What is the challenge your project is going to address and how does it connect to your chosen theme?
“The UK’s health and social care system is, appropriately, one of our most treasured national assets. However, the sheer size and complexity of the system, as well as the pressures it faces from an ageing population and finite resources, mean that making improvements to health and care can be a significant challenge. Successful transformation must take into account the needs of all patients, carers, healthcare professionals and other staff. It requires consistent consideration of every element of the system, the way each element interacts, and the implications of these interactions for the system as a whole – that is, it requires a ‘systems’ approach.” This comment from the foreword of Engineering Better Care echoes a number of key global reports and advocates the need to describe a systems approach to design and continuous improvement, to build on current practice and bring renewed focus onpeople, systems, designand riskas vital perspectives in the improvement of complex systems.
What does your project aim to achieve?
Engineering Better Care sought to co-design a systems approach to health and care design and continuous improvement by bringing together improvers, healthcare providers and systems engineers in a series of workshops to define a common language for improvement. The resulting approach, based on a series of simple questions, formed the basis of a landmark report from the Royal Academy of Engineering, Royal College of Physicians and the Academy of Medical Sciences. This project aims to take this work further, co-designing a systems approach toolkit with health and care improvers, based on a prototype developed by the University of Cambridge. The main objective is to create a toolkit, owned by the improvement community, that shares ideas and good practice in taking a systems approach to improvement. This will be achieved by building an active, self-sustaining forum for discussion, learning and sharing where success is measured by interaction with the toolkit and stories of its use.
How will the project be delivered?
The core team will run a series of face-to-face workshops, site visits, online debates and forums to encourage improvers to share experiences of improvement. Particular attention will be paid to the improvement frameworks and approaches used and their accompanying activities and tools, the choices made in their deployment and the top tips for achieving success or avoiding failure. Q members will be asked to describe new tools, add references to existing tools, provide rationale for their tool choices and examples of their use. Stories will provide the basis of members’ narratives and a culture for sharing stories will be actively supported and encouraged as the primary mechanism for improving improvement. The core team have significant experience of facilitating improvement and working with Q members and the improvement community. The risk of poor engagement will be mitigated by identifying members from the early Engineering Better Care workshops to assist in building the community.
What and how is your project going to share learning throughout?
The project will deliver a toolkit, based on the Engineering Better Care prototype that provides guidance on a systems approach to improvement. This will be a dynamic resource ‘owned’ by the Q members, updated and choreographed by the core team. The project will also deliver a forum and events to encourage such ownership and a culture of storytelling to sustain the development of case studies which will add insight as to the use of systems tools and the value of using a systems approach. The toolkit and its associated guidance and resources will be made freely available to a Q members.
How you can contribute
- Ideas for resources to include in a systems toolkit
- Identification of existing improvement toolkits that work
- Discussion on the best means to encourage toolkit ownership in a busy world
- Identification of core team members
|14 Jan 2020||Initial workshop to roadtest toolkit|
|10 Feb 2020||Ongoing curation of toolkit content|
|11 Feb 2020||Online discussion session|
|25 Mar 2020||First site visit to those using the approach|
|29 Apr 2020||Second online discussion session|
|13 May 2020||Second workshop to test content (incorporating feedback)|
|17 Jun 2020||Second site visit to those using the approach|
|23 Jul 2020||Final online discussion session|
|9 Sep 2020||Final site visit|
29 May 2020
As promised, this is our update following the second workshop which took place on the 19th of May. Overall, the session was a success, with participants scoring the session just under 8 out of 10. However, we faced two significant challenges. Firstly, whilst there was a good level of attendance, there were a number of people who attended the second workshop who could not attend the first. To mitigate this, we made the recording of the first session available. We’re sure for those people, whilst the recording helped, it wasn’t the same as going through the experiences (all the exercises and discussions). So now we are reflecting on the wisdom of splitting the day-long session into these two workshops. The second challenge was around using virtual on-line documents. We set people an individual task, based on their own work project. In doing this, we couldn’t see well enough how people were using the online documents, and any challenges they were having. This meant that, for some individuals, the technology got in the way of some of the learning. We’ve learnt lessons from this, about how we remove technical challenges, either avoiding these in the design of the documents, or taking that challenge outside of the learning environment.
Despite these challenges, we now have a core group of people who are eager to apply the Improving Improvement approach so that we can continue to refine the online toolkit, which is available to everyone at: http://www.iitoolkit.com
There are platforms we’d like to re-iterate the importance of as we work more and more virtually: Zoom, the backbone of the workshop, iCloud.com, to create and share collaborative documents, and WhatsApp so that workshop facilitators can communicate during the session.
We are now finalising plans with the core cadre of people mentioned above regarding how we can support them and how they can support each other, and are in the process of putting the message out (for instance in the Special Interest Group) for people to contact us if they would like to be part of this core group, should people have both the capacity and the energy to get involved.
Thank you for your interest; we will keep updating you as we progress. If you would like to contact us, please message myself, Peter Dudgeon, via the Q community website.
21 Apr 2020
As with so many other cases, Improving Improvement has moved on-line for the foreseeable future. We planned our initial day-long workshop on the 2nd of April. Given this moved on-line, it was split into two virtual sessions, one on the 2nd, and the follow up to be help on the 19th of May. We were all surprised by how well the first session went – we used Zoom, as well as Apple’s online iCloud documents (like Google docs) to facilitate this. Of course, many people had to cancel because of COVID 19. Out of the 20 people initially booked, only 7 could join. However, we were able to record the session and make it available to those who were unwilling to attend. Our attendees gave helpful feedback (using google forms); the event scored a solid 8/10, with attendees looking forward to the second session, where we’ll get into the details of the toolkit. We are currently in the design process for the 19th of May, and will contract with people at that session, how we will mentor them through their project delivery going forward.
Any questions, please don’t hesitate to contact me via the Q members website or by email at: email@example.com
I’ll post another update after the 19th of May. All the best, Pete Dudgeon.