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Harnessing learning from staff experiences of QI during COVID-19

Harnessing learning from staff experiences of QI and innovation during the extraordinary pandemic response to understand why and how positive/negative outcomes were observed, to inform ongoing service reform and improvement.

Read comments 4 Project updates 1
  • Winning idea
  • 2020

Meet the team


  • HSE National Quality Improvement Team (Ireland)
  • Professor Eilish McAuliffe
  • UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems (UCD IRIS Centre)

What is the positive change that has emerged through new collaborations or partnerships during Covid-19 that your project is going to embed?

We have seen an extraordinary and unprecedented response from healthcare staff to ensure continued care delivery during the pandemic. There is much that we can learn from these experiences of rapid innovation, change and adaptation of services. We propose to collect and explore staff narratives of innovation and adaptation to make care delivery effective, efficient, and safe during the COVID-19 response. In partnership with multiple collaborators in the Irish health service and with patients, we will analyse narratives to extract learning on how QI training has been applied during the pandemic, to what extent this has been effective, and why. There is a unique opportunity to learn from these narratives to improve the quality of service changes throughout and beyond this pandemic by understanding how QI methods and non-technical skills have been utilised to promote rapid change, and to embed this learning in education, training and practical guides for staff.

What does your project aim to achieve?

Aim: To conduct an in-depth analysis of staff experiences of the extraordinary delivery of healthcare during the COVID-19 pandemic response in order to generate practical, applied learning for the continued reform and improvement of care delivery services and QI education. The beneficiaries will extend beyond the Irish health system as these experiences are similar across contexts and thus learning will be broadly generalisable.

a)  Understanding the organisational barriers/enablers during the pandemic and how these differed from the non-COVID situation.

b)  Identifying the key motivators and mechanisms that prompted staff to engage in joint problem-solving and extra-role behaviours to inform QI interventions.

c)  Assessing the extent to which QI training influenced adaptations and to what extent QI methods were used to improve/adapt services to reduce inequalities and promote access.

d) Translate this learning into practical advice/supports for QI practitioners and trainees.

e) Explore staff resilience and the sustainability of QI implementations/efforts

How will the project be delivered?

The Lead Applicant and UCD IRIS team are already collaborating closely with the Irish National Quality Improvement team on multiple projects related to QI training and evaluation. This work seeks to expand this collaborative to include HSE Values in Action, Human Resources and Communications teams to meet the shared goal of learning from innovative practice and experiences of team working and develop synergies to ensure knowledge is shared across the health service and more broadly across the entire Q Community. This team have a track record of delivering impactful research and have the requisite expertise and links to ensure findings inform decision-making, practice, and policy (e.g., to influence/inform planned interventions in staff engagement, to inform training programmes in QI ). Findings will be of international interest given the pivotal role staff have played in helping to contain the spread of COVID-19 whilst still delivering crucial services without overwhelming the health system.

How is your project going to share learning?

Our collaborative approach will ensure ongoing knowledge exchange with all stakeholders, including the Q Community, during the project.

Patients & public: We will prepare a plain English summary of the research and create infographics and webinars for dissemination jointly by the health service to the public, patients and the health service. We will seek to co-deliver research findings to ensure findings are presented in accessible and meaningful ways.

Practitioners & policymakers: We will communicate our findings during targeted webinars/recordings. We will produce practical guidance and strategies for QI practitioners to support them through our learning of what has been effective elsewhere and why. Short videos, infographics, summaries of the findings and key recommendations will be shared via our networks and via the Q Community.

Academic audiences: We will present the research findings at conferences and will also share findings via publications in international journals (BMJ Quality & Safety).

How you can contribute

  • We would benefit from the Q Community’s help in the call to share stories of innovation and practice changes during the COVID-19 response to extend our sample beyond the Irish context to achieve a broader understanding of the mechanisms and enablers of innovative quality improvement practice during the pandemic response.

Plan timeline

1 Feb 2021 Collation of staff narratives through interviews in Ireland
1 Apr 2021 Collaborative design of analytical strategy; on-going analysis for rapid feedback
1 Apr 2021 Extending data collection beyond Ireland (interviews to collect stories)
1 Jul 2021 Analysis of key enablers and mechanisms underlying (un)successful change
30 Nov 2021 Preparation of final outputs (infographics, reports, papers, videos)

Project updates

  • 16 Sep 2021

    Progress update:

    The support of the QExchange has been a fantastic opportunity to harness learning from effective QI during the pandemic response to inform learning and training materials. It has also been a means to understand the stories and experiences of those doing the incredibly challenging work of keeping the health service operational during this unprecedented time of strain and pressure.

    To date, we have collected narratives from the Irish health system and are working on outputs from this work.  We have shared findings as they have become available, for instance, through the Irish National Health Service QI TalkTime webinar series. Ms Zuneera Khurshid presented the findings to date based on emerging results: “Nothing like a crisis to get things done” Zuneera Khurshid. This presentation is available to view via YouTube at the link below. We are grateful to the HSE QPS team for this invitation to present this work.

    QITalktime No 5 “Nothing like a crisis to get things done” Zuneera Khurshid – YouTube

    Key challenges and next steps:

    One of the key challenges we have faced over recent months has been the cyber attack on the Irish health service. This has hampered our ability to continue data collection efforts. However, we are now in a position to re-commence data collection with the support and collaboration of health service partners. The QExchange funding has enabled the team to recruit a research assistant to support and extend this current work. We will be collecting further stories with a view to exploring the sustainability of QI efforts during COVID and to explore staff resilience in the face of on-going challenges in supporting quality and patient safety. We are hoping the QCommunity will support us in these efforts!

    Planned outputs:

    We are currently

    • Preparing an academic paper for publication based on this work
    • Designing infographics and short communications to highlight key learnings.
    • Compiling case study exemplars of QI during COVID for training and educational use.
    • The Irish health service will be promoting an infographic based on this work via social media during World Patient Safety Day on September 17th 2021.
    • Preparing short targeted reports to highlight some of the key themes evident in this work.

    We will continue to share outputs from this work as they are finalised.


  1. Hi Aoife

    There is a lot of capturing the learning activity happening in England, including a call from NHSEI. I wanted to ask you which staff are you proposing to focus on in this proposal, and which aspects of health and social care delivery? Its a massive topic area with wide variety such as innovative 'Proning team models'; psychological impact on ICU staff from dealing with relatives; liberating factors etc.

    I have been capturing the learning from implementation of a NICE rapid COVID-19 guidance and one of the areas related to barriers and enablers, which were sometimes the same issue!


    1. Hi Elizabeth,


      Thank you for your question and great to hear that there is interest in capturing this activity.

      We realise that there is a huge range of initiatives across the system demonstrating the extraordinary efforts of healthcare staff to respond to the pandemic. One of the factors we're been particularly interested in is multidisciplinary team working, and what brings people together to work in new collaborations with new partners in response to health system needs. I think this would be a key focus and which would produce valuable learning.


      I think the value of this QCommunity process is also being open to ideas from the network at this stage. We would be eager to hear from others in terms or key focus areas for this work!


      Thanks again, Elizabeth.


      Best wishes,


  2. Hi Aoife,

    Myself and my colleague Emma Adams (Health Transformation Partnership) are supporting the Health Foundation this year by fostering conversations between Q members and encouraging collaboration. We were Exchange applicants last year, so we’re hoping that our experience will help us to help others, as their ideas take shape.

    It's a great idea to take macro level learning from covid innovation and to share this widely. Whilst I've not yet come across other Q -Exchange ideas in this vein (I'll keep looking), I am aware that a large London Trust has completed its own analysis, and I'll seek to connect you, should they feel they're in a position to share and you feel this is helpful. I'll also keep an eye out for other collaboration/
    sharing opportunities.

    Maureen may also be aware that I've suggested, through comments on the idea: 'Walking our way through COVID: Using QITALKTIME Podcast series' that the suggested podcasts might be an effective channel to share learning from your idea. What do you think?

    Best of luck with your idea, Pete


    1. Hi Peter,

      Many thanks for your comment. It would be fantastic to linkup with the London Trust you mention to see if we can pool our learning. Yes, as you say, I think we can extract a lot of broad learning from the macro-level, specifically around the contexts and mechanisms can support effective outcomes.


      The QITalkTime podcast is a great idea and would be a great way to rapidly share learning!


      Thanks again for these suggestions, Peter.

      Best wishes,



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