What is the challenge your project is going to address and how does it connect to the theme?

Engaging a diverse group of staff in continuous improvement and developing a problem-solving mentality is our challenge. Staff can be cynical to change, feeling like they have seen similar initiatives previously that have not delivered. This is exacerbated by current burnout. Being responsive is key to changing this. Ensuring every suggestion raised by staff is considered and outcomes are fed back builds trust in our Learning Health System (LHS) as people feel listened to. This promotes staff engagement and wellbeing.

Additionally, some managers feel cognitively overloaded because of the pace and volume of insights identified.

Previous interventions to collate insights and feed back improvements include spreadsheets, electronic whiteboards, emails and word of mouth. The barriers were: lack of visibility on progress and time taken/complexity of updating.

In our latest evaluation, staff across the hospital ranked using an app so insights are all in one place, as their 2nd highest priority.

What does your project aim to achieve?

The aim is to co-design and implement an app which puts what matters to diverse staff and patients at the centre of decisions, by making this visible and accessible. The long-term aim is to develop a culture of continuous improvement, by integrating improvement into daily work and making it easy and accessible. The LHS we are implementing is an adapted version of what was tested at the London Nightingale hospital: https://catalyst.nejm.org/doi/pdf/10.1056/CAT.20.0318

The project objectives are:

Insights in one place and visible to staff

Easy to feed back updates and improvements to staff and patients

All insights considered, and feedback provided rapidly

Reduced health inequalities through amplifying more diverse, junior staff and patient voices

Reduce cognitive overload, allowing staff to focus on improvement efforts not administration

Straightforward to measure progress of the LHS, e.g. number of insights

Easily-identified themes for improvement and triangulation as part of the wider Quality Management System

How will the project be delivered?

The basic bedside-learning-coordinator (BLC) application was developed via UCLPartners to support capturing, analysing and feeding back actions from insights. All services in the hospital are currently testing this and feeding back many improvement suggestions. Funding will enable this feedback to be actioned. This includes extensive design sessions with stakeholders including the learning coordinators, front-line staff, service leads, patient partners and executive management.

The overall impact will be measured through our periodic LHS evaluations. There will be additional app-specific surveys and feedback sessions to gauge ease, accessibility and usefulness through quantitative metrics like number of LHS emails, and qualitative information like whether staff get more updates/feedback.

To maximise value for money, application development costs will be benchmarked and optimised against industry standards.

Risks around application accessibility will be mitigated through have an ongoing dialogue with staff, embedding equality and diversity into the next iteration e.g. language translations, and comprehensive roll-out support.

How is your project going to share learning?

Chase Farm Hospital will be one of the first hospitals in the country to test the BLC app.  As active members of UCLPartner’s community of practice for bedside learning coordinators (a special interest group open to all Q members), we regularly share learning and practical resources with other organisations on this topic.

We share learning internally through blogs and lunch&learns. We have also linked with other healthcare organisations across the UK to share our experiences and learning on setting up the learning health system. This includes 1:1 meetings, being webinar panel members, hosting workshops and presenting at wider forums. We regularly also host site-visits, e.g. other Trusts and NHSE&I.

Project learning will be shared via the above. Our aim is to support other organisations to test and implement this app. To support, we plan to increase our suite of digital resources e.g. 360 videos speaking to our staff and a readiness quiz.