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Effective learning is hard when change is happening at incredible pace. But now, more than ever, it feels important that we keep our focus on collaborative learning; adapting how we do this to fit the environment we’re working in. In the Q team, we’re exploring with members, partners and others how we can support services to capture and learn from the rapid innovation and improvement that is taking place at the moment.

In our second weeknotes blog last week, we mentioned some low-tech tools members have been using to support effective learning during COVID-19:

1. A ‘Weekly Learning Log’

Nathalie Delaney (who co-ordinates the COVID-19 response for West of England AHSN) shared how they’ve started a weekly learning log to look at how they are working differently and what they can take forward into the post-COVID world.

The log asks:

  • What have you done differently this week? (descriptive)
  • What did you learn? (reflective)
  • What has gone wrong? (“we don’t take ‘nothing’ for an answer, something always goes wrong)

2. Two daily ‘Take Fives’

Q member Suzette Woodward recommends – in her blog ‘Safety II and Covid-19’ – inviting everyone to “Take five minutes at the beginning and end of the day to value and recognise everyone’s contribution, say thank you, and importantly ask what did we learn today that we would want the next shift to know, what did we learn today that we will take forward tomorrow.”

“Involve everyone”, she adds, “the health care assistants, the porters, the receptionists in these precious 5 minutes”.

Some agile-orientated organisations make it easy for everyone to get things discussed in meetings,  whenever they spot a challenge or gap,  by holding a space for ‘processing tensions’ on the agenda. The agenda of tensions is created during the meeting. “I feel empowered to bring things to the table that could be improved upon”, one user explained.

3. Use of Twitter for ‘Working Out Loud’

‘The future is already here — it’s just not very evenly distributed’

– William Gibson

Q, and its many groups, have done a lot to understand and make real novel learning spaces.

You can emphatically see how these spaces for learning really come into their own during this pandemic. For example, Prof Trish Greenhalgh is unusual in using her Twitter account day-in-day-out in a hugely transparent and collaborative way. It  feels like a great illustration of ‘Working Out Loud’.

Prof Greenhalgh’s typical Twitter uses include:

  • Asking for feedback to help draft a new early warning score
  • Suggesting new research that’s needed
  • Offering a potential new source of Oximeters
  • Updating on what she’s doing (e.g. her latest rapid evidence reviews)
  • Taking a stand in favour of face covering
  • Celebrating when ‘incredible, overnight transformations’ take place prompted by COVID-19.

And that’s as well as her non-Twitter activity, such as her recent Q webinar where she shared insight on how to set up video consultations, fast.

Last year, Q members learned about ‘Working Out Loud’ during an online event with Helen Sanderson, which was followed up with a 6-week course. In her accompanying blog, Helen shared some key lessons for collaborating out loud.

 

4. ‘Adaptive Space’: an explanatory framework for cross-silo learning and innovation

A valuable framework for understanding how to create cross-silo spaces for learning together and testing new ideas is Prof Mary Uhl-Bien’s ‘Adaptive Spaces’ approach, partly based on tracking how successful changes took place in health care over 10 years.

The framework explains why the Adaptive Spaces created using tools like Liberating Structures, Communities of Practice, Co-labs, Design Thinking and Positive Deviance are so powerful in responding to new needs. Health care systems are set up primarily for delivery rather than creative adaption to ensure future viability. However, Sir Chris Ham recently blogged that “Adaptability and agility will be the key leadership attributes in the recovery phase from COVID-19.”

Mary’s first call with members of the Closing the gap: developing improvers for a complex world group was particularly popular. A second follow-up event got even deeper into the nitty-gritty of how to create ‘Adaptive Spaces’.

 

We recently discussed the insights and learning from using a Safety-II lens during COVID-19 in a rewarding Zoom with 130+ participants (organised with Q’s ‘Organisational Resilience and Safety-II’ group). Read a blog from Simon Gill summarising the insights from this session.

This conversation was one of many. The Q team is working with members and others to support health and care services to capture and learn from the rapid innovation and improvement that is taking place during this time. Keep an eye out for upcoming opportunities to collaborate, share and learn.

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