How did you first get involved in improvement, and what has been your journey since then?
I trained as a doctor in Germany and had the opportunity to see different healthcare systems. Through that, I became very aware of how the system and the organisation I work in can either help me to provide the best care for my patients or make it more difficult. I became really interested in that and left clinical medicine to do an MSc at the London School of Hygiene. Since then my work has been helping health systems and organisations to improve. Still, I did my first improvement project without knowing much about QI methodology! I am a coach so breaking down big challenges into manageable steps is natural to me, but I think it was quite a revelation to learn there is a third way between measuring for science and measuring for performance.
Kindness and compassion are all of our business, particularly in the pressured environment we all work in.
What most inspires you professionally?
As a former clinician, I feel very passionate about providing the best environment for those who care, so all the staff that work in health and social care. If I need to go to the GP/hospital I want to know that the staff are as happy as they can be, we know this makes care safer as well! I find people inspiring who can embody that, looking after their team, having that broader perspective of what we are all here for. I practice mindfulness and have offered that as a skill to my colleagues in my current and last job, and I know it has really made a difference for some colleagues. Kindness and compassion are all of our business, particularly in the pressured environment we all work in.
Can you share a hard-won lesson you’ve learnt about what makes for a successful (or unsuccessful) improvement project?
People need to want to make a change (buy-in, in management speak) or rather you need to find the people that want the change – naturally not everyone, but there needs to be someone to start with. Also, develop the change with people in mind! I was recently involved in developing an improved community integrated care team to support elderly people living at home. When the prototype started, it became clear that some of the professionals who had been seconded into the team had not only not been involved in developing the idea, they also couldn’t see why they had been asked to do things differently in a certain way. In the end, we all sat together for one morning talking about why we are all here, what we are trying to do, and from finding this common purpose we developed how they would work together. Then the prototype started to have impact! That was a big lesson and looking at the turnover and workforce challenges, it’s a continual challenge.
What change could we make that would do most to embed continuous improvement in health and care?
I think there is a lot of resistance to trying out things in an iterative way – often people are looking for the perfect solution, with written up evidence, and with our linear way of project managing change and the short time horizons we work in, we often work as if change is a one-off thing. I think as a system we need more patients and realism instead of cynicism about what it actually takes to change.
I think there is a lot of resistance to trying out things in an iterative way – often people are looking for the perfect solution
Why did you join Q?
I was looking to connect with others who are on a journey to improve. Network and learn what others are doing I could learn from. I really appreciate opportunities to step out of my work routine and hear about what’s possible and reflect on how I might be able to apply that in my work.
What new connections have you made as a result of joining the Q community – and what have you learnt so far?
I think the reality of how to embed QI into organisations is complex, and I’ve found people in Q who are interested in exploring complexity as well people who are also interested in exploring how inner chance effects outer change – for example in the Mindfulness in Quality Improvement Special Interest Group that I recently helped set up. On a practical level, it has been super useful to learn about Liberating Structures! And I loved the session on sustainability at the last national event – we are starting to look at sustainability here at the Royal Free.
Can you tell us about something you’re currently working on that Q members might be able to get involved with?
We have formed a Special Interest Group of people interested in Mindfulness for Quality Improvement; not for health but to change organisations. We’re also running our first webinar at the beginning of February where we’ll be joined by mindfulness teacher, Karen Liebenguth, looking about how mindful leadership can change organisations which I am very much looking forward to – please join us for that.