Principles for learning as a team or system during COVID-19

The pressures on the health and care system during COVID-19 mean that we are seeing unprecedented changes in how care is delivered.

With such change happening at pace, it is crucial that we find the time and space to capture and make sense of learning on the changes that are taking place. We know there are many challenges in doing this well.

This resource provides an overview of principles to pay attention to, and tools that can support learning practices within teams, organisations and the system.

In this framework, we identify six principles to consider when approaching learning practices within your team, organisation or system.

It can be easy to make assumptions and jump to conclusions, particularly when we’re busy or stressed.

But when it comes to learning, it can mean we misinterpret what’s happening around us, and spot patterns which may not be there.

A tool we’ve found helpful to try and explain and address this, is the ladder of inference, developed by Chris Argyris and popularised by Peter Senge.

What, So What, Now What? is a Liberating Structures method, designed as a practical way to use the ladder of inference framework in an activity.

A good learning process should help you to move up each stage of the ladder one by one, rather than jumping straight to the middle or even the top.

• Identify your goals: what it is most important for you to learn from, and what’s feasible with the resources you’ve got.
• Consider how you’ll use the information that has been collected.
• If you want a simple tool to help you make sense of the changes you have implemented during COVID- 19, and what this means for the future, you may want to look at RSA Future Change Matrix, which is in the guide below.

It is important to capture learning as you go. There are lots of great tools you can use and adapt.

Two of the most popular tools are (see Find out more for links):

• Quality impact assessment for service change during COVID-19 from East London Foundation Trust (ELFT)
• Learning from COVID-19: A tool for capturing insights (from Collaborate CIC)

• Use tools that enable diverse participation
• Choose tools that are accessible
• Consider where people are already meeting and discuss learning there, for example:
• Existing team meetings or huddles
• Getting people to share feedback on WhatsApp groups
• Taking advantage of other virtual platforms

Safety goes hand in hand with a teams’ ability to learn. If people don’t feel safe, they won’t speak up. 

Read more from the Insitute for Health Improvement for ideas about language and behaviours you can model at this time (download the guide and see Slide 5).

Some of the most significant changes we’ve seen over the last few months have been behavioural and cultural. For example a renewed sense of shared purpose across systems, a willingness to try new things, greater sense of permission and autonomy for frontline teams to implement changes.

• It’s important to think about the change you’re seeing, and the patterns and systemic structures that may be causing that to happen.
• A useful model to support conversations on this is the iceberg model (download the guide and see Slide 6). This can help you to think about the structure.