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Rapid learning and improvement during COVID-19: workshop #2 write-up

Catch up on the second in our series of practical workshops featuring some rapid learning from three Q members and our guide to designing virtual events.

Health and care service are undergoing rapid change during the Coronavirus (COVID-19) pandemic. In response we are hosting a series of workshops to support Q members and others to develop how they capture the learning and innovations that are taking place.

Through these workshops, we will help identify structured ways to make sense of what is being learnt and provide opportunities to connect and share with others across the UK and Ireland.

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Q member experiences

During the workshop, we heard from three Q members working in different roles: Paul Gimson, Jit Olk and Nicola Bent. They provided a brief overview of the work they are doing to support rapid learning and improvement. You can view the recording of their session below.

Paul talked about his work to rewrite the medicine safety programme and to develop offers to support services to transition to a new normal. He referred to a sensemaking framework in a recent RSA blog, and a number of participants shared similar tools including Adopt, Adjust, Abandon.

Jit talked about the importance of capturing individual staff and patient experiences during this time. He referred to some of the major innovations that have occurred, including virtual consultations, and the importance of capturing the ‘secret sauce’ that has enabled us to make these changes at such pace. Sussex Community Trust is also using the RSA framework mentioned by Paul, but have merged this with Rolfes reflective learning model using the What, So What, Now What tool. They will use these frameworks with an Appreciative Inquiry approach, seeking to learn about staff and patient experience during this time.

Nicola talked about her work to support 3 systems across the region to understand what changes they want to maintain and build on. Wessex AHSN has developed their own framework asking:

  • What is new that you want to take forward?
  • What has been stopped that should be rescued?
  • What is suitable for crisis mode but not long-term?
  • What has stopped that you don’t want to resurrect?

They are facilitating virtual workshops and doing turnaround analysis of key themes and priorities.

Workshop discussions

Participants were then divided into small breakout groups. We used a Liberating Structures method called a Conversation Café to enable people to listen to one another’s thoughts and reflect on a shared question together: how are you making sense of the changes that are taking place, and what is this telling you about the future?

How are you making sense of the changes that are taking place, and what is this telling you about the future?

We then asked a series of questions to build on this, creating a shared understanding of the service changes that are taking place, and the perceived barriers and enablers to these changes being embedded.

There was a lot of rich feedback from the discussions. We heard that the crisis has brought necessity and urgency, and a clear common goal. Frontline teams have experienced the removal of ‘red tape’ and a shift to rapid decision making. But this was shared alongside some examples of increased command and control, and siloed working in areas of crisis response.

There have been positive changes, with better joined up working across services, a clear focus on patient need as the driving mission and high levels of autonomy felt by staff. However there have also been some immediate negative changes, such as the need to stop non-essential services and low stakeholder engagement.

Looking ahead, the things to pay attention to include capacity issues in services as demand returns to normal, the reduction in the funding that has enabled change, and increased pressures on an exhausted workforce. Participants also shared that the desire to return to normal and default to old ways of working could mean we ‘revert back’, and result in the loss of unity across services.

More detail on the themes can be read in the full write up of the session.

Designing virtual workshops and events

We finished the workshop with some practical learning from the Q team on designing virtual workshops and events. Before COVID-19, online meeting design was not a strong area of expertise. But for us, as with everyone else, it’s been a steep learning curve. It has given us the opportunity to think about how we translate our experience of what works face to face and adapt this to virtual meetings.

We firmly believe that good virtual meeting design isn’t all about technology, although it will help to have a grasp of the basics. The steps you go through to design virtual meetings are no different than face to face, but you need to be paying attention to how the experience will be different for people, in order to translate your expertise to a session that will work well virtually. We have identified five principles that it’s useful to consider:

  1. Have a clear purpose and determine the mode you want people to be in, for each individual activity
  2. Make sure everyone can contribute and engage in activities
  3. Accommodate for reduced attention spans, and different learning styles
  4. Take advantage of technology, when it feels right
  5. Prepare

We have developed a checklist for things to consider when planning and delivering virtual events and workshops, drawing on our knowledge and experience in the Q team. And you can find more detail on each of the five principles in the full write-up.

Resources

Resources from previous workshops
Related resources and activity from Q and the Health Foundation
Frameworks and learning models