Challenge, Opportunity and Gaps

Within the last 3 years a new senior leadership team including the CEO, Chief Nurse and Medical Director have come into post all with a shared vision around quality improvement.  This provides KCHFT with a unique opportunity to create the right context for QI by shifting away from quality assurance and towards continuous improvement.  This cultural shift is integral if the programme is to be a success – as denoted by failure to sustain and embed change programmes in the past not least because of size and geographical context of the organisation.   As part of this opportunity to roll out and embed QI we have undertaken a gap analysis which shows that we need to:

• Build improvement capacity through the reduction of low value work

• Enhance organisational capability around improvement through a training and dosing plan

• Show staff what makes this different from any other initiative

• Put the relevant infrastructure in place and embed this

• Invest in team leaders and influencers to champion QI

• Align the organisation around improvement priorities which is already underway with our new Quality Strategy, our quality goals and our aspiration for the QI programme already aligned.

What we will do:

To inspire and empower our workforce to lead improvement KCHFT wants to implement a large scale QI roll-out at significant pace.  Over the summer months we are going to engage our 5000 strong workforce in a communications and marketing campaign involving a key element of which will be an on & off line question to staff asking what we can stop doing in order to create time for QI, increase their Joy at Work and positively impact patient care.  We plan to build a new infrastructure to support improvement at scale including a dedicated ‘micro site ‘ accessible to all, a core ‘tool kit’ for use in large and small scale projects; and a hierarchy of in-house trained improvement experts, sponsors and coaches.  The Trust launch is planned for October 2018, the first tranche of coaches, the experts and sponsors should be trained at that point and the microsite tested and ready for use.  The funds will be used to launch the large QI programme of work including development of tools and resources, fund training for peer leaders through a QI Fundamentals package accessible to all staff aiming to undertake their own QI project, as well as a comprehensive communications & marketing campaign.

Benefits we hope to achieve:

• Happier more engaged workforce experiencing ‘Joy at Work’, we want our staff to remember why they were motivated to join the NHS: their desire to provide exemplary care for their patients and service users.  Metrics to evidence success include friends and family test results, staff survey responses, and number of staff engaged in projects with quantitatively measurable patient outcomes.  Improvement in retention of staff.

• We want to see improved patient satisfaction and will actively work towards including patients in our projects – our QI fundamentals package will be open to patients, carers and service users to experience.  There is a strong link between an engaged workforce and better patient outcomes.

• Implementation of our QI Strategy will unblock and stop some of the low value work that we do therefore increasing our value for money.

• Through this programme we hope to deliver the quadruple aim of enhancing patient experience, improving population health, improving staff experience at work and reducing costs by increasing value for money and efficiency.

• Increase links with our colleagues across the health economy.  We are working on QI across organisations by collaborating with colleagues in the acute and mental health trust.

 Benefits for the Q community

As a member of the Q community we would be happy to share our experiences and learning from implementing QI in the second largest community provider trust in England.  Our project is in line with the ethos of the Q community and we are also exploring links with regional partners within our STP, some of whom are also engaged within the Q community.  On an ongoing basis we would welcome the opportunity to share lessons, both virtually and face to face, from individual QI projects developed as a result of the implementation of this programme.