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In the Royal College of Physicians Quality Improvement Programme (RCPQI) we champion patient experience and patient-centred care throughout our work programme. We aim to facilitate leadership by patients, carers and the public, and their involvement in service redesign and delivery.

Between 2014 and 2017 we cultivated our learning in this area as we ran our Future Hospital Programme (FHP), where patient involvement was mandated for all of the hospital teams involved. External evaluation of the FHP demonstrated that a patient-centred approach to improving services can help deliver better care by more motivated, engaged staff. You can read more about the approach, results and external evaluation in the link at the end of this summary.

The model we used for patient involvement saw local hospital patient representatives supported by a member of our RCP Patient and Carer Network (PCN). There was involvement in all stages of the programme from project design and data collection, through to governance and recruitment of further teams. The PCN representative was able to provide peer support to the local patient representative and provide a direct link between the RCP and local patients. This way of working, while not without its challenges, was well received by both the local and PCN representatives, the clinical teams and the programme staff at the RCP. We were able to record improved patient experience and outcomes at each of the hospitals we worked with.

Our PCN have identified QI as their key priority for future work but have highlighted a development need for a more detailed understanding of quality improvement both in its theory and application. Equipped with these skills, our PCN members would not only be empowered to more confidently support national initiatives, but they will also be better placed to provide peer support to local patient representatives in hospitals across the UK through their support of RCPQI.

Our PCN QI experts would be engaged in delivering sessions to multidisciplinary healthcare teams as part of our RCPQI Breakthrough collaboratives and would support the local patient representatives in the participating teams. They would help us to continue to shape the curriculum for medical trainees and could contribute to discussion with the Academies of Medical Royal Colleges on the same topic. Through participation in our RCPQI clinics, they would be able to offer guidance to those undertaking QI work (local and national) and ensure it is patient focused.  They would contribute to and have the opportunity to influence the direction of national policy, guidelines and assurance processes by having an informed voice on advisory groups.  The would ensure that patients remain at the centre of all the work that we do and that quality improvement methods are used to ensure that change results in improvement.

It is our vision that we will develop a QI patient faculty at the national level, for the benefit of local health and care teams.

To achieve this we think we need to work with our PCN to co-produce, test and refine a bespoke training package that addresses the theory and application of QI from a PPI perspective and also the peer support element specific to this group. We would do this through dedicated workshops with our PCN members, and by using the skills and expertise of our QI faculty in developing multimedia educational materials, taking learning from the existing packages and toolkits that address generic patient QI training.

Once we have an offering that we believe is fit for purpose, we would like to share it with others and would particularly promote it to those who could benefit from a similar approach such as national patient charities with an interest in quality improvement. Crohn’s and Colitis UK, for example, are interested in becoming one of our early adopters.

The work would be led by the RCPQI team, in collaboration with our patient involvement unit, and would be rolled out through our national networks. We would welcome and encourage participation in this work from any interested Q community members and are open to working in partnership with those developing work in related fields.

Further information about RCPQI: https://www.rcplondon.ac.uk/projects/rcp-quality-improvement-rcpqi

Further information about the Future Hospital Programme: https://www.rcplondon.ac.uk/projects/outputs/future-hospital-programme-delivering-future-hospital

You can read about the reflections of our PCN members on their involvement in QI, and their intentions to continue to do so here: https://www.rcplondon.ac.uk/projects/outputs/patient-and-carer-network-impact-report-2017

Further information about Crohn’s and Colitis UK: https://www.crohnsandcolitis.org.uk/

How you can contribute

  • Do you have a training package we could use as a starting point for our own work?
  • Do you have any ideas about how we can strengthen our plans?
  • Is this something you can help us with, we're always open to partnership design and delivery?

Further information

FHP final review summary_0 (2) (PDF, 483KB)

Reviewer feedback

This is a great project because…

It's good to see professional bodies setting the pace in terms of QI and patient and public involvement. The combination of existing work and national influence, this project can make a difference at scale. 

By the time of the event we encourage the project team to think more about…

How you will ensure this work is led by and with members of the patient network, and how you might link with the Q infrastructure. Consider further the approach to peer learning and collaboration within the network.

Comments

  1. Hi Aimee

    I am so glad that your project got shortlisted, I am also pleased that we have been shortlisted with a similar project. Our idea and planning has now come a long way and we are scheduling our training in the SW area supported by the SWAHSN. As part of the feedback we were given for Q Exchange we have been asked to ensure we work toward both spread and adoption and work together with similar projects. I would therefore like to offer you 2 places on our training programme for yourself and a patient reprentative to see exactly what we are delivering. If you'd like to take us up on this please email me via jonobroad@qipi.co.uk and I'll send you all of the paperwork and dates.

    Many thanks, Jono Broad

    1. Hi Jono, likewise - I was really pleased to see a few projects focused in this area make it through the shortlisting and I'll be delighted if any/all of of the projects make the final cut.

      Thank you so much for your generous offer, I would really value attending your training, I'm sure there is so much that we can learn from you. I imagine Lynne, our Patient and Carer Network member who will be representing us at the Q event would love to come along too and maybe it will give us a good opportunity to talk about the ways we may be able to support your plans to spread using our networks too. I'll email you shortly.

      Really appreciate it. Aimee

  2. Aimee I'm so happy to see PPI taking a central role in many QI projects. It is not familiar territory in ED, and certainly not with regards mental health in frequent attenders. I would be interested to see how we could collaborate and use your learning in this patient group. I look forward to meeting at the Q event in September (or hearing from you beforehand)!

    1. Deon, hi - and I'm sorry for the slow response to your comment! I completely agree with regard to the particular (extra) challenges faced in ED and mental health care. It would be great to talk with you about opportunities for collaboration at the Q event. Sadly I'm no longer able to attend in person but if you pop along to see us during the market place, you'll be greeted by the amazing Lynne from our Patient and Carer Network and Dr John Dean who will be able to explore some ideas with you. Perhaps you and I can catch up after the event too. Thanks for getting in touch, Aimee

  3. Hi Aimee

    I completely agree we all need to work together regardless of outcome. It seems that the overarching similarity is that we all want to upskill our PPI with QI skills enabling everyone to benefit. Id be very happy to work with everyone to help pull together a SIG and help wherever possible.

    Good luck with you bid. Jono Broad

  4. Hi all, I'm really keen that we find a way to pull all of these threads together too. I love Claire's idea of at the very least pulling us all together into a SIG. My plan in the next hour is to support as many of us that are making suggestions in space as possible. I'm certain that there's a way for us to come together irrespective of the funding decisions come September's conference. That would be a big win in itself I think wouldn't it. Best of luck to everyone bidding ... go team PPI :)

    1. Hi Aimee - yes, I think a SIG would be good a good idea.  We are aiming to develop resources that support the development of skills to promote involvement in healthcare improvement and/or research projects as our PPI community gets involved in both.  Like Aimee, I am supporting related projects - would you and perhaps Jono like to visit and support our idea? 'Co-creating capacity for meaningful involvement in healthcare research and improvement' ?

      many thanks and look forward to linking up regardless of outcome

      Susan

    2. Hi Aimee

      I completely agree we all need to work together regardless of outcome. It seems that the overarching similarity is that we all want to upskill our PPI with QI skills enabling everyone to benefit. Id be very happy to work with everyone to help pull together a SIG and help wherever possible.

      Good luck with you bid. Jono Broad

  5. Beyond this bid process it sounds like we have a special interest Q group around skills/empowerment for patients in QI that we could develop so that we can continue to learn from our different/possibly similar approaches.  I coordinate a small but growing network of 'Lay Improvers' as part of the Yorkshire & Humber Improvement Fellow scheme.  It's in its infancy but the key is linking and nurturing relationships between these lay fellows and the professionals in the scheme.  Not bidding around this topic this time but will follow with interest.

    1. I like the idea of a special interest group on this topic. It sounds like there would be definite value in it.

  6. I think this is a great idea, and believe that the more patients, carers and families included in QI, and well versed in it the better. In my organisation we also champion true involvement and have a lived experience panel who help us to shape our programmes, undertake specific delivery and also deliver programmes independently. I'd be really interested to see how your project progresses

  7. Hi Aimee

    Like Robin earlier I am also putting in a similar bid proposal to you. If you would like to look at it you can find it here

    https://q.health.org.uk/idea/patients-are-equal-partners-in-quality-improvement/

    I have asked if there is any way for projects like ours to work together and if you think this is something you would like to do please do connect with me. I wish you all the very best with your project adn hope to see you in September at the national event.

  8. Hi Aimee

    I'm working with Robin on our bid which gives a local flavour, similar to your bid. At the end of the day it is about a central and empowered patient voice... so seems like an ideal opp to work together potentially?

     

    What is the best way to connect?

    Love the similar threads..

     

    Sarah

  9. Hey Mirek, lovely to hear from you. Good question too. To begin with, we'd want to work with our patient and carer network (https://www.rcplondon.ac.uk/patient-and-carer-network). They are our natural constituency for this work initially I think, they have supported us through national level QI programmes (such as the Future Hospital Programme - FHP) and in doing so have also supported many local teams in their own QI initiatives, including through the provision of support to local patient representatives within those teams.

    You'll see in the PCN work plan for 2016-2020 that they have identified QI as a key interest and activity of theirs and following initial discussion are very keen to receive this sort of training package. Within our PCN we have members with vast experience of involvement in QI through to no experience at all, so a good range to test our product. Our PCN is open to others that may wish to join it and I can put anyone who is interested in touch with the team that support our PCN members.

    I think experience of involvement in QI will be important to those that join a national faculty and this training would be a part of that process, we would help those who are interested to gain that experience by exposing them to opportunities both at the national level but also through our links with local hospitals and regional networks.

    Do you think there is another / better way we could consider for this? I'm really very open to suggestions, this is not a nailed on process by any means.

    1. Sounds like a good way forward and I am sure that some AHSNs would have a number of experience QI members who may regard themselves as patients. We also host the service user network (SUN) https://www.hqip.org.uk/involving-patients/service-user-network/  and this may be a good source for faculty recruitment/consultation or even future collaboration. Happy to connect if useful.

  10. Hi Jem, we'd absolutely be keen to collaborate. I think it might be a good idea to try to get us all together on a call / Skype maybe what do you think? Thanks for your support, really appreciate it (still haven't worked out how to add my support to others but I'm working on it). Aimee

  11. Hi Aimee,

    Sounds like a great project. What are your thoughts around faculty recruitment/selection? Would the faculty members need to be experts in QI or have been involved in QI projects/work previously?

    BW

    Mirek

  12. Hi Aimee,

    We have just started thinking that we would like to develop a QI training package for patients.

    We haven't started yet so id be keen to link up to see if we can collaborate on this.

    Regards,

    Jem

    1. Jem, Hello!!! Long time no chat

      We have a bid around much the same thing. I am sure we can all pull something together - how fab would it be to work together, it was Q that first introduced us as eager community trust peeps

       

      let's catch up and develop this idea?

      Sarah

  13. This project sounds great. We are trying to expand our patient group and how they work with us at Yorkshire Ambulance Service and it comes at a good time when we are launching our QI Strategy so we are trying to link them in with that. Training for them would be great. We are working with the Improvement Academy and have built a training package for our QI Fellows in the Trust so this is something we could build on.

    1. Great, thanks Aimee. Looking forward to chatting.

    2. Hi Rebecca, thank you for your reply. We would be really keen to learn from the work you have undertaken to date and hopefully we can develop something that will be of use to you too. I will send through a friend request on here shortly and we can get the conversation started. Thanks again, Aimee

  14. This sounds like a great idea.    There are a couple of similar ideas /project - it would be good to make sure we all link up.

    https://q.health.org.uk/idea/putting-patients-and-families-in-the-driving-seat-of-quality-improvement/

    https://q.health.org.uk/idea/patients-are-equal-partners-in-quality-improvement/

    I think there are two sides to the coin on this one , giving patients and carers the skills, confidence and opportunities to be involved AND giving clinicians and professionals the skill, confidence and opportunities to work with patients and carers.  Very happy to work with you on this idea.

    1. Hello again Aimee - great to see your idea is attracting such valuable interest and support!  I wish you well with your funding application.  As we discussed earlier this month it would be great to link up as we hope to develop what will be complimentary and mutually supportive resources.  Robin it would be similarly good to link with your work too - as good PPI facing resources to enhance skills in QI would be great to include in our support and training toolkit.  I also agree with Claire Marsh (post towards the end of this feed) that a SIG around patient empowerment might be a useful addition to the specialist interest groups.

      bw

      Susan

    2. Hi Robin, I've just replied with a comment on your thread - thanks for sharing the link, I'd not spotted your bid previously. We'd be delighted to explore the ways we can work together and share learning etc. Good luck with your bid, we should definitely keep in touch. Aimee

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