":"ltr","width":"337.09","height":"8.58","transform":["8.58","0.00","0.00","8.58","195.14","440.20"],"x":195.140705304064,"y":440.20427995663}
{"page":52,"change":"none","str":"Feedback will be gathered during the test and via a flipchart in the nurses office.","dir":"ltr","width":"300.21","height":"8.58","transform":["8.58","0.00","0.00","8.58","195.14","429.98"],"x":195.140705304064,"y":429.98449106095}
{"page":52,"change":"none","str":"All staff will have copies of both the old and new handover templates for the chosen bay. ","dir":"ltr","width":"334.02","height":"8.58","transform":["8.58","0.00","0.00","8.58","195.14","399.33"],"x":195.140705304064,"y":399.32512437390994}
{"page":52,"change":"none","str":"Handover will be timed and number of patients used to calculate handover time per patient.","dir":"ltr","width":"342.25","height":"8.61","transform":["8.62","0.00","0.00","8.61","174.33","368.80"],"x":174.329911705504,"y":368.80262985957995}
{"page":52,"change":"none","str":"The following questions will be asked:","dir":"ltr","width":"142.34","height":"8.58","transform":["8.58","0.00","0.00","8.58","174.33","358.58"],"x":174.329911705504,"y":358.58284096389997}
{"page":52,"change":"none","str":"Suggestions to improve the template? Content, layout, design?","dir":"ltr","width":"236.40","height":"8.58","transform":["8.58","0.00","0.00","8.58","195.14","348.36"],"x":195.140705304064,"y":348.36305206822}
{"page":52,"change":"none","str":"Any other information needed during the shift","dir":"ltr","width":"169.40","height":"8.58","transform":["8.58","0.00","0.00","8.58","195.14","338.14"],"x":195.140705304064,"y":338.14326317253995}
{"page":52,"change":"none","str":"? Or not needed?","dir":"ltr","width":"65.89","height":"8.58","transform":["8.58","0.00","0.00","8.58","364.59","338.14"],"x":364.59046242076,"y":338.14326317253995}
{"page":52,"change":"none","str":"support would you like to help you use the template","dir":"ltr","width":"193.12","height":"8.58","transform":["8.58","0.00","0.00","8.58","217.04","327.92"],"x":217.04376131518,"y":327.92347427685996}
{"page":52,"change":"none","str":"What we did was..... (brief description of actions)","dir":"ltr","width":"197.85","height":"8.58","transform":["8.58","0.00","0.00","8.58","174.33","307.79"],"fontName":"Arial,Bold","x":174.329911705504,"y":307.78805686929996}
{"page":52,"change":"none","str":"Bay 3 was handed over by Staff Nurse KS to Staff Nurse YB.","dir":"ltr","width":"228.35","height":"8.58","transform":["8.58","0.00","0.00","8.58","195.14","297.57"],"x":195.140705304064,"y":297.56826797362}
{"page":52,"change":"none","str":"Time to handover Bay 3 ","dir":"ltr","width":"92.39","height":"8.58","transform":["8.58","0.00","0.00","8.58","195.14","287.35"],"x":195.140705304064,"y":287.34847907794}
{"page":52,"change":"none","str":"Addition of mobility and dietary needs is good","dir":"ltr","width":"170.88","height":"8.58","transform":["8.58","0.00","0.00","8.58","219.60","266.91"],"x":219.59947280974,"y":266.90890128658}
{"page":52,"change":"none","str":"Expected Date of Discharge is not required","dir":"ltr","width":"161.89","height":"8.58","transform":["8.58","0.00","0.00","8.58","219.60","256.69"],"x":219.59947280974,"y":256.6891123909}
{"page":52,"change":"none","str":"Include patient age as well as date of birth","dir":"ltr","width":"158.48","height":"8.61","transform":["8.62","0.00","0.00","8.61","219.60","246.42"],"x":219.59947280974,"y":246.42369943765}
{"page":52,"change":"none","str":"Increase font size for recommended actions column","dir":"ltr","width":"193.99","height":"8.58","transform":["8.58","0.00","0.00","8.58","219.60","236.20"],"x":219.59947280974,"y":236.20391054197}
{"page":52,"change":"none","str":"With suggested changes it will be better than current template","dir":"ltr","width":"231.79","height":"8.58","transform":["8.58","0.00","0.00","8.58","219.60","225.98"],"x":219.59947280974,"y":225.98412164628996}
{"page":52,"change":"none","str":"Guidelines for completing the template on the computer are ","dir":"ltr","width":"225.44","height":"8.58","transform":["8.58","0.00","0.00","8.58","219.60","215.77"],"x":219.59947280974,"y":215.765853552529}
{"page":52,"change":"none","str":"More practice using SBAR and ","dir":"ltr","width":"118.48","height":"8.58","transform":["8.58","0.00","0.00","8.58","219.60","205.73"],"x":219.59947280974,"y":205.728560887129}
{"page":52,"change":"none","str":"is required for it to feel comfortable","dir":"ltr","width":"130.68","height":"8.58","transform":["8.58","0.00","0.00","8.58","375.36","205.73"],"x":375.36096086212,"y":205.728560887129}
{"page":52,"change":"none","str":"Looking at what happened, what we learned from this was..... ( lessons learned)","dir":"ltr","width":"321.85","height":"8.58","transform":["8.58","0.00","0.00","8.58","174.33","185.43"],"fontName":"Arial,Bold","x":174.329911705504,"y":185.434980079993}
{"page":52,"change":"none","str":"Handover per patient using the new template is quicker than the current process. This may be because it ","dir":"ltr","width":"397.46","height":"8.58","transform":["8.58","0.00","0.00","8.58","195.14","175.22"],"x":195.140705304064,"y":175.215191184313}
{"page":52,"change":"none","str":"eliminates the need for questions until all information has been communicated about that patient.","dir":"ltr","width":"362.84","height":"8.58","transform":["8.58","0.00","0.00","8.58","195.14","165.00"],"x":195.140705304064,"y":164.995402288633}
{"page":52,"change":"none","str":"The template is popular, with some changes to be made.","dir":"ltr","width":"213.06","height":"8.58","transform":["8.58","0.00","0.00","8.58","195.14","154.78"],"x":195.140705304064,"y":154.775613392953}
{"page":52,"change":"none","str":"Although the team asked to remove expected date of discharge, Senior Sister wants to keep to encourage ","dir":"ltr","width":"400.60","height":"8.58","transform":["8.58","0.00","0.00","8.58","195.14","144.56"],"x":195.140705304064,"y":144.555824497273}
{"page":52,"change":"none","str":"What we plan to do next is .... (state next ","dir":"ltr","width":"166.71","height":"8.58","transform":["8.58","0.00","0.00","8.58","174.33","115.21"],"fontName":"Arial,Bold","x":174.329911705504,"y":115.21043066824899}
{"page":52,"change":"none","str":"Make agreed changes and test template again with night staff for 2 bays","dir":"ltr","width":"270.58","height":"8.58","transform":["8.58","0.00","0.00","8.58","195.14","104.99"],"x":195.140705304064,"y":104.99064177256899}
{"page":52,"change":"none","str":"Deliver more training and practice opportunities using SBAR with ","dir":"ltr","width":"245.83","height":"8.58","transform":["8.58","0.00","0.00","8.58","195.14","94.77"],"x":195.140705304064,"y":94.770852876889}
{"page":53,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":53,"change":"none","str":": Example PDSA for testing new transfer of care process","dir":"ltr","width":"321.97","height":"12.00","transform":["12.00","0.00","0.00","12.00","118.58","524.38"],"x":118.58,"y":524.38}
{"page":54,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":54,"change":"none","str":"Reproduced with permission of ","dir":"ltr","width":"154.05","height":"11.04","transform":["11.04","0.00","0.00","11.04","660.46","473.74"],"x":660.46,"y":473.74}
{"page":55,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":55,"change":"none","str":"Reproduced with permission of the ","dir":"ltr","width":"172.32","height":"11.04","transform":["11.04","0.00","0.00","11.04","561.07","521.02"],"x":561.07,"y":521.02}
{"page":55,"change":"none","str":"Heart of England NHS Foundation ","dir":"ltr","width":"169.95","height":"11.04","transform":["11.04","0.00","0.00","11.04","561.07","506.50"],"x":561.07,"y":506.5}
{"page":56,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":56,"change":"none","str":"HAND ME AN ","dir":"ltr","width":"72.99","height":"11.04","transform":["11.04","0.00","0.00","11.04","191.78","422.59"],"x":191.78,"y":422.59}
{"page":57,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":57,"change":"none","str":": Example of how a poster can be used to spread the word about ","dir":"ltr","width":"371.41","height":"12.00","transform":["12.00","0.00","0.00","12.00","119.18","524.50"],"x":119.18,"y":524.5}
{"page":58,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":58,"change":"none","str":"Appendix M: Summary of the six step improvement process for tran","dir":"ltr","width":"387.28","height":"12.00","transform":["12.00","0.00","0.00","12.00","53.88","524.50"],"x":53.88,"y":524.5}
{"page":58,"change":"none","str":"sfer of care","dir":"ltr","width":"64.70","height":"12.00","transform":["12.00","0.00","0.00","12.00","441.41","524.50"],"x":441.41,"y":524.5}
{"page":58,"change":"none","str":"Start out (page 10)","dir":"ltr","width":"92.86","height":"12.00","transform":["12.00","0.00","0.00","12.00","153.77","487.49"],"fontName":"ABCDEE+Calibri,Bold","x":153.77,"y":487.49}
{"page":58,"change":"none","str":"Refer to existing policies and procedures for transfers of care in your organisation","dir":"ltr","width":"394.25","height":"12.00","transform":["12.00","0.00","0.00","12.00","162.77","472.13"],"fontName":"ABCDEE+Calibri","x":162.77,"y":472.13}
{"page":58,"change":"none","str":"Observe, measure and process map the current communication process","dir":"ltr","width":"349.33","height":"12.00","transform":["12.00","0.00","0.00","12.00","162.77","456.77"],"fontName":"ABCDEE+Calibri","x":162.77,"y":456.77}
{"page":58,"change":"none","str":"What does good look like? Compare your policy and communication process with the good practice checklist. ","dir":"ltr","width":"535.99","height":"12.00","transform":["12.00","0.00","0.00","12.00","162.77","441.26"],"fontName":"ABCDEE+Calibri","x":162.77,"y":441.26}
{"page":58,"change":"none","str":"Define and scope (page 13)","dir":"ltr","width":"134.66","height":"12.00","transform":["12.00","0.00","0.00","12.00","153.77","415.30"],"fontName":"ABCDEE+Calibri,Bold","x":153.77,"y":415.3}
{"page":58,"change":"none","str":"Begin to answer the three questions of the model for improvement (Appendix C)","dir":"ltr","width":"391.66","height":"12.00","transform":["12.00","0.00","0.00","12.00","162.77","399.94"],"fontName":"ABCDEE+Calibri","x":162.77,"y":399.94}
{"page":58,"change":"none","str":"Set your project aim and scope and link this to your organisational big issues on a driver diagram (page 22)","dir":"ltr","width":"516.44","height":"12.00","transform":["12.00","0.00","0.00","12.00","162.77","384.58"],"fontName":"ABCDEE+Calibri","x":162.77,"y":384.58}
{"page":58,"change":"none","str":"Engage staff, patients, clients and residents using patient stories and evidence from useful resources","dir":"ltr","width":"485.92","height":"12.00","transform":["12.00","0.00","0.00","12.00","162.77","369.10"],"fontName":"ABCDEE+Calibri","x":162.77,"y":369.1}
{"page":58,"change":"none","str":"Choose your project team, include senior and frontline staff and patients/clients/residents","dir":"ltr","width":"438.58","height":"12.00","transform":["12.00","0.00","0.00","12.00","162.77","353.74"],"fontName":"ABCDEE+Calibri","x":162.77,"y":353.74}
{"page":58,"change":"none","str":"Document your project plan (Appendix F) and use the sustainaiblity guide to think about long term impact of change","dir":"ltr","width":"565.57","height":"12.00","transform":["12.00","0.00","0.00","12.00","162.77","338.38"],"fontName":"ABCDEE+Calibri","x":162.77,"y":338.38}
{"page":58,"change":"none","str":"Measure and understand (page 19)","dir":"ltr","width":"174.01","height":"12.00","transform":["12.00","0.00","0.00","12.00","153.77","322.27"],"fontName":"ABCDEE+Calibri,Bold","x":153.77,"y":322.27}
{"page":58,"change":"none","str":"Choose and define your outcomes and process measures, collect baseline data and display on run or SPC charts","dir":"ltr","width":"546.31","height":"12.00","transform":["12.00","0.00","0.00","12.00","162.77","306.91"],"fontName":"ABCDEE+Calibri","x":162.77,"y":306.91}
{"page":58,"change":"none","str":"Design and plan (page 24)","dir":"ltr","width":"128.54","height":"12.00","transform":["12.00","0.00","0.00","12.00","154.63","285.19"],"fontName":"ABCDEE+Calibri,Bold","x":154.63,"y":285.19}
{"page":58,"change":"none","str":"Design your standard transfer of care template and test using Plan Do Study Act (PDSA) cycles (Appendix I & J)","dir":"ltr","width":"533.18","height":"12.00","transform":["12.00","0.00","0.00","12.00","162.19","269.83"],"fontName":"ABCDEE+Calibri","x":162.19,"y":269.83}
{"page":58,"change":"none","str":"Use dot voting to define your minimum data set (Appendix G)","dir":"ltr","width":"299.48","height":"12.00","transform":["12.00","0.00","0.00","12.00","171.19","254.47"],"fontName":"ABCDEE+Calibri","x":171.19,"y":254.47}
{"page":58,"change":"none","str":"Select a standardised communication tool (e.g. SBAR) to organise your minimum data set","dir":"ltr","width":"432.31","height":"12.00","transform":["12.00","0.00","0.00","12.00","171.19","238.99"],"fontName":"ABCDEE+Calibri","x":171.19,"y":238.99}
{"page":58,"change":"none","str":"Generate and test other change ideas using the good practice checklist (Appendix B) and examples (Appendix K)","dir":"ltr","width":"543.49","height":"12.00","transform":["12.00","0.00","0.00","12.00","162.19","223.63"],"fontName":"ABCDEE+Calibri","x":162.19,"y":223.63}
{"page":58,"change":"none","str":"Choose process measures (Appendix H) collect data and display on run or SPC charts","dir":"ltr","width":"412.38","height":"12.00","transform":["12.00","0.00","0.00","12.00","162.19","208.27"],"fontName":"ABCDEE+Calibri","x":162.19,"y":208.27}
{"page":58,"change":"none","str":"Pilot and implement (page 34)","dir":"ltr","width":"150.50","height":"12.00","transform":["12.00","0.00","0.00","12.00","153.77","191.59"],"fontName":"ABCDEE+Calibri,Bold","x":153.77,"y":191.59}
{"page":58,"change":"none","str":"Document your new standardised transfer of care process","dir":"ltr","width":"281.12","height":"12.00","transform":["12.00","0.00","0.00","12.00","162.77","176.23"],"fontName":"ABCDEE+Calibri","x":162.77,"y":176.23}
{"page":58,"change":"none","str":"Plan your tests for implementation using PDSA cycles. Plan training, measurement, resources & stakeholder ","dir":"ltr","width":"527.51","height":"12.00","transform":["12.00","0.00","0.00","12.00","162.77","160.87"],"fontName":"ABCDEE+Calibri","x":162.77,"y":160.87}
{"page":58,"change":"none","str":"engagement. (Appendix I & J)","dir":"ltr","width":"142.97","height":"12.00","transform":["12.00","0.00","0.00","12.00","162.77","147.67"],"fontName":"ABCDEE+Calibri","x":162.77,"y":147.67}
{"page":58,"change":"none","str":"Consider 'flexible standardisation' and spread good practice to other teams, departments and organisations","dir":"ltr","width":"522.48","height":"12.00","transform":["12.00","0.00","0.00","12.00","162.77","132.17"],"fontName":"ABCDEE+Calibri","x":162.77,"y":132.17}
{"page":58,"change":"none","str":"Sustain and share (page 38)","dir":"ltr","width":"136.61","height":"12.00","transform":["12.00","0.00","0.00","12.00","153.24","113.33"],"fontName":"ABCDEE+Calibri,Bold","x":153.24,"y":113.33}
{"page":58,"change":"none","str":"Use the sustainability guide to ensure your changes will be sustained","dir":"ltr","width":"333.66","height":"12.00","transform":["12.00","0.00","0.00","12.00","161.64","97.97"],"fontName":"ABCDEE+Calibri","x":161.64,"y":97.968}
{"page":58,"change":"none","str":"Celebrate and spread your success through conferences, posters, journal articles etc. (Appendix L)","dir":"ltr","width":"474.72","height":"12.00","transform":["12.00","0.00","0.00","12.00","161.64","82.61"],"fontName":"ABCDEE+Calibri","x":161.64,"y":82.608}
{"page":59,"change":"none","str":"P a g e","dir":"ltr","width":"34.79","height":"11.04","transform":["11.04","0.00","0.00","11.04","391.49","30.84"],"x":391.49,"y":30.84}
{"page":59,"change":"none","str":"QI project, Patient Safety Leaders Programme, NHS Institute for Innovation and Improvement ","dir":"ltr","width":"420.61","height":"11.04","transform":["11.04","0.00","0.00","11.04","111.07","449.14"],"fontName":"ABCDEE+Calibri","x":111.07,"y":449.14}
{"page":59,"change":"none","str":"Staff at George Eliot Hospital NHS Trust (see acknowledgements on page 3) ","dir":"ltr","width":"340.80","height":"11.04","transform":["11.04","0.00","0.00","11.04","111.07","415.54"],"fontName":"ABCDEE+Calibri","x":111.07,"y":415.54}
{"page":59,"change":"none","str":"2012, First deisgn and testing phase","dir":"ltr","width":"162.75","height":"11.04","transform":["11.04","0.00","0.00","11.04","111.07","357.53"],"fontName":"ABCDEE+Calibri,Bold","x":111.07,"y":357.53}
{"page":59,"change":"none","str":"Focus Groups x 2, NHS Institute Associates, Fellows and Critical Friends","dir":"ltr","width":"316.01","height":"11.04","transform":["11.04","0.00","0.00","11.04","111.07","323.93"],"fontName":"ABCDEE+Calibri","x":111.07,"y":323.93}
{"page":59,"change":"none","str":"Second design and testing phase","dir":"ltr","width":"148.41","height":"11.04","transform":["11.04","0.00","0.00","11.04","167.35","157.46"],"fontName":"ABCDEE+Calibri,Bold","x":167.35,"y":157.46}
