Table 1

Summary of PDSA cycles and Integrated Care Flash Curriculum of Flash Teaching Topics to improve Interdisciplinary Documentation of Aspirations.

PDSA CyclePERIODInterventionTeam DevelopmentIntegrated Care Flash Curriculum of Flash Teaching Topics
(Topics highlighted in bold relate to team development)
Cases with Individualised goals documentedCaseload

Enhanced Clinical Supervision (ECS)Cohesion
(Period of high team turnover)
Case based review0210

ECS+Flash Teaching (FT)Communication (Period of high team turnover)24 Flash Teaching Topics
Strength Based Approaches (Solution Focused Therapy, Mindfulness); Chronic Non-malignant Musculo-skeletal Pain; Allow Natural Death /DNACPR; Vitamin D Deficiency; Bereavement; Healthy Prescribing /Polypharmacy; Domestic Violence; Kindness; Recognising Dying; Managing Sleep Disorders in the Elderly; Occupational Therapy/ Empowered Living; Social Prescribing; Consent; Lower Urinary Tract Symptoms - Incontinence and Falls in Elderly People; Restoring ‘Pride and Joy’ and abandoning fear, in our work in the NHS; Time Management; Daily Self Care in our Teams; Schwarz Rounds; 'Hello my name is …"; Systemic Inflammatory Response Syndrome[SIRS] screening and evaluation for Red Flag Sepsis; Delirium; Subdural Haematoma in the elderly; Health Literacy; 'What your patient is thinking'

ECS+FT+ Handy Approach (HA)Role and Goal Clarity
(Period of high team turnover but onset of Team Consolidation (TC)
20 Flash Teaching Topics
Social Capital; Medicalising unhappiness; Type 2 Diabetes - Self-monitoring of blood glucose; Mini-Cog; Social Capital in our Teams; High INR on warfarin; Labels in Older People; Sexuality in the Older Person; How would you know that what we have offered has been useful?; Hungry, Angry, Late, Tired? So H.A.L.T./Pause and Self Care; Antibiotics for Uncomplicated UTI; End of Life Care. The neglected core business of medicine; Protecting resources, promoting value; Bridge over Diagnosis; Adverse Drug Reactions and hospital admissions; DoLS - Deprivation of Liberty Safeguards in the home setting; HUDDLES ‘Improvement in health care is 20% technical and 80% human’; Personal Health Budgets; Hydration and Dehydration; Living and Dying with Dementia: Advance Preparation.

ECS+FT+HATeam Primacy
+TC +
Team Stability
9 Flash Teaching Topics - all relate to Team Development
Medicine waste - enormous potential for savings in the NHS; Heart Failure; How can GPs and Community Health Services work more effectively together?; Medical Care for the Final Years of Life: “When you're 83, it's not going to be 20 years”; Loneliness; Staying with older people overnight in hospital; Social Deprivation and Costs of Care; Improving care in complex systems – ‘if quality isn't your job, then what is your job?’; Co-production. What does this mean?