Everyone can be at the frontline of Quality Improvement
- Winning idea
What is the positive change that has emerged through new collaborations or partnerships during Covid-19 that your project is going to embed?
London Nightingale Hospital was a test bed for new ideas. One of MSEFT’s clinical facilitators volunteered at Nightingale and was key in developing the “Bedside learning coordinator” role, a success during the pandemic surge. Together with Prof Richard Bohmer and UCLP AHSN, they designed the learning system, helping the hospital remain safe while improving care. The coordinator introduces a cycle of learning, enabling staff to identify & resolve problems while delivering care. Through structured real-time observation and reporting for both local action and escalation to a leadership level, solutions are put in place to improve the environment within 72 hours. This empowers teams, creating a culture of engagement and involves a wider team of colleagues in improving care.
This concept is being adapted in Essex by the Clinical Directors for Improvement and rebranded to Frontline Learning Coordinator (FLC) while collaborating with Richard, UCLP and Royal Free who are also implementing the idea.
What does your project aim to achieve?
Our ambition is to embed the bedside learning coordinator across all of our acute hospital sites and eventually our community bed base, helping staff from all disciplines both clinical and non-clinical to take part. Moreover, we would like to go beyond clinical areas to see if similar roles can deliver improvement in areas such as corporate services, sterile services, patient and client customer care etc. This will be part of our initial experiment with this project.
Learning from the Nightingale and Royal Free experience, we aim to develop and adapt this role for our DGH/Acute Trust setting, creating a local learning system and then to share our learning and further develop this project/role for spread across the UK via a Learning community on Q and by publishing the findings, to spread the learning internationally.
How will the project be delivered?
We will use learning from our colleagues from UCLPartners and Richard Bohmer who led this work at Nightingale, and are helping our clinical leaders in Essex. We are building on our local knowledge, starting in the Emergency Department and will do PDSA cycles of improvement. We will endeavour to have FLCs on 3 acute sites in 3 different clinical areas – so scaling to OPD, Maternity Unit and ITU.
We plan on building support for the FLC role through local improvement champions through developing learning packages, whilst we recruit a clinical improvement fellow to support rollout, measurement metrics and an evaluation framework. This project is one of the key priorities for the improvement team this year and has already gained support of the executive team and our Clinical Strategy Board. We aim for the role to become a key feature of ward and departmental establishments in all areas.
How is your project going to share learning?
– At Q community level: This project is being trialled in Barts Health and the Royal Free London, who are working with staff from NHS Nightingale and UCLPartners. The Association of Groups’ are developing learning sets on improvement and FLC as well. We will work together to share our learning, measuring and tracking our progress through our improvement team. This will be through communities of practice – one per quarter.
– At local/regional level: Comms campaigns will be targeted to (1) engage nursing community, internally in the pilot, the overall MSE improvement strategy and Q community (2) disseminate learning to non-clinical areas (3) disseminate learning to other organisations e.g. community and mental health in MSE
– we expect all learning to be delivered via webinars and share our experience on social media and electronic publications. We feel that this model for bedside improvement is manageable and scalable within our busy COVID-19 world.
How you can contribute
- Collaborators especially when we are disseminating the learning.
|14 Mar 2021||Project set up for Q exchange learning funding|
|30 Jun 2021||Community of practice 1 - Q community|
|30 Jun 2021||Completion of pilots for clinical areas (impacted by wave 2)|
|30 Jun 2021||MSE Wide Implementation campaign - clinical|
|30 Sep 2021||Evaluation report complete|
|30 Sep 2021||Plan for development of learning for non clinical areas|
|31 Oct 2021||Community of Practice 2 - Q community|
|31 Jan 2022||Community of Practice 3 - Q community|
|31 Jan 2022||MSE Completion of sharing learning with Community and mental health|
|30 Apr 2022||Community of Practice 4 - Q community|
|30 Apr 2022||Completion of MSE Wide implementation|
4 Oct 2021
The project is going very well. We now have an FLC at two of our three sites and the feedback from staff is overwhelmingly positive. We are about to launch in one of the departments at our third site, building on the lessons we have learnt so far.
Staff report feeling empowered and the vast majority of issues raised are solved rapidly and at a local level.
See the attached project on a page report and feedback from staff in the departments.
We are now starting to do our formal evaluation and will feedback when we have this.
27 May 2021
We are pleased that the community of practice is now starting in conjunction with UCLP and we are also planning a special interest group within Q.
We have appointed a clinical lead for our Frontline Learning Coordinator (FLC) project and it is now live in 2 areas at 2 sites in our Trust (ED and maternity) and we are just completing our first 1 month review of outcomes.
We are starting to design a short eLearning package for future FLCs and hope to have this ready for sharing over the next few months.