Identifying where to start

Once a process map has been produced, teams can identify numerous issues that need resolving to improve their service. This simple tool helps teams to arrange these issues into quick wins and to identify which ones needs more resources.

We asked teams to list their issues on post-it notes and place them in the correct quadrant as per Template.

This is what they come up with:

• Bradford

Easy/ Us	Hard / Us	Easy/ Them	Hard/ Them
Fistula criteria	E-learning	Fistula Criteria	Patient involvement
Fistula care plan			Cannulation language barrier
Feedback loop			Staff allocation
Scanner training

• Doncaster

Easy / Us	Hard/ Us	Easy/ Them	Hard/ Them
AVF/ AVG care plans for cannulation	Formal Training Packages	E-learning	Patient focus group
			Separate access info for every session

• Leeds

Easy/ Us	Hard/ Us			Hard/ Them
Documentation BRS tool	Staff e-learning			Patient champions
Fistula Huddle	Sonosite education			Patient ownership
Group meetings	Staff emotions			Surgical assessment
Education materials	Staff time			Radiological intervention
	Shared experience

• York

Easy/ Us	Hard/ Us	Easy/ Them	Hard/ Them
Use look, listen, feel	Do e-learning	Look, listen, feel assessment	Needling techniques
Patient feedback			E-learning
Needling techniques			Patient feedbak