'An amazing opportunity for networking, learning and development' ... Lucy James shares her experiences of completing a Quality Improvement (QI) Fellowship and her top ten QI tools and insights.
In September 2019, with very little knowledge of QI, I started a 12 month QI Fellowship with the Wessex branch of Health Education England.
I have been reflecting on my experiences on this journey so far and would like to share my top 10 QI tools and insights!
- Build relationships with your stakeholders and involve them in the project from the beginning. They might be people that could have an influence on your project, those that could contribute to it, and those that might be impacted upon by it. This might include your direct colleagues and patients, and those in other departments or organisations. Get them together (virtually perhaps!) to share perspectives and ideas, and create a diverse project team.
- Be curious and let this fuel meaningful conversations. Ask plenty of questions and listen attentively - this can prompt others to openly share their experiences and ideas. Find out what works well and what matters most to people. Appreciative Inquiry is a great way to inspire and create positive culture.
- Be aware of your own perspectives and assumptions. Try not to jump in with a solution. Take time to explore and seek out other people's ideas so that they are part of the change.
- Take time to explore and understand the intricacies of the aspect of your service or processes that you would like to improve. Process mapping is incredibly useful and can be combined with emotional mapping to capture patient and staff experience.
- Mapping the last 10 patients is an insightful exercise to see how things are currently working and to identify any variation, delays or duplication in a process.
- Be experimental. Try out changes on a small scale and use Plan-Do-Study-Act (PSDA) cycles to evaluate them and move forwards.
- Collect data that you can easily capture to measure improvements – this could relate to improvements in processes, improvements in outcomes, or perhaps balancing measures. A balancing measure could be an unintended consequence of an improvement somewhere else – look out for these!
- Consider sustainability and develop processes that do not rely on an individual person.
- Small changes can have a big impact… something simple that takes you 15 seconds, could save someone else 30 minutes, reducing frustration and increasing joy in work.
- Be flexible and adapt your approach or plans as things change!
My project broadly aimed to improve implementation of the Cerebral Palsy Integrated Pathway within our service, however the opportunity to try out QI tools, and the learning from experience based on what has worked, and not worked so well, has really helped me to learn about myself and others, and I hope will benefit our team moving forwards.
This has been an amazing opportunity for networking, learning and development, and I would really encourage APCP members to explore opportunities that might be available in their regions. Some NHS Trusts also have QI leads, QI teams, and forums, which can offer support and organisational networking.
If anyone would like to contact me to talk about QI or service development, please contact me ... I would love to hear from you! I am also on Twitter, @lucyjamesphysio.
Lucy James
Children’s Physiotherapist, University Hospitals Dorset NHS Foundation Trust