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Our weeknotes are based on what we’re hearing from improvers across the UK and Ireland, members and partners, and colleagues at the Health Foundation.

We try and publish these weekly and keep them relatively short. Let us know if you find them helpful, or have suggestions for improvements.


What’s going on in improvement?

While the immediate response to COVID-19 remains front of mind for many, I’ve been struck this week by the increased focus on recovery and beyond, and the critical role of improvement within that.

My week started with an inspiring call with our country partners – the lead organisations for improvement across the UK and Ireland – who are all developing plans to understand, embed and spread the positive changes that are surfacing through the pandemic. As is woven through the links below, paying attention to the conditions within which change is happening is critical. We’ll share more next week.

As we start to take a longer term view of the changes we are introducing, there’s more explicit focus on how far changes like video consultations should go, and the factors that need further work before we ‘lock things in’.

It’s easy perhaps to feel frustration with professional push back, but creating space to not just celebrate what’s working, but also stress-test plans and understand how they can improve, is a critical part of adoption.

I’m going to use editor’s privilege to bring in here a pre-COVID-19 blog series by Ruth Glassborow, which three people have mentioned to me this week. Some great insights on what lies behind resistance to change, which feels important as we enter the next stage of this long and profound period of upheaval.

Rapid learning and improvement

As we’ve seen and heard from Q members, QI projects have been hibernated and expertise has been redeployed elsewhere to support COVID-19 efforts. But when do we ‘bring back’ quality improvement? This article argues ASAP. As Karen Fechter pointed out on Twitter this week, while specific programmes may be paused, ideally improvement should be continuous and fully integrated

A fantastic zoom call today #connectingimprovers gave a window on the vibrancy of QI work underway across the UK. The call focused on rapidly converting face-to-face training courses to online options. I was struck by how people are making space for building improvement capability despite other pressures, with the additional challenge of adjusting to virtual at the same time. A write-up blog will follow soon.

This tweet from James Mountford was especially popular this week, sharing Scotland’s driver diagram to planning their COVID-19 response. (The content was of course interesting, but the driver diagram appreciation from QI Twitter colleagues was also noted!)

Video consultations

The Q team this week hosted a second zoom on maximising the use of video consultations in different settings (it’ll be on our YouTube channel soon!).

The latest learning from the Q insight project on this topic has just been shared, shining a light on some important factors that will need more attention if we’re to make the most of this change in services.

Prof. Trisha Greenhalgh, who presented at the first Q webinar on this topic, published a new BMJ paper: Guidance on the introduction and use of video consultations during COVID-19: important lessons from qualitative research. The paper is interesting, arguing that if remote video consultations are to be adopted at scale, implementation will need to allow for ‘a socio-technical approach, continually adjusting the technology and work processes to become better aligned’.

Staff health and wellbeing

This week has been Mental Health Awareness week, focusing on the theme of kindness. With everything that is going on, it feels particularly poignant right now.

The Royal College of Psychiatrists shared a number of videos to mark the week, with colleagues sharing why mental health is important and the kindness they have witnessed in their work.

AQuA have also published resources to support health and care professionals’ wellbeing.

Perhaps a less documented take is the impact of COVID-19 for those living with severe mental health problems. It’s a couple of weeks old, but Sky News shared this account of what it’s like working in the UK’s first mental health COVID-19 ward.

“But what’s unique about mental health units is most patients here don’t know why they are in hospital, don’t want to be in hospital and they don’t know why the doctors working with them are wearing personal protective equipment.”

From the article it sounds as though the staff at Hammersmith and Fulham mental health unit are adapting brilliantly. How might we better support those health care professionals adapting to COVID-19 in some of the most challenging environments?

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