Psychology 4 Improvement (P4I) – what’s it all about?

We know that W. Edwards Deming talked about a profound knowledge of human behaviour being key to any endeavour that is about changing things, making things better for staff and service user’s alike… but what does that actually mean?

It seems to me that the psychological environment within which improvement takes place is a key predictor to achieving aims

When I was trained as a quality improver, it struck me that the thinking at the time was that psychology of improvement was predominantly about motivation theory. Fundamentally important, but it struck me that there was more that psychology had to offer in support of improvement. The habits of an improver Health Foundation publication talks about improvers and uses words like creativity, influencing, learning, resilience; compounded by words like communication, coproduction, empathy, team-playing, optimism, tolerating uncertainty, comfortable with conflict and making connections. It seems to me that the psychological environment within which improvement takes place is a key predictor to achieving aims, and evidence bears this out. Concepts such as psychological safety, relationships, team dynamics, wellbeing, joy and whole lot more are the bedrock for great experiences of quality improvement.

So, are there ways we can support improvers to build this profound knowledge? This is what the Psychology 4 Improvement Q Exchange community are thinking about; aiming to build practical resources to be shared with the wider network, and to do this in a co-productive and inclusive way. This blog is a round-up of resources and ideas that were discussed at the first P4I Community of Practice get-together.

Our first Community of Practice meeting

At the first P4I Community of Practice Zoom call in April, replacing the planned get-together in Bristol, was attended by people from across the UK. We shared thoughts, ideas about what Psychology 4 Improvement means to the community and how we could take this work forward. Sessions included:

Kate Hilton: We were grateful to welcome Kate Hilton to the call, Kate authored the paper IHI Psychology of Change Framework and presented this framework whilst also hosting a discussion around its fundamental principles.

Anna Burhouse: Anna is a founder member of the Psychology 4 Improvement Q Exchange project and presented thoughts and research around psychology of improvement, plus hopes for the future of P4I work.

ABCi Team: ABCi are the P4I Q Exchange fund holding team. Benna Waites chaired this session where Matt Ploszajski presented an overview and update of the Q Exchange P4I work and Rachel Trask presented the Ψ4QI Framework that has been developed within Aneurin Bevan University Health Board.

Thinking Space: Benna Waites ran a Thinking Space session during the call, where all participants met each other and each had space to express their thoughts and experiences around psychology for improvement. This provided a rich seam of thoughts and ideas that will be used to shape the future of the P4I work.

It was great to catch-up with and meet new people who are passionate about developing this area of improvement theory and practice. As a result of the call, participants were surveyed in order to gain an initial view of the priorities and volunteers were invited to be part of the P4I Steering Group, who will lead the work.

If you are interested in contributing, taking part or listening in to what is happening around P4I please join the Psychology for Improvement Special Interest Group.

Or if you want to have a chat about P4I please contact Rachel Trask.

References

Hilton K, Anderson A. IHI Psychology of Change Framework to Advance and Sustain Improvement. Boston, Massachusetts: Institute for Healthcare Improvement; 2018. (Available at ihi.org)

Lucas B with Nacer H. The habits of an improver: Thinking about learning for improvement in health care. London, UK: Health Foundation: 2015. (available at health.org.uk)