Management, Training, Progress
Health Service Executive (HSE)
Since the onset of the first wave of Covid-19, the HSE has reviewed and developed its approach to testing, balancing rapid responses with longer term sustainability planning. CES designed a programme and worked with the HSE Community Testing team to improve the accessibility, efficiency and effectiveness of the service.
The initial wave of COVID-19 in March 2020 saw the establishment of a Test and Trace Service to quickly identify people with the disease to control and stop its spread. Following this initial wave, it was essential to critically review the Community Testing Service to ensure a service model that could deliver consistently reliable turnaround times, quicky respond to evolving COVID-19 testing demands and deal with any likely surge in community transmission. The CES team led by Ken Stanley, designed a programme of work to improve the efficiency and effectiveness of the service from initial patient referral for a COVID-19 test to the point of the swab test being delivered to the laboratory.
"Putting in place the necessary structures, methodology and frameworks to support and enable its delivery, the CES team members led the programme team to deliver with impact."
Noreen Curtin, Community Testing Lead, Covid Operations (HSE)
Understand the challenge
This ambitious programme involved establishing eight workstream teams, each with a clear remit to deliver improvement in specific areas. CES Team members, Grainne Ryan and Dave Cornwall, led teams and cross-functional groups from across the service including from HSE Community Healthcare Organisation Community Testing Teams, National Ambulance Service, Information Technology, Communications, Human Resources and General Practice.
Improvement through collaboration and change
Teams worked together to assess the current ‘as-is’ state to identify potential changes and opportunities. Working collaboratively, they imagined, designed and evaluated solutions to the challenges before developing a detailed plan to implement the resulting improvements.
Best practice from project management and implementation ensured that improvements were implemented into operating processes. Change management expertise was called upon to ensure that these improvements were subsequently embedded as standard practice.
Support progress
An overarching structure was established and tightly managed to monitor progress, to evaluate risks and opportunities, to review dependencies and to ensure strong communication across individual workstream teams. As Project Lead, Ken led and chaired programme meetings. Clear documentation and progress reports were shared to ensure that all stakeholders were kept informed and engaged
"The outcomes of this Service Improvement Programme were hugely impactful in terms of improving the accessibility, efficiency and effectiveness of the Covid-19 testing service."
Noreen Curtin, Community Testing Lead, Covid Operations (HSE)
The team delivered significant improvements to the overall COVID-19 Community Testing service. These included the establishment of Community Testing Centres and pop up testing fleets. Technology was used to improve processes and to manage appointments. A structured forum was established and meets regularly to actively manage testing demand, nationally, regionally and locally. A national, centralised operation reduced the administrative burden locally.
These changes helped the HSE deliver a safe, responsive and effective national Covid-19 testing service around Ireland. Improvements in process and efficiency supported the service to respond to large surges in demand, most especially during the third and fourth Covid waves where demand was exceptionally high. The high level of satisfaction reported by users is testimony to the effectiveness of the service.
The cross-functional team involving representatives of the National Community Testing Team, CES, the 9 CHO area Community Testing Leads, members of the National Ambulance Service and partners from the Defence Forces received a 2021 Health Excellence Award for ‘Operational Services Integration in a COVID Environment’.
Ken and Dave are members of the Community Operations Improvement Programme (COIP) team. This programme involves CES working with the HSE to build and implement change to improve community health services. CES works with HSE Community Operations and Community Health Organisations (CHOs) to further develop service improvement capacity across the country. Ken and Dave are experienced programme managers who have worked in the public and private sector.
