Posted on: 10 May 2019
Leading and managing for Quality Improvement
In this month’s newsletter we’re focussing on the role of managers in supporting the development of QI projects within their services. If you’re not a manager though, do read on as you should get a clearer idea of what QI support you can expect from managers and from other leaders in your service.
Remember, one of the most important characteristics of QI is that it is a collaborative endeavour. A QI project requires a team to drive it forward. If you’re a manager please make sure any QI project team in your service doesn’t have just one (albeit enthusiastic) person, as it is destined to fail. If on the other hand you are in a non-management role and are interested in being involved in a QI project, do speak to your manager. You will need your manager to endorse your project, help to secure senior sponsorship, if that’s required, and to support you in assembling a team that is suitably equipped to deliver the project.
Wherever you are on your QI journey there are opportunities to become more involved, and it’s never too late! For those of you just starting out, why not register for Bitesize QI, a monthly half-day training session outlining the key components of the Model for Improvement. Details of the training are here.
Alternatively, for those happy to go it alone, the IHI modules QI101-QI105 of the excellent online training will give you what you need to get your project started. You also get certificates for completing each module- good for your CV!
QI spotted on Twitter this month
It’s always good to see Big I involvement in action. If you would like to learn more about how to involve patients and carers in your QI project we have a toolkit to help you. Available here
Quality Improvement (QI) management and leadership
In 2017, CNWL launched a quality improvement programme to encourage a culture of continuous improvement and make sure we focus on listening and learning.
Everyone in healthcare has two jobs when they come to work; to do their job and to improve it.
This is the essence of quality improvement.
We know that frontline staff, along with the people who use our services and their carers are the experts and best placed to be able to identify, test and drive what changes need to be made to improve quality. As such, much of CNWL’s approach to continuous improvement focusses on giving staff, patients and carers the skills, knowledge and freedom to bring about improvement. It is about working differently, not harder.
Your leadership is essential to drive improvement in healthcare quality and patient safety, and to lead change within your team/service.
To do this we have adopted a standardised approach to improvement using the Model for Improvement
What does this mean for you as a manager?
Establish a culture of continuous improvement in your team. Your team’s processes and procedures should support and be integrated with your quality improvement efforts. For example you may include discussing improvement ideas as part of your regular team meetings or hold workshops to establish your team’s quality improvement goals. You should always include service users and/or carers in your improvement projects.
Ask "What needs to be done?" rather than "What do you want?"
Ask "What can and should I do to make a difference?"
Ask “What matters to you?”
Ask “How will we know that we have been successful in making an improvement?”
Ask “How much do we want to improve and by when?”
Start small. Remember to keep your project aim small. Be curious about your systems and processes. Do not try and make improvements across a whole pathway or service. Although that may be the ultimate goal start improvement within your sphere of influence.
Collect and analyse data. Data collection and analysis lie at the heart of quality improvement. Your data will help you understand how well your systems work, identify potential areas for improvement, set measurable goals, and monitor the effectiveness of change. Improvement data can be simple. Jotted down on a piece of paper daily or hourly. Keep it visual; somewhere the entire team can see the effect of their improvement efforts. It’s important to collect baseline data before you begin a quality improvement project, commit to regular data collection, carefully analyse your results throughout the project, and make decisions based on your analysis.
Test small rapid cycles of change. These tests of change are known as Plan-Do-Study-Act cycles. Keep measuring to see if the change supports your improvement. Test a change with one patient, scale up to five patients, then twenty-five patients and keep going. Soon that small change could have a big impact.
Communicate your results. Quality improvement efforts should be transparent to your staff, service users and carers. Include the entire team and the people who use your services when planning and working on QI projects. Communicate your project needs, priorities, actions, and results to everyone; including patients and carers. When a project is successful, celebrate and acknowledge that success.
Commit to ongoing improvement. Quality improvement is an ongoing process. A high-functioning team will strive to continually improve and revisit the effectiveness of interventions. They will regularly get patient, carer and staff feedback and use it to inform their next improvement.
Training
There are a number of courses the Trust offer to support you and your colleagues with quality improvement. You can find out more about QI training here.
This includes how to start a QI project, how to contact your Divisional Clinical QI Lead and how to get support from a QI coach: http://qi.cnwl.nhs.uk . You can follow and share your improvement with us on twitter @QICNWL
Central QI programmes launched
This year, as we develop QI within CNWL, we have launched two central QI programmes on key areas for improvement. One of these programmes will look at Reducing Falls and the other will look at Violence Reduction.
These central QI programmes arenot only to achieve improvement but to build on our ability to spread and share QI learning across CNWL.
More information will be shared in this newsletter as these programmes and related QI projects develop.
If you would like to get involved, please contact your Divisional Clinical QI Lead.
New QI training: Improvement Science in Action (ISIA) Practicum
This year we are introducing a more intensive 12-month training programme. This training is open to all teams wishing to undertake a QI project. On this training course you will be supported to deliver your QI project through a structured learning practicum with the Institute for Healthcare Improvement (IHI).
We have 90 places for 30 projects (three team members from each project need to attend).
Project teams who are part of the practicum will be developed over the course of one year to learn together and share their successes. To support your project’s development you will also be allocated an Improvement Coach to coach your project team for the duration of the practicum.
Applications for this exciting training opportunity with the IHI will open in early June 2019 and will start in September with a virtual workshop and the first in-person days in October 2019. More news on the ISIA practicum and how you can apply with your project team will be available in the next newsletter.
In the meantime, if this sounds like something you and your team would be interested in please contact your Divisional Clinical QI Lead.
QI tip of the month: New Life QI timelines
A useful new addition to the Life QI has been added. This means you’re able to tell the history of changes to your project.
In any section you can view the timeline by clicking “I” and then “timeline”
Your QI stories
We have a new QI poster on our QI microsite
Quick to the wards
Northwick Park Psychiatry Liaison is one of the largest liaison psychiatry teams in the UK. They aim to see patients referred from the Emergency Dept. within one hour and medical wards within 24hrs. They’ve been running a QI project since August 2017 to improve response times.
Congratulations to the project team on their achievements.
If you have a QI poster or would like to share your learning in a video please get in touch via
cnw-tr.improvementsupport@nhs.net.
Life QI users and project update
Here’s an update on numbers of live projects on Life QI .
o We now have 270 active projects on Life QI
o 1050 staff have now registered on Life QI
o 33 QI projects have been completed on Life QI
You can see here that more of you have joined our Life QI community online:
