Q Exchange

Making space for ‘Place’: supporting system-wide improvement through digital spaces

We want to explore digital ways to connect improvement across Bradford (our Place) by creating digital 'spaces' that help us to overcome access barriers, develop our common approach & build engagement.

Read comments 50 Project updates 1

Winning idea
2022

Meet the team

Also:

Chris Hunt - Head of Kaizen Promotion Office, BDCT
Claire Reed - Kaizen Promotion Office manager, BDCT

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

Increasingly, we need to be able to take our place-based improvement efforts outside of the walls of our Trust and into a wider, more complex system involving primary care, social care and the voluntary sector. We find that different organisations have varying degrees of maturity and can tend to be ‘siloed’ in their own technologies and improvement methods. We therefore see two main challenges to address:

lack of common improvement approach
absence of an ‘accessible to all’ online space where everyone can view information and work together efficiently and collaboratively.

This project will seek to understand how we can use digital technology to foster cross-system collaboration, build a simple, common approach to improvement, share information & learnings and provide practical and timely support.

Our project connects strongly to the Q Exchange themes by exploring how improvement and digital can combine to support service change and system-wide collaboration.

What does your project aim to achieve?

We aim to provide a simple, easy way to improve patient journeys and experiences without borders, silos and organisational limits getting in the way. By creating digital ‘working’ space in partnership with Bradford South Community Partnership, Primary Care Network & Bevan House wellbeing Centre Bradford, we will focus on:

Improving MDT quality improvement across the local area
Improve communication and working relationships between Bevan House & MyWellbeing IAPT service

We will do this by:

Develop an online space to break down stigma/enigma around QI, particularly for teams with little knowledge or training
Develop introduction to improvement in a collaborative and easy way
Use that space to develop a common approach and deliver a targeted improvement project
Build learning around how to improve collaboratively and effectively using a digital platform
Identify the conditions for success which are needed to achieve cross-system improvement
Share this learning widely and consider how to spread at scale

How will the project be delivered?

The multi-agency project team in Bradford has chosen an area of high priority for improvement. Using the established Bradford District Care Trust Way improvement approach, we will ensure that the project has clear metrics and objectives to meet the above aims. The project team will consist of:

Clinical leadership
Improvement coaching from BDCT’s Kaizen Promotion Office
Project management support
Technical support from improvement software provider (Changeway)

We will work closely with stakeholders and people who use our services to ensure that we develop solutions that ‘work’ within our local context.

An outline plan is shown below:

Establish project and work closely with Changeway to develop an accessible digital platform
Develop easy to access powerful tools and support traditionally only available to QI teams
Deliver the improvement project working with multi-agency partners and evaluate impact
Capture learning through a sustainable platform and develop wider approach for cross-system improvement and collaboration

How is your project going to share learning?

This project should unlock considerable learning which is relevant to Q community members involved in cross-system improvement and who seek to learn how digital can enhance this. We will design a project that is focused and deliverable, through which we can develop principles which apply for all cross-system improvement programmes. We will be transparent about our approach, project progress and the challenges and opportunities we uncover.

We will:

Share our project design through Q Community networks e.g. Special Interest Groups.
Share ‘snapshots’ of our learning e.g. QI Community on Twitter
Contribute to local forums for improvement and system working
Hold open online forums periodically to demonstrate the digital solutions and the advantages we find

How you can contribute

Give us some feedback on the idea
Tell us where other local systems are exploring ways to collaborate together
Point us to any resources that might support our work
Suggest ways we could measure impact and gather insight

Plan timeline

5 Sep 2022	Project set-up: team, plan, governance & evaluation
26 Sep 2022	Develop digital platform and Improvement learning materials
7 Nov 2022	Delivery of improvement projects with partners using platform (6 months)
8 Nov 2022	Ongoing capture of learning & digital development (6 months)
8 May 2023	Evaluation and plan for wider spread across local area

Project updates

1 Dec 2023

Our project, “Making Space for Place,” aims to improve connectivity across Bradford and Craven by fostering cross-system collaboration to share resources for Quality Improvement. The goal is to break down siloed working among individual Trusts and engage the wider system, including primary care, social care, and the voluntary sector, in the pursuit of improving patient pathways and addressing health inequalities.

We initially planned to use Changeway, a QI cloud software, but due to its administration issues, we pivoted to create our own Improve as One QI Hub. This hub will serve as a catalyst for Bradford’s Improve as One strategy coming under the Act as One programme and will incorporate the NHS Impact national strategy to work towards finding a singular improvement language across Place.

The hub will cater to various needs, from the shop floor to the transformational, facilitating collaboration and providing coaching for QI journeys. It will connect colleagues, empower staff to use QI methodologies, and reduce barriers by linking individuals with specialist knowledge across Place by offering 30-minute Time to Think sessions with a network of experts.

The IAO QI Hub will support sharing learning and scaling best practices across Place and beyond. Ideally focussing on Primary Care Networks and the Charity and Voluntary sector, the hub will support and encourage these organisations to upload case studies and share their knowledge across organisations.

Challenges have included the issues procuring Changeway for this project and the need to reconfigure the output. Organising governance and resources among the partner organisations has been challenging, but the hub aims to streamline this going forward as working across Place with Improve as One expands.

The project has primarily been promoted to those directly involved but will soon engage the wider system. The output will be completed by March 2024, with a phased launch. Sustainability is a key concern; discussions are ongoing to secure funding for further advancement with the IAO QI Hub however with the network of experts running Time to Think sessions the QI Hub will be sustainable and offer great benefit for the foreseeable future.

We are looking forward to launching the IAO QI hub in the new year and we are confident this can become a notable example of working together across Place beyond organisational boundaries. We invite the community to share their stories of working across their own Place beyond individual Trusts and how they have engaged Primary Care and VCS with improvement work. What have been the successes and challenges with this?

Comments

Farhan 31 May 2022

This is a great idea and please to see the localized and partnership ethos behind this so impact and can be seen and felt on the ground by those will access services here. Agree with many of the comments made by colleagues from across the place and system above. Can see this being a good vehicle for testing new approaches on a continual basis and tackling difficult health challenges with specific communities of interest. Where the opportunity exists, it would be good to consider if a citizens QI programme can be developed as an extension to this work (if it offers value)
Tracy Martin 25 May 2022

Great idea - look forward to seeing how this develops. Good luck!
Laura Polkinghorne 23 May 2022

This is a great idea and has the potential to support MDT improvements nationally ensuring improvements are aligned and collaborative. Good luck!
sasha karakusevic 19 May 2022

Really interesting. We are doing a lot of work on how to increase physical activity and connection at a place level is clearly essential. Local solutions that can interface with other systems could be really important so this could work well.
1. Sue Lacey Bryant 20 May 2022
  
  Really like the focus of this work. As you identify the conditions for success which are needed to achieve cross-system improvement, please please share what doesn't work!
Claire Bevan 18 May 2022

This is so needed and will be such a beneficial project - really interested to receive updates on your journey and learning - good luck
1. Richard Jenkinson 18 May 2022
  
  Thanks, Claire! Agree. (And please feel free to vote for us! ;-) )
Grainne Eloi 18 May 2022

What a fabulous idea, totally agree this could be a game changer!
Elizabeth Bradbury 18 May 2022

I like this ideas, its innovative and definitely aligns to the current health and care digital transformation agenda. Pleased to see WYATT mentioned as there is already a strong learn and share ethos there.

Wondered if experts by experience who are involved in your work will be able to access some of the material, contribute and indeed lead elements?

This also sounds a great way to convene, problem solve and connect with people outside your footprint, and to create the networks and forums for people to sustain their energy and commitment to continuous QI.

Understand this is a phased innovation and you cant do everything at once...wondered if you'd considered how this could support the QI element of professional revalidation?

Good luck!
1. Chris Hunt 18 May 2022
  
  Thanks for you comments and support Elizabeth, indeed this has so much potential and this is the beauty of such a platform that we can collaborate without the usual/traditional restrictions. So many other areas we could look at too like your idea of revalidation. Early stages but keen to explore all possibilities.
Kate Mackenzie 18 May 2022

This project is a great exploration to removing barriers to system wide improvement. By creating the digital learning and collaborating space with shared ownership rather than a more traditional experience of the biggest partner rolling out what they use internally will really foster the spirit of collaboration.
1. Chris Hunt 18 May 2022
  
  Absolutely Kate, it is really important for us that this is a tool to break down barriers and obstacles for people so that the focus is on collaboration and improving, that is what is important. Thank you for your support.
Liz Kay 17 May 2022

This project has inspiration attached to it; to facilitate the collaboration of those directly involved with continuous improvement within a digital space is a fantastic idea. A means of maximising collaborating on our use of resources is something we should embrace. System wide improvement - sharing the language - sharing the philosophies - growing and learning together- I love it!
1. Chris Hunt 18 May 2022
  
  Thanks for your support Liz, we think there is huge potential and always great to get support from all professions across the sector, pharmacy being a huge area of potential and ripe for this type of platform.
Joanne Beckmann 14 May 2022

Hi 👋🏻 Chios, Emma, Richard, Chris, love the idea and it’s very similar to mine for East London, would love to collaborate!
1. Chris Hunt 18 May 2022
  
  Hi Joanne, would be great to connect and collaborate.
2. Chioma Obasi 16 May 2022
  
  Thanks a mil Joanne for the shout out.
  
  We’ve reached out to our Place & System partners and it has been inspiring to hear that there’s an appreciation of the value of this work and the benefits to be gained through coproduction, partnership working and maximising the resources we’ve got to address the inequalities that exist within the communities we serve.
  
  I agree there are similarities with your project Embedding community participation in meaningful transformation for improving population health&well-being | Q Community. We are keen to collaborate with others to share our learning and build on knowledge to be gained.
3. Joanne Beckmann 14 May 2022
  
  *apols Chioma
Ash Alom 12 May 2022

This is brilliant and a real pleasure to support - this will generate real change and improvements
1. Chioma Obasi 16 May 2022
  
  Thanks Ash for the feedback, we are excited about our idea and hopeful we go all the way
Mark Wilson 12 May 2022

This sounds like a great project and will really help to deliver visibility across the system. Also really like the idea of having a standard improvement approach as it really does cut down on variation, improves efficiency and helps to implement lasting improvement.
1. Richard Jenkinson 13 May 2022
  
  Thanks for the support, Mark. Glad you've picked up that our focus is both on how the work is done (common improvement methods) and where it is done (a digital platform that allows highly effective collaboration, sharing and learning).
Chris Jackson 12 May 2022

Great idea and i'd be really interested in your learning,impact, and results.
1. Chioma Obasi 16 May 2022
  
  Thanks for the support Chris. Hopefully you can help us think about our impact evaluation plan especially as we plan to share our learning widely.
Keir Shillaker 12 May 2022

This sounds like a really exciting concept, and something to learn from across our wider West Yorkshire Health and Care Partnership, particularly in improving joint working on Community Mental Health Transformation between our NHS Trusts, Primary Care and VCSE colleagues
1. Chris Hunt 18 May 2022
  
  Thanks for your support Keir, we see the potential for this at place, system, north, south, infinity and beyond! That is the beauty of a digital platform, boundaries become a thing of the past
John Hartley 12 May 2022

Brilliant idea, supportive of so many things we are trying to achieve in Bd&C through our shared strategy and building on our string partnership working.

Will be fantastic alongside our QI work at a system level
1. Richard Jenkinson 13 May 2022
  
  Thanks for the support, John - and agree that in order for a shared strategy and a partnership mentality to be effective, organisations across the system need both common, intuitive ways of working and an effective (digital) 'place' to do the work.
Therese Patten 12 May 2022

The NHS and Care sector have never been more challenged as we come out of the ravages of COVID-19 which has impacted disproportionately on our most vulnerable - our only way forward is through partnership and using our resources to maximum effect this project is a brilliant idea of how we can come together and do this.....it is a must do!!
1. Richard Jenkinson 12 May 2022
  
  Having the support of the Trust's CEO will undoubtedly give the project a real boost, Therese - thank you! It will help ensure it delivers valuable outcomes and learnings.
2. Chris Hunt 12 May 2022
  
  Thanks Therese, you are so right. Covid, if nothing else has shown us we are better and stronger together, and anything that helps us to collaborate and improve together is a winner in my eyes. Thank you for the support.
James Drury 11 May 2022

The timing of this project is spot on.

Two years ago we would have struggled to blend on-line and in-person collaboration, but we've all learnt so much in the last few years about how to incorporate technology in our day to day interactions, which means that user acceptance should now be much faster.

Would be great to share learning from this project about incorporating co-production with the public - e.g. what works to support digital inclusion in improvement?
1. Chris Hunt 12 May 2022
  
  James, indeed! For all it's downsides, Covid has moved us forward with technology, collaboration and how we embrace both. This is a really exciting opportunity for to develop this further, build stronger relationship, learn together and co design even greater service for our people. #ActasOne!
Catherine Hughes 11 May 2022

This is an exciting project! Connecting people across our place with their different perspectives of health and care is fundamental to delivering our transformation ambitions for integrated care. Having a digital platform to accelerate the connection across boundaries and make improvement methods accessible and usable for all will be transformation in itself. Such potential for Bradford District and Craven and beyond.
1. Chris Hunt 12 May 2022
  
  It is so exciting! And being on this journey with so many like minded colleagues fills me with joy and enthusiasm. Great to have your support Catherine!
Louise Clarke 11 May 2022

As a GP I absolutely welcome this approach to deliver improvements through co-design by multiple stakeholders and service-users.

So much opportunity in this bid to learn and grow together across our partnership, and in doing this to provide the best care for the population we serve.
1. Chris Hunt 12 May 2022
  
  Absolutely Louise, the people who deliver and use our services are the most important assets we have, enabling them to be involved is at the very heart of this. Really looking forward to working with you.
2. Richard Jenkinson 11 May 2022
  
  Great points, Louise. There was lots of focus on co-design in today's The Big Conversation organised by Helen Bevan of NHS Horizons.
Mel Pickup 11 May 2022

As the Place Based Lead of the Health and Care Partnership across Bradford District and Craven I am really excited by the potential of this project to accelerate the work of our Place based improvement and transformation teams as we collectively strive to integrate care delivery seamlessly around meeting the needs of our citizens, irrespective of which provider, discipline or sector we come from 'Acting As One'. This will be a powerful proof of concept with huge scalability potential not just hear across Bradford and District but beyond.
1. Chris Hunt 12 May 2022
  
  Thank you Mel and couldn't agree more! Individually we're all great, together we are amazing. Having a digital platform that can seamlessly transcend our boundaries will be another huge step forward for us as a place on this exciting journey we're all on, and potential for so much more too! Thank you for the support.
Clare Smith 11 May 2022

I really like this idea, sharing a common digital space across different organisations in a system is a real challenge, and it would be really useful for document sharing and keeping all the relevant information about initiatives in one space. It's a challenge we have in our area, so we'd be really interested in learning about your developments.
1. Chris Hunt 12 May 2022
  
  Thank you Clare, the struggle is so real! We can't even decide between Zoom and Teams to just talk to each other sometimes. Hopefully we can start to overcome some of these barriers. We would love to hear some of your thought and challenges as we work through this. Feel free to get in touch.
2. Richard Jenkinson 11 May 2022
  
  Thanks Clare. Glad you see the value in the project. Digital can open up lots of possibilities to collaborate, but you're right that often access / permissions can hinder our work together, or we find it hard to make sense of files 'uploaded and dumped' out of context. It's a problem worth solving, in our view.
Nadine Payne 8 Mar 2022

Very interested in the potential results of this - we have been exploring ideas for something similar in primary care / care homes in Salford for some time, but so far haven't ID'd any promising 'off the shelf' solutions that would work at a system level
1. Chris Hunt 12 May 2022
  
  Thank you Nadine, I think it's a very common struggle that connects us all! And you're right, nothing ticks all the boxes, which then by the very nature of having to use multiple tools, causes more confusion... Hopefully we can start to tackle some of these challenges, would be great to hear some of your experiences.
2. Richard Jenkinson 8 Mar 2022
  
  Thanks for your interest, Nadine! I think most people would agree with you... Here's hoping we are down-selected and able to run the programme and share the findings. Would be great if you wanted to follow progress and provide helpful inputs/feedback along the way!
Jon Armstrong 7 Mar 2022

Excited to support this valuable learning opportunity and to share and contribute to the development of new approaches to cross-system improvement
Chioma Obasi 4 Mar 2022

I agree a total game changer. The prospects of coproducing an interactive, interoperable collaborative platform is exciting and novel. Any feedback, input and /or any opportunities to learn from others and collaborate to enable the development of a pragmatic solution would be appreciated.
Claire Reed 4 Mar 2022

Really keen to be part of this idea. Could be a game changer for QI at a system level.
1. Richard Jenkinson 4 Mar 2022
  
  Completely agree, Claire. Would be great to build on the existing links & networks you have to tackle an issue that's really relevant for BDCT locally, but also has applicability for cross-system improvement at all levels.