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PocEd QI - Fundamentals of Quality Improvement Virtual Course

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PocEd QI - Fundamentals of Quality Improvement Virtual Course

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PocEd QI is a two part live virtual course to give ABUHB staff the fundamentals of QI in order to start to engage in their own Quality Improvement initiatives. Sign up via Eventbrite.

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aneurin bevan continuous improvement   tickets

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"The Aneurin Bevan Continuous Improvement (ABCi) centre is about bringing frontline teams together - to learn what works well and what doesn't. We know that the knowledge and experience lies with those delivering care everyday and we are delighted to be supporting colleagues as they shape and lead new ways of working."

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The Impact of 'Making Data Count' Training Programme

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The Impact of 'Making Data Count' Training Programme

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Time Series Data

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Background Red, amber, green (RAG) reports persist as the tool most commonly used by NHS trust boards to understand performance and gain assurance, despite statistical process control (SPC) being a more reliable way of presenting data over time. The aim of this study is to report board members' feedback on an educational intervention focusing on the use of SPC in NHS trust performance reports, review the presence of SPC charts in performance reports and explore board members' experience of behavioural changes in their board or fellow board members following the intervention.

Methods A 90-minute board training session in the use of SPC-Making Data Count-was delivered to 61 NHS trust boards between November 2017 and July 2019. This paper describes the approach taken with boards to enable them to understand the limitations of RAG reports and the benefits of using SPC and analyses the extent to which the Making Data Count training has led to boards adopting SPC. The paper provides quantitative analysis of the increase in SPC use across the 61 participating boards, summaries from the board evaluation forms and qualitative reflections of seven senior leaders from four boards who consented to participate in post-training interviews with an independent evaluator.

Results During the period covered by this study, 583 participants of board training provided feedback. 99% of respondents agreed that the training session was a good use of their time. 97% of respondents agreed that participating in the event would enhance their ability to make good decisions. A review of the presence of SPC charts in the board papers of the 61 trusts prior to the board training revealed that 72% contained 0-5 SPC charts. A review of the same trusts' papers 6-12 months after the training revealed a significant increase in the presence of SPC with 85% of reports containing a minimum of six charts.

Conclusion The Making Data Count education intervention has increased the use of SPC in board reports and has had some self-reported impact on individual and collective behavioural changes by board members, including reducing the amount of time wasted by boards discussing insignificant changes in data and providing a clearer focus on those issues requiring board attention. Further research is required to see if this immediate impact is sustained over time and to identify the key enablers and barriers to organisational adoption of SPC by boards in the NHS.

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National Health Service (NHS) trust boards adopt statistical process control reporting: the impact of the Making Data Count Training Programme

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Background Red, amber, green (RAG) reports persist as the tool most commonly used by NHS trust boards to understand performance and gain assurance, despite statistical process control (SPC) being a more reliable way of presenting data over time.

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QI Resources

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There are a range of quality improvement tools which will help with your project.

The tools are tried and tested and different tools will help you at different stages of your project.

They will help you to:

Identify what your quality improvement issue is

Understand the problem

Develop a clear strategy

Test your idea

Implement your idea

Maintain the momentum

Measure the difference your project improvement project has made.

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Tools to help you with your quality improvement project

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There are a range of quality improvement tools which will help with your project. The tools are tried and tested and different tools will help you at different stages of your project.

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Network for Sustainable Healthcare

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A Network for Sustainable Healthcare in Wales

The Climate Crisis is a Health Crisis

Green Health Wales is a network of healthcare professionals in clinical, non-clinical, administrative, support and managerial roles across Wales who recognise that the climate and ecological emergency is a health emergency.

We aim to Connect, Learn & Transform; to connect across Wales, transcending geographical borders while supporting cross-departmental collaboration. We aim to learn more and empower everyone in the health and social care sector in Wales with the tools and knowledge to address the climate crisis - transforming health care to be climate smart.

Our vision is sustainable healthcare that protects the health of people and the planet; the two are inextricably linked. We recognise that healthcare must play an active role in limiting global temperature rise. Find out more about us.

We invite you to connect by your location or speciality, to learn from our collection of resources, and to get inspired by others in working in healthcare across Wales to deliver your own transformational project.

Green Health Wales: The Launch

Do you work in the healthcare sector in Wales? Are you concerned about the planetary health emergency? Do you want to find out what you can do and how to get support?

Join us for our virtual conference on Tuesday 29th June 2021 where we will be launching Green Health Wales: a day of raising awareness, building will, and transferring skill.

The morning begins with expert speakers outlining the link between the climate and health crisis, and the healthcare response required to address the biggest threat to global health of the 21st century.

We will then share learning from both local Welsh initiatives and global sustainable healthcare projects across a breadth of speciality areas.

​

The afternoon offers workshops from which you can choose, aimed to equip you with the information and skill to start your own sustainable project, and to grow your idea to meet the challenges and ambitions set out by the NHS Wales Decarbonisation Strategic Delivery Plan.

​

Subscribe to our mailing list below to be notified as soon as registration opens!

© 2021 Green Health Wales | Iechyd Gwyrdd Cymru.

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A Network for Sustainable Healthcare in Wales The Climate Crisis is a Health Crisis Green Health Wales is a network of healthcare professionals in clinical, non-clinical, administrative, support and managerial roles across Wales who recognise that the climate and ecological emergency is a health emergency.

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Amar Shah

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Driver Diagram and Change Package for Falls

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Approach to Patient safety (first 3 short articles)

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Approach to Patient safety (first 3 short articles)

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Sustainable QI

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Have to do a QI project? Why not do one that both improves patient care but also environmental, social and financial outcomes. Use the Centre for Sustainable Healthcare Free Sustainable Quality Improvement resources, teaching templates and casestudies.

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BMJ - 2021 Virtual Improvement Conference

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BMJ - 2021 Virtual Improvement Conference

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Europe 2021 - International Forum on Quality and Safety in Healthcare site

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Welcome to our 2021 Virtual International Forums!

In 2021 we will be offering a year of continuous learning and improvement, as we look to reconnect with colleagues, revive momentum and build back better, stronger and fairer systems.
Programme timings are in CEST (Central European Summer Time), GMT+2.

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Welcome to our 2021 Virtual International Forums! In 2021 we will be offering a year of continuous learning and improvement, as we look to reconnect with colleagues, revive momentum and build back better, stronger and fairer systems. Programme timings are in CEST (Central European Summer Time), GMT+2.

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Log in to the Q Community

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Q is led by the Health Foundation and supported by partners across the UK and Ireland

Congratulations to the Q Exchange 2023 winners!

A big thank you to the 418 members who voted and congratulations to all the Q Exchange funded projects! Read more about the winning projects below.

Find out who won

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A connected community working together to improve health and care quality across the UK and Ireland

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Health Foundation

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Unfortunately, your browser is too old to work on this website. Please upgrade your browser

Key points

This guide focuses on quality improvement, and is especially useful for health care staff leading fast and efficient service change as a result of the pandemic.

Quality improvement involves the use of a systematic and coordinated approach to solving a problem using specific methods and tools with the aim of bringing about a measurable improvement within a health care setting.

Improving quality is about making health care safe, effective, patient-centred, timely, efficient and equitable. It's about giving the people closest to problems affecting care quality the time, permission, skills and resources they need to solve them. In the history of the NHS, there has never been a greater focus on improving the quality of health services.

As we shift from the emergency phase of COVID-19 it is vital that health and care workforces are able and supported to lead radical service change and improvements through re-starting, re-designing or developing new processes, pathways and services.

This guide offers an explanation of some popular approaches used to improve quality, including where they have come from, their underlying principles and their efficacy and applicability within the healthcare arena. It also describes the factors that can help to ensure the successful use of these approaches and methods. to improve the quality of care processes, pathways and services.

It is written for a general health care audience and will be most useful for those new to the field of quality improvement, or those wanting to be reminded of the key points.

First published in 2013 and updated in 2021, this is the third edition of Quality improvement made simple. The third edition was updated on 19 May 2021 to reflect NHSEI's newly published definition of quality.

A panel discussion exploring the extent of the backlog facing the NHS in the recovery period and how...

Cite this publication

Quality improvement made simple. The Health Foundation; 2021 (www.health.org.uk/publications/quality-improvement-made-simple).

Further reading

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About 21 mins to read

During the pandemic, the NHS has rolled out technologies at impressive speed. But what will need...

A learning report explaining why improvement in health care matters, and how to get started in your...

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Work with us

We look for talented and passionate individuals as everyone at the Health Foundation has an important role to play.

View current vacancies

The Q community

Q is an initiative connecting people with improvement expertise across the UK.

Find out more

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Updated in 2021, this third edition outlines what you need to know about health care quality improvement.

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Tools & techniques to help you with your quality improvement journey

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Home Page Internet

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Amar Shah

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Quality Improvement - East London NHS Foundation Trust

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There's no doubt that quality improvement employs a large set of tools - driver diagrams, statistical process control charts, Pareto charts, force field diagrams, cause and effect diagrams, PDSA cycles, affinity diagrams, flow charts... The list could go on and on. Indeed, one of the comforts that quality improvement brings is the chance to build experience with a repertoire of tools that can help us as a team view systems and processes, gather information, organise information, understand variation and relationships between factors. Knowing that there is a tool to use in a given situation helps build belief that there is value in applying a systematic approach to solve a complex problem. As an organisation or system builds improvement capability, there is additional comfort from the increased fluency that builds across a community of improvers with these tools, which provide practical and helpful structure when working through complex problems, much as a structured risk assessment tool helps frame a clinical team discussion and decision-making. Most of these improvement tools are more powerful when applied by a team of staff and service users working together, and so utilising tools together as a team can help create and reinforce the cultural aspects of quality improvement such as a flattened hierarchy, equal voice, inclusivity, shared purpose.

The extensive use of tools within quality improvement has led some to ask if quality improvement is simply a toolbox - a set of tools that one applies within a broader approach to change. Are we applying and embedding quality improvement if we are just utilising tools at appropriate times? There appears to be an increasing narrative that using process mapping to understand a system, creating a driver diagram to help visualize our theory of change, or using statistical process control charts to view variation demonstrates that we are applying quality improvement.

It's fantastic that teams are seeing the value of using QI tools as part of their daily work, helping them view the system, organize information or understand variation. In my view though, this isn't sufficient to truly build a culture of continuous quality improvement. At ELFT, we encourage the use of QI tools - something we describe as daily improvement. However, we need to also recognise that using tools in our daily work misses the opportunity of applying rigour and a burst of energy within formal quality improvement projects to achieve breakthrough levels of performance.

Quality improvement projects also employ tools, but in pursuit of solving a complex quality issue and achieving an aim that really matters to service users and the team. Without the use of structured projects applying the quality improvement method for 6-9 months on a complex issue, we run the risk of getting better at the daily operational challenges, without really tackling the complex, more strategic, longer-term challenges that require us to think differently and discover new ways. Of course, the quality improvement project requires us to create temporary project teams and dedicate resource to work on the issue, which creates a healthy tension with the demands of delivering the day job. Perhaps this might be one reason for people preferring to see quality improvement as a set of tools for teams to apply when they see the benefit, rather than an approach to applied problem solving for both daily challenges and the more strategic long-term challenges.

Continuous quality improvement also requires a change in leadership mindset - devolving problem-solving to the point where the problem is experienced, actively supporting broad involvement in experimentation and improvement activity, encouraging those we lead to take a systematic approach to problem-solving, creating an environment where people feel safe to speak up and contribute to improvement.

In the Toyota production system, the word 'kata' describes the set of behaviours and habits that enable the organisation to continually improve. The word kata comes from the choreographed movements practised in martial arts.

Within the management system developed at Toyota, there are two forms of kata - the improvement kata, and the coaching kata. The improvement kata involves four steps:

1. Understand the direction or challenge (clarifying the long term goal or vision)

2. Grasp the current condition (understand the current system and issues)

3. Define a target condition (set an improvement aim)

4. Experiment towards the target condition (test new ideas using a structured Plan-Do-Study-Act process)

Most improvement practitioners would recognise the improvement kata as the core steps for any improvement method, and fundamental to the design and delivery of QI projects.

The coaching kata redefines the role of leaders as guiding learning and application of the PDSA cycle to navigate uncertainty in order to achieve the target condition. This involves asking questions instead of providing solutions, and transmitting confidence. It is believed that one can only teach something and convey confidence if they themselves have tried it and mastered it. So leaders can only become good coaches if they themselves have been a learner, and have adopted the improvement kata to solve problems.

I think this is helpful in showing us that using QI tools as part of daily work can support embedding of improvement into the way our team works together and tackles challenges on a day-to-day basis. To truly adopt the improvement kata, we need to also apply quality improvement to identify our biggest challenges, and discover our way to new levels of performance through structured experimentation. All of this relies on leadership that has first-hand experience and expertise in quality improvement, and adopts the coaching kata in guiding and supporting teams through the complex challenges they are working through.
@DrAmarShah Find all of Amar's blogs here >>

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QI Essentials with Dr Amar Shah - blog series - Quality Improvement - East London NHS Foundation Trust

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In this blog series, Dr Amar Shah, Consultant forensic psychiatrist & Chief Quality Officer at ELFT, will explore all things QI, sharing tips and tricks, demystifying QI and sharing stories to inspire everyone to improve the system in which they work. You can access all posts below.

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Academy of Medical Royal Colleges

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Developing quality improvement into practice - Academy of Medical Royal Colleges

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The Academy of Medical Royal Colleges speaks on standards of care and medical education across the UK. By bringing together the expertise of the medical Royal Colleges and Faculties it drives improvement in health and patient care through education, training and quality standards.

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MINDSetQI is a quality improvement toolkit for people involved in providing and commissioning services for people with mental health problems. It has been designed with the involvement of a range of organisations with the aim of making continuous improvement in mental health easier. The toolkit provides a range of improvement tools and handy summaries of national policy and guidance.

We have given examples of how mental health services have used the tools and the results and learning the teams have achieved. Some of these projects did not originally use quality improvement science, but are now embracing it to help with sustainability and spread of ideas.

If you have feedback, updates or if you have been involved in using quality improvement in mental health we would love to hear from you at

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MINDSetQI Working together to achieve measurable improvements in mental health MINDSetQI is a quality improvement toolkit for people involved in providing and commissioning services for people with mental health problems. It has been designed with the involvement of a range of organisations with the aim of making continuous improvement in mental health easier.

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Improvement as Learning

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carbon footprint calculator for individuals and households

This carbon calculator is provided free to use

Show you care for the environment and communities across the World by Carbon Offsetting.

You can support Carbon Offsetting Projects that both tackle climate change and support impoverished communities across the world. Just click the 'Offset' button after you have finished your calculation. It takes only a few easy clicks and costs only a few Pounds/Dollars/Euros per tonne CO ₂. You also get a personalised Certificate recognising your offsetting - makes an ideal gift too!

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Carbon Footprint Ltd using RADsite CMS (https://www.radsite.co.uk/)

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Use the World's most popular online carbon footprint calculator, and it's FREE. Calculate your carbon emissions from Buildings, Cars, Flights and other sources.

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Despite being a galaxy far, far away the principles of quality improvement still hold. Here is what we can learn from some of the main Star Wars protagonists...
Yoda (The Improvement Guru)
Yoda knows every improvement methodology in the book. Sadly like many experts his explanation of it doesn't always go down well with his disciples. Especially novices who often get bored and run off to try it their own way. Perhaps Yoda should read Demystifying Theory and its use in improvement. To be fair he has some great stories to tell though...
R2-D2 (Data)
As Deming said, " In god we trust, all others bring data ". The problem R2-D2 has is despite being full of information very few people are willing to listen, or even when they do, understand him. Whether a brilliant shot with a blaster, handy with a light sabre or a fantastic pilot if you don't understand data you will never find the solution (map) to the really big problems (death stars)
Han Solo (The Charmer)
You have read the latest improvement science literature. You have run through your model of improvement. Your PDSA templates are ready to go. And two weeks later you are still waiting for someone, anyone, to complete your new proforma. Just as you are about to give up, Han Solo wonders into cantina, picks up a dog-eared form used by someone to doodle on and says, " this looks ok kid ". Suddenly, everyone, is using the form.
Finn (The convert)
Having just read " Don't just do another audit " Finn has had something of an epiphany. Jumping ship from his organisation's normal way of doing things he finds things are a little tougher than he expected. Improvement is really hard but it's a lot more beneficial in the long run...
Darth Vader (The Strangler)
All good improvement projects meet a brick wall. Darth Vader is an especially tall and strong one. Able to silence any new innovation without even speaking Darth knows it is going to be his way.

Or his way. Or someone is going to suffer.
The above were the first 5 which I have subsequently added to. Always keen to hear more suggestions! Rey (The learner)
Very rarely do health care professionals lack passion. However like Rey you sometimes don't realise what your actual talents are. A small improvement project can be the first realisation that you really can make a difference and not just talk or dream about it. And even more like Rey learning is pretty exponential when it begins.

Thanks to Helen Bevan for suggesting Rey
C-3PO (The sceptic)
To some people the status quo is simply the safest place to be and trying anything new is never going to be successful.

" The odds of successfully surviving an attack on an Imperial Star Destroyer are approximately... "

However sceptics are often predictable and can be inquisitive enough that with a bit of persistence you may find they join for the ride (only to find something else to complain about...)
Tie-Fighters and X-wings (Design)
There is an inherent attraction to things that look good. Great visual design is always going to improve the chance of a successful project. From observations charts to surgical checklists you want something that looks streamlined and efficient.
Lando Calrissian (The inconsistent supporter)
A improvement project is failing when you find unexpected support from someone who comes out the woodwork to provide additional help and resources when they are most needed. Then just as you think things are back on track they side with the stranglers and the project is stopped dead. Building a team is vital but understanding their allegiances even more important. Remember though not everyone who sides with the Empire does it for ever... (thanks to Olusegun Olusanya for suggesting Lando)
Boba Fett (the mercenary)
Hard working, resourceful and clever but really only in it for the reputation or an award. Always delivers but only at a price. Watch out for short terms allegiances with Stranglers and inconsistent supporters

(Thanks to Ross Fisher for suggesting Boba Fett)
Princess Leia (the deliverer)
With a determined, pragmatic and no-nonense approach to getting the job done all improvement projects need a Leia. Equally at home dealing with high level hierarchy as she is with front line staff; Leia makes sure the right processes happen at the right time. Not afraid to express her opinions but always willing to recognise the skills of others.
Galen Erso - The Saboteur
When you're putting together a new idea or initiative, it is helpful to have a team with you helping to troubleshoot problems and brainstorm ideas. Whilst heterogeneity in the team prevents a series of "yes-men" mindlessly agreeing, be wary of those taking part against their will.

The Saboteur may appear to want the same as everyone else, but if they don't believe in the project they may deliberately overlook flaws, or even introduce some. This could result in your world changing plan being blown apart by troublesome rebels before it can ever make a difference. Conversely it may be your original plan was actually the wrong solution to the wrong problem and some would consider Galen a hero. Sometimes improvement and change is a matter of perspective. To paraphrase the saying, ".. one man's freedom fighter, is another man's terrorist." (Thanks to James Nurse for suggesting Galen Erso)

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The Star Wars guide to Quality Improvement

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Despite being a galaxy far, far away the principles of quality improvement still hold. Here is what we can learn from some of the main Star Wars protagonists... Yoda (The Improvement Guru) Yoda knows every improvement methodology in the book. Sadly like many experts his explanation of it doesn't always go down well with his disciples.

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Networking Opportunity

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Home | Sustainable Healthcare Networks Hub

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The Centre for Sustainable Healthcare's Networks Hub is here to help you share and collaborate - generating knowledge and building a culture of sustainable practice in healthcare.

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IQT and Online Training

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improvement cymru academy: log in to the site

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Improvement Cymru Academy: Log in to the site