Title: Acute Change Network
1Ensuring benefits through the transformation of
healthcare processes
- Acute Change Network
- 11th May 2007
2Welcome to the third Acute Change Network event!
Eileen Fairclough Head of Service Implementation
and Benefits NHS London, LPfIT
3Workshop agenda
- This morning
- Update from NHS London Programme for IT
- An overview of the BT Engagement Approach
- Acute Programme Governance NHS involvement
- Update on Acute Strategic Route Map
- KCW - Care Pathways Case Study
- This afternoon
- Early Engagement experience of St.Marys
- Discussion sessions on Early Engagement
- Event Methodology Approach
4Icebreaker
- Please introduce yourself to two people you have
not met before, including - Your role
- Your involvement on the London Programme
5NHS London Programme for IT - update
- Kevin Jarrold
- Chief Information Officer for NHS London and
- Programme Director for NHS London, LPfIT
-
6London Programme for IT Update
- CCN2 Update
- NPfIT Local Ownership Programme
- Progress with deployment
- Cerner in London
- Final thoughts
7CCN2 Progress
- Final issues resolved with BT
- London Programme Board approved it yesterday
- Final sign off scheduled for early next week
- Quick re-cap on contents of CCN2
8CCN2 Overview (1)
- Change to main sub-contractor
- Cerner via 3 releases to all acute trusts
- CSE Servelec RiO to Mental Health and PCTs via 4
releases - INPS to GPs via 3 releases
- Integration of above products via 2 releases
- BT have a clear commitment to release dates and
deployment dates
9CCN2 Overview (2)
- Revised service commencement date 31 October
2006 for 9 years (with option to extend by a
further year) - London configuration of Cerner
- Interim solutions NHS benefit in period up to
31st October 2006 - Map of Medicine now within scope
- Improved deployment model more support
- Citrix over Citrix now supported
- File print servers provided
- Spine disconnected working now included
- Training capacity increased
- Support for early adopters
- Social care solution is being worked up
- GP option to retain EMIS to be developed
10CCN2 Workload Implications
- The Challenge
- Move to three sub-contractors with integration
means increased need to - Elaborate on requirements
- Design the clinical and business process
- Configure the solution
- Test including usability
- Action Needed
- Increase NHS input into the process
- Support short term secondments
- Consider longer term approach to increase
stakeholder input
11CCN2 Communication
- Plan to be open and transparent about contents
both functional and financial - Contract schedules will be available to IT
Directors and Finance Directors - Chief Executive Forum being held next week with
Medical Directors and Opps Directors also invited - Open to further suggestions on what we need to do
to improve visibility
12National Programme for ITLocal Ownership
13Main Drivers for Change
- National Audit Office Report and Public Accounts
Committee Review - David Nicholson wants to see change
- Negative feedback from within the NHS about
delays to the realisation of benefits - Continuing bad press
- Office of Government Commerce review
- Changes to LSPs in North, Midlands and East meant
clusters needed to change
14National Audit OfficeReport
- Two and half years into the 10 year programme the
report recommends the procurement strategy for - Speed of contract closure
- Success in transfer of cost of delay to suppliers
- But raises concerns about
- Impact of delay in delivery from key suppliers
- NHS ownership and commitment to deployment
- Clinical engagement
15The NPfIT Forward Plan
- Development of the Forward Plan is being led by
the DOH with input from - NHS CFH
- Office of Government Commerce (OGC)
- Cabinet Office Delivery and Transformation Unit
- Have had a structured approach to evaluation of
current position - Interviewed circa 160 people
- Main findings
- Strong support for vision
- But changes to priorities not taken into account
- Lack of NHS leverage over contracts
- NHS supplier capacity to deliver change a key
issue - Supplier failure to understand federated nature
of NHS an issue - Delay undermining credibility
- Regional variation London NHS more positive.
16NPfIT Review - Context
- London
- 1 SHA
- 1 NHS CFH Cluster
- 1 LSP (Circa 1bn)
- North/Midlands/Eastern
- 6 SHAs
- 3 NHS CFH Clusters
- 1 LSP and 1 software supplier (circa 3bn)
- Southern
- 3 SHAs
- 1 NHS CFH Cluster
- 1 LSP (Circa 1bn)
17Transition Challenges
- London SHA has a new set of responsibilities to
discharge on delivery of the NPfIT - Will need to ensure that fit for purpose
governance arrangements exist - Will need to develop an organisational design and
operating model to discharge the responsibilities
18Governance
- A range of tasks have to be carried out by the
SHA in partnership with Trusts and PCTs - Process needs participation of all NHS
organisations in London - Two options
- Retain existing arrangements with modifications ?
- Develop new governance arrangements ?
19Existing Governance
- London NPfIT Programme Board with sub-groups for
- Mental Health
- Primary and Community
- Acute
- Recently introduced
- Already moving in direction of Local Ownership
- But may need to
- Strengthen the membership of the boards
- Have key decisions signed off by London-wide
chief execs groups - Place greater emphasis on reference groups in
which all organisations are invited to participate
20What benefit will local ownership bring to the
NHS in London
- Transfer of staff and resource to the SHA from
NHS CFH - Improved control over direction of travel
- Maximise benefit to the London NHS of the
contract with BT - Greater flexibility to respond to emerging
healthcare strategy for London
21Progress with Deployment
22Deployment Progress - Acute
- PACS delivered to 21 acute hospitals
- Homerton and Newham now supported
- 3 RO trusts tracking to plan
- 5 LC1 trusts progressing
- Additionals/Interim solutions live
- 3 of 6 theatre systems
- 2 interim Order Communication Systems
- 3 Pathology
- 3 Pharmacy stock control
23Deployment Progress - RiO
- Mental Health
- 5 of 10 now live
- 6th on schedule for July go live date
- PCTs
- 13 of 31 now live with RiO
- Including 8 with Child Health functionality
- Further 6 in pre-deployment phase
- Plus all 10 CHIA using PCTs now planning
migration to RiO
24Detailed Implementation Plan
- RiO sufficient demand to meet slots for
deployments and upgrades for MH and Community - Planning for PACS London-wide data store in
progress - Acute
- Slots for deployment in 2007/8 filled
- Slots to commence in 2007/8 for deployment in
2008/9 still to be identified
25Cerner in London (1)
- Cerner being deployed in Southern Cluster across
acute, mental health and community. - RO gaps identified and enhancements being
planned - LC1 gaps identified and resourced for London
configuration
26- RO improvements
- Expanded sub-specialty list
- Appointment types
- NACS file
- Request catalogue
- Pull specimen numbering
- PACS/RIS integration
- Data extract
- Cancelled ops report
- Children at risk alert
- OP follow up details
- 18 week wait
- LC1 improvements
- Millennium core
- PAS workflow
- Medical records
- Correspondence
- Clinical workflow
- Order enhancements
- Maternity
- AE workflow
- Theatres
- Data quality reports
27Cerner in London (2)
- RO
- Barnet and Chase Farm
- Queen Marys Sidcup
- Barts and the London.
- LC1
- Royal Free,
- Kingston,
- St Marys,
- St Georges,
- Queen Marys Roehampton
28Cerner in London (3)
- Keen to exploit the learning from Homerton and
Newham - Feedback from lessons learned in the South
- A better product
- Earlier engagement with Trusts
- More support from BT especially around business
transformation
29Final thoughts
- End of an era
- CCN2 signed off
- NHS CFH London Cluster is no more
- Start of a new one
- Greater local ownership
- New healthcare strategy being developed for
London - Potential for IT to become the enabler of change
and transformation
30BT Engagement Approach
- Paul White, Chief Executive London NHS Programme,
BT - Brendan Major, BT Client Engagement Director
- David Wilson, BT Health Director of Deployment
31BT has successfully delivered capability to 57 of
the 74 Trusts
71
21
10
13
8
14
5
3
1
1
RiO MH
RiO CH
PACS
RIS
CHIA
Theatres
eSAP
GP
Additionals
Acute PAS
32It is a Partnership
33Change Transformation from a CEO's perspective
- Strategic objectives
- Balancing priorities
- Synergies with other programmes
- Staff engagement, particularly clinicians
- Working with the culture
- Benefits driven
- Communication
34Early Engagement
35Where Does Client Engagement Fit?
- If the programme is to credibly present itself
as an IT enabled transformation initiative and
not simply an IT system deployment challenge we
need to engage with Trusts - Much earlier
- More inclusively
- More sensitively
36The Current Programme/Trust Deployment Model is
Indigestible
Deployment
Preparation
It feels like this
It needs to feel like this
37Acute Deployment
- David Wilson, BT Deployment
38Clinical Transformation - people
- Clinical Leadership
- Organisational Readiness
- Communication
- Skills and Capabilities
- 5. Performance Incentives
39Effective Transformation
Improve Patient Care Execution
Identify and Drive Improvements
Process Redesign
Benefits Realisation
Governance and Leadership
Optimise Systems Utilization
Change Management
Clinician Participation Adoption
Improve Adaptation/ Reduce Risk
Ensure Clear Accountability
40Panel discussion- over to you for your
?
Comments
Questions
Issues
41Refreshment break
42Acute Programme Governance NHS involvement
- Breid OBrien, Head of Deployment
- Eileen Fairclough, Head of Service Implementation
and Benefits - NHS London LPfIT
43Interim Acute Programme Board
- Chaired by Nancy Hallet, Chief Executive,
Homerton - Role to steer development and delivery of
London CRS Acute solution - Remit - Looking after the interests of the Acute
sector eg Cerner, PICIS, Anglia, PACS - Plan is to have broad representation from Acute
Trusts reflecting spread of geographies and range
of interests e.g. CE, Director level
(Operations), IT, Clinical - Membership being reviewed now Board is
established. - Input into Board is either from sub groups or
through Chief Executives through the Chair
44(No Transcript)
45Business and Benefits Realisation Advisory Group
Issues Lessons Learned Recommendations
Acute Change Network
R0/LC1 Change Leads Group
Directors of Operations Forum
Benefits Reviews
46 Acute Change Network
- Share lessons learned - Trusts support each
other in their management of change - Identify key issues that are shared, and
facilitate resolution through joint working - Assist the LPfIT and BT team to make informed
decisions about our support to you by receiving
feedback from the change network - Increase the NHSs overall capacity to manage
change by helping to embed business change
principles and skills within programmes/projects
47Acute Change Network
- Your suggestions for the change network
- Objectives of the change network
- Composition (do we have everyone here that needs
to be here?) - Preferences as to meetings full day/half
day/virtual network - Ways to share information
Please record your responses in the activity
worksheets provided, and hand these in at the end
48Your feedback from last time
- Change experience from R0 sites
- More on benefits
- More lessons learned from other deployments (we
havent done any yet) - More on timings of Cerner releases
- Feedback from Southern implementations
49Acute Deployment Strategy Update
- Trina Adams
- BT Acute Deployment Manager
-
50Impact on Release Bundle Map
Release LC0
Release LC1
Release LC2
Release LC3
Spine LC1
Spine LC2
Spine LC3
PAS R0
PAS LC1
PAS LC2
Clinicals R0
Clinicals LC1
Clinicals LC3
Clinicals LC2
Prescribing LC2
Prescribing LC3
Care Pathways LC1
Care Pathways LC2
Theatres R0
Theatres LC1
Theatres LC3
Theatres LC2
Maternity R0
Maternity LC2
Maternity LC3
Maternity LC1
AE R0
AE LC2
AE LC1
Information for Analysis R0
Information for Analysis LC1
Information for Analysis LC2
Information for Analysis LC3
- Introduction of the enhanced scope pulls LC2
functionality forward into the LC1 release in the
highlighted areas.
51Acute Deployment Strategic Updates
- LC1 Release
- Scope Enhancements
- Progress Report
- Impact on Acute Bundle Map
- LC2 Release
- Configuration Design Approach
- Timeline
52LC1 Enhancements Summary
53LC1 Progress Report
- LC1 Scope and Design (Complete)
- Finalised LC1 scope and design
- Validated standard reference data code sets
- LC1 Domain Delivery (Complete)
- Created London Cluster master domains for LC1
configuration - Established the basis for the London Cluster
SIMLAB (referred to as LCDC) - LC1 Millennium Configuration Build (85 Complete)
- Developed updated Design Decision Matrix
workbooks - Developed updated Data Collection Worksheets,
workflows - SIMLAB Testing (In progress)
- Develop test scripts (26/4/07)
- Conduct unit testing against documented scripts
(11/5/07) - Conduct integration testing against documented
test scripts (1/6/07) - LC1 Code Delivery (Scheduled 4/6/07)
54LC2 Project Timeline (tentative)
55Proposed LC2 Release Team Structure
13 Work streams Critical care Clinical
Documentation Clinical Planning RRR Maternity PAS
IFA Pharmacy stock Control Meds Admin Meds
Prescribing Theatres AE CORE General rule -
Ratio Consideration one, two, one 1 Cerner per
work stream 2 CFH per work stream 1 BT per work
stream Will vary per work stream CFH working
team engages through LCDC release CFH Steering
Committee involved in scheduled events, and does
not necessarily adhere to these rules.
Empowered Trust representatives that review
design through structured events. Consultants,
directorates, and department heads.
Used as a resource for the working team,
providing input through ad-hoc and informal
communication.
The day-to-day team made up of CfH,
Trusts, BT and Cerner. Responsible for driving
the design and configuration.
A set of workflows and solutions that are a
logically-related unit
56Kensington, Chelsea Westminster Care Community
Integrated Service Improvement Programme
- Jas Panesar
- Programme Director, KCWCC
-
-
57- Kensington, Chelsea Westminster Care Community
(KCWCC) - There are approximately 426,283 people registered
with the GPs in KCW, with 240,283 in Westminster
and 186,000 in Kensington and Chelsea - KCWCC is an NHS-led local partnership of NHS and
local authority services, working together to
improve patient care. - The Care Community is leading a number of
innovative change programmes to improve the
delivery of health and social care to the
residents of KCW - KCWCC consists of the following Organisations
- Central and NW London Mental Health NHS Trust
- Chelsea and Westminster Hospital Foundation NHS
Trust - Kensington and Chelsea Primary Care Trust
- Kensington and Chelsea Social Services
- London Ambulance Service
- Royal Brompton and Harefield Hospitals NHS Trust
- St Marys Hospital NHS Trust
- Westminster Primary Care Trust
- Westminster Social Services
58KCWCC Programme Organisation
KCWCC Programme Board Chair Lynda Hamlyn Chief
Executives of health social care agencies,
Multi-disciplinary Clinicians, KCWCC Programme
Director
Clinical Workstream Lead Dr Roger
Chinn Multi-disciplinary Clinicians
Programme Mangement Office
Information Governance Lead Dr Richard Rees IG
Leads, Caldicott Guardians
SAP Project Board SRO Marian Harrington PM, IT,
Clinicians, HR
NPfIT Delivery Board SRO Heather Lawrence
Clinical Lead, IT Leads
LTC COPD Project Board SRO Julian Nettel PM, IT,
Clinicians, HR
LTC Diabetes Project Board SRO Lynda Hamlyn PM,
IT, Clinicians, HR
EUC Project Board SRO Andrew Kenworthy PM, IT,
Clinicians, HR
59(No Transcript)
60- Re-designed patient pathways will underpin both
commissioning and provider modernisation agendas,
and improve the patient experience
61KCWCC Care Pathways Case Study
- Dr Roger Chinn, KCWCC Clinical Workstream
LeadConsultant Radiologist Chelsea
Westminster NHS Foundation Trust -
62Clinical Perspective - Why sign up?
- Patient pathways could be improved to accommodate
modern ways of delivering care - ISIP could allow process and workforce issues to
be addressed in advance - Should prevent delivery of IT solutions into
vacuum or relative void - Enable improvement in absence of delivery of IT
solutions - Partnerships may overcome silo working
- Primary
- Acute
- Social and housing services
- 4 Clinical imperatives derived
- Areas where some ground has already been made
- Areas that hold importance in central priorities
63Clinical Imperatives
- Long term Conditions
- Diabetes
- Chronic Obstructive Pulmonary Disease (COPD)
- Emergency Unscheduled Care
- Single Assessment Process for the Elderly
64Long term Conditions Diabetes Chronic
Obstructive Pulmonary Disease
- Develop KCWCC Integrated Care Pathways
- Protocols and guidelines
- More care in primary and community care settings
- Reduced avoidable hospital admissions
- Share all relevant information on these patients
between all Health Care Professionals patients - Increased Patient Empowerment
- Enables self management
- Develop joint approach to workforce development
65Emergency Unscheduled Care
- Establish a single out-of-hours access point
- for both patients and healthcare professionals
- Reduce AE walks-ins more appropriate to Primary
Care - Reduce Ambulance Service Category C calls that
result in AE attendance - Improve efficiency and quality of EUC OOH
services - Improve the information sharing by EUC services
during OOH period - Improve the skill mix of key care professional
groups that deliver EUC OOH services
66Single Assessment Process
- All vulnerable/at risk elderly people should
undergo a single assessment process - Electronic Process (eSAP) used in all the health
and social care organisations in KCWCC for SAP
assessments - Enhance information sharing
67The Roadmap to Improvement
- As Is Process Mapping Workshops
- Multi-disciplinary workshops
- Agreed process maps
- Develop issues logs
- Indicative opportunities for improvement
- To Be Process Workshop
- Inter-agency, multidisciplinary workshop
analysing As Is maps current issues - Define the To Be patient pathway
- Identify potential service improvement
opportunities - Service Improvement Opportunities Ratified
- Inter-agency project group consider practicality
impact of each service improvement opportunity - Confirm those to be recommended for
implementation - Benefits Planning
- Inter-agency project group identify the benefits
- Select those to be performance managed,
- Agree targets, timescales and metrics
- Business Case
- Developed by PMO, quality assured by inter-agency
project group - Ratified by Project Board
68Examples of Outputs
- Benefits Dependency Networks
- COPD Diabetes
- EUSC
- COPD
- Service Improvements
- Main Benefits
- Diabetes
- Service Improvements
- Main Benefits
- OOH
- Service Improvements
- Main Benefits
69KCW LTC Integrated Change Programme Benefits
Dependency Network
70EUSC Integrated Change Programme Benefits
Dependency Network v0.8
71COPD Service Improvements
72COPD Main Benefits
Patient Safety
Accessible responsive Care
Clinical Cost Effectiveness
Governance
Patient Focus
Projected financial values available from Jas
Panesar
73COPD Main Benefits
74Diabetes Service Improvements
75Diabetes Main Benefits
Patient Safety
Accessible responsive Care
Clinical Cost Effectiveness
Governance
Patient Focus
76Diabetes Main Benefits (Continued..)
77OOH Service Improvements
78OOH Main Benefits
Patient Safety
Accessible responsive Care
Clinical Cost Effectiveness
Governance
Patient Focus
79Challenges to the Process
- Care community is an artificial coalition
- All parties have many other key partnerships
- Ambivalent commitment from partners
- At institutional level
- At grass roots level
- Evolving priorities
- Payment by result and commissioning appeared
during the process - Meeting targets can cut across other developments
- Partnerships are meant to be something new
- Not just a meeting of organisations
- Shared priorities are sound principles
- In practice they are hard to generate
- Benefits derived may be distant to resource input
- Possibly outside care community
80My perspective
- This is not generally new work it is building on
current activity - but it is empowering stalled processes
- Powerful mechanism to draw the Care Community
towards alignment - ICP for COPD
- Urgent care networks
- Common themes apparent
- Information sharing in smart fashion ( IT
enabled?) - Workforce development
81High Level Lessons Learned
- Change Methodology
- ISIP is very resource intensive but as a
cross-agency structured planning tool - it does
work! - Programme Governance
- Top level Programme Board is a mandatory
pre-requisite for implementation of
cross-organisational change - Clinical Leadership
- Crucial multi-disciplinary group with delegated
authority to agree best practice and provide
clinical assurance to board - Information Governance
- Key to getting organisations to agree information
sharing protocols between each other and the
public - Resources
- Organisations lack capacity to manage
cross-agency programmes - Need dedicated CC-wide Programme Management
Office and budget - Timeline
- It takes years to develop cross-agency strategic
organisational objectives implement
cross-organisational change - IT Enabled Change
- Cannot implement Integrated Care Pathways without
IT to enable communication and coordination
across organisational boundaries - Benefits Led
- Integrated working requires development of
business cases to work together - Tracks the delivery of benefits.
- Lean Sigma
82Lunchtime!
83Early Engagement experience of St. Marys
- Rachel Barlow, General Manager for Clinical
Diagnostics - Elisabeth Hewson-Hesketh, Change Lead Mona
Illari, BT -
84Pre-Engagement - Background
2007
2008
Jan
Jan
Feb
Mar
Dec
Nov
Feb
Mar
Sep
Jul
Apr
Aug
May
Jun
Oct
Apr
May
12th
1st
4th
Early Engagement
E 1
To Be Processes Data Collection
E 2
Preparation
E 3
Training
Support
85GMs Overview of Early Engagement
- Communication
- Timing
- Content
- Planning and resource implications
- Timing
- As Is
- Event 1
- Data Collection Worksheets (DCWs)
86GMs Overview of Early Engagement
- Relationships
- Planning / Programme and Managers
- Work As Usual
- NHS Targets
- Objectives
- Planning Blight (existing systems)
87CommunicationsPlanningStakeholder and As is
Meetings
88Positives
- The outputs were completed on time
- An Excellent Trust Profile was created
- Trust wide Communications has been established
- Good relations have been established between Team
and Managers - Good relationship between Team and BT
- Programme is on schedule
- Early adopter test site for LC1
89 Time and Planning
90Discussion Session Early Engagement
Carol Day, Consultant NHS London LPfIT
91 Discussion session
- Following on from what you have heard today
- How can we get the best from the early engagement
approach? - What will this mean for the way we engage with
stakeholders during this early phase? - 20 minutes to discuss in the group and then 5
minutes each to present back -
92Event Based Methodology and Approach -
experience from Barnet and Chase Farm R0
- David Kretschmer, Project Manager, Barnet Chase
Farm Hospital -
93Barnet Overview
- Two main sites plus peripherals
- 450 beds, 2000 users
- Deploying R0 PAS, AE and elements of Theatres,
Maternity - Not utilising R0 Clinical Orders for Go Live
94Where We Are - Timeline
- Event 1 10th 13th Oct 2006
- Event 2 5th - 9th Feb 2007
- Event 3 2nd 4th May 2007
- Go Live Gate 10th July 07
- Deployment testing starts 09/05
- End user training starts 21/05
95Event 1
- Aims and objectives
- Initial demo of system
- Explanation of DCW process
- Setting of timelines for data collection
- Explanation of work to be done before next Event
- Lessons learned
- Open the Event with clear definition of purpose
and timescales - Re-iterate DCW timescales at opening and all
breakout sessions - Close each session with a wrap up
- Document raised issues for follow up prior to
next Event
96Event 2
- Aims and objectives
- Demo of partial build
- Setting of timescales for data collection
- Explanation of work to be done before next event
- Lessons learned
- Plan session in advance, work collaboratively to
agree content for demos and breakout sessions
dry runs were particularly useful - Re-iterate DCW timescales at opening and all
breakout sessions - Close each session with a wrap up
- Document raised issues for follow up prior to
next Event - Ensure issues raised during Event 1 are either
closed or are able to be demonstrated at Event 2
(circulate FAQ log prior to Event) - Plan sessions carefully parallel sessions may
limit attendance of key staff
97Event 3
- Aims and objectives
- Demonstration and sign off of final build
- Explanation of DCW final submission timescales
- Lessons learned
- Plan session in advance, work collaboratively to
agree content/scripts for demos and breakout
sessions dry runs were particularly useful.
This was a real success for our Event 3 - Present process overview at start of Event and
ensure clear delineation between data collection
and local process activities - Re-iterate DCW final submission timescales at
opening and all breakout sessions - Document raised issues for follow up, pay
attention to those that impact on process sign
off and training localisation - Ensure issues raised during Event 2 are either
closed or are able to be demonstrated at Event 3
(circulate FAQ log prior to Event) - Plan sessions carefully parallel sessions may
limit attendance of key staff - Ensure attendance from key hospital staff
98Overall Summary
- What Worked
- Pre-planning dry runs
- Collaborative working both to plan and run Events
- Logging of raised issues in a clear and easy to
track fashion - Trust ownership of process presentations and
queries (Event 3) - What Didnt
- Failure to be clear in presentation of data
collection timescales and amount of work required - Poor joint planning (this demonstrably improved
for latter Events) - Follow up of issues from Event to Event
(circulation of FAQ log before Events 2 and 3
mitigates) - Sense of ownership of demonstrations by vendor
constrained presentation - Presenters did not have an understanding of the
health environment or Trust processes
99Over to you for your
?
Comments
Questions
Issues
100Workshop Wrap-up
Carol Day, Consultant, NHS London LPfIT Eileen
Fairclough, Head of Service Implementation and
Benefits, NHS London LPfIT
101Workshop Wrap-up
- Further questions?
- Next workshop September 2007
- Feedback forms
102Thank you!