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  • 11/29/2016


    M24: Engaging staff and building a movement for QI




    Monday, December 5, 2016

    Introducing the ELFT team

    Marie Navina Kevin Mason

    Paul Leigh James Amar

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    Objectives for todays minicourse

    qi@elft.nhs.uk @ELFT_QIhttps://qi.elft.nhs.uk

    1. Developing a framework for creating momentum for improvement at scale

    2. Creating ideas and a strategy for engaging people in quality improvement

    3. Understanding the key leadership behaviours needed to lead improvement at scale

    Todays agenda

    qi@elft.nhs.uk @ELFT_QIhttps://qi.elft.nhs.uk

    Using complexity and social movement thinking to design your improvement approach

    Executive leadership for improvement Engaging teams and building an improvement

    infrastructure Involving patients, service users, carers and families

    in quality improvement Board leadership of improvement

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    Some key principles to guide how you design your

    improvement approach

    qi@elft.nhs.uk @ELFT_QIhttps://qi.elft.nhs.uk

    with Dr Amar Shah (Associate Medical Director for QI)

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    Arguably the most important competency for dealing with complexity is systems thinking

    The three characteristics of systems thinking include:

    1.A consistent and strong commitment to learning

    2.A willingness to challenge your own mental model

    3.Always including multiple perspectives when looking at a phenomenon

    Senge, 2006

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    A social movement can be defined as

    a voluntary collective of individuals committed to promoting or resisting change through co-ordinated activity

    Seven common characteristics of social movements:

    Energy Mass Passion Commitment

    Pace and momentum

    Spread Longevity

    Bate, Bevan & Robert, 2004)

    Current prevailing beliefs about change

    Change starts at the top

    It takes a crisis to provoke a change

    Only a strong leader can change a large institution

    To lead change you need a clear agenda

    Most people are against change

    Change management is a disciplined process

    A movement perspective of change

    Change builds from bottom-up action

    Change can be driven by passion to improve

    Change comes from the collective action of individuals

    You need to have a clear cause but can be uncertain about how you will achieve it

    People have an inner desire to make things better

    Change is opportunistic and spontaneous

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    Five key principles that can help a movement approach

    1.Change as a personal mission2.Frame to connect with

    hearts and minds3.Energise and mobilise4.Organise for impact5.Keep forward momentum

    Things to consider

    qi@elft.nhs.uk @ELFT_QIhttps://qi.elft.nhs.uk

    Planning versus Prodding, Analysing and Reacting

    Who should build the movement?

    Pace & momentum

    Existing structures versus under the radar

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    Executive leadership of improvement at scale

    with Dr Kevin Cleary (Chief Medical Officer)

    Mason Fitzgerald(Executive Director for Corporate affairs)

    1. To provide an understanding of the quality journey that ELFT has been on;

    2. To examine the role of all executives in leading quality improvement; and

    3. To consider the contribution that executives need to make in order to build an organisation wide QI system and movement

    Objectives for this session

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    Mental health servicesNewham, Tower Hamlets, City & Hackney

    Forensic servicesAll above & Waltham Forest, Redbridge, Barking & Dagenham, Havering

    Child & Adolescent services, including tier 4 inpatient service

    Regional Mother & Baby unit

    Community health services Newham

    IAPTNewham, Richmond and Luton

    Speech & LanguageBarnet

    web qi.elft.nhs.uk

    email qi@elft.nhs.uk


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    The culture we want to nurture

    A listening and learning organisation

    Empowering staff to drive improvement

    Increasing transparency and openness

    Re-balancing quality control, assurance and


    Patients, carers and families at the heart of all

    we do

    AIM:To provide the highest

    quality mental

    health and community

    care in England by


    Build the will

    Build improvement



    QI Projects

    1. Launch event & roadshows2. Microsite3. Using the power of narrative4. Celebrate successes5. Network of champions / ambassadors6. Learning events

    1. Initial assessment of alignment & capability2. Recruiting central QI team3. Online training4. Face-to-face training5. Follow-up coaching on projects6. Develop in-house training for 2016 onwards

    1. Align all projects with improvement aims2. Align team / service goals with improvement aims3. Align all corporate and support systems4. Patient and carer involvement in all improvement

    work5. Embed improvement within management structures

    Reducing Harm by 30% every year1. Reduce harm from inpatient violence2. Reduce harm from falls3. Reduce harm from pressure ulcers4. Reduce harm from medication errors5. Reduce harm from restraints

    Right care, right place, right time1. Improving patient and carer experience2. Reliable delivery of evidence-based care3. Reducing delays and inefficiencies in the system4. Improving access to care at the right location

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    QI ResourcesService User Input

    Support around every team

    Project Sponsor QI Coach

    QI Forums

    QI Team

    The role of executives in leading

    quality improvement

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    Kevins story

    Dr Kevin ClearyChief Medical Officer

    qi@elft.nhs.uk @ELFT_QIhttps://qi.elft.nhs.uk

    Masons story

    Mason FitzgeraldExecutive Director of Corporate Affairs

    qi@elft.nhs.uk @ELFT_QIhttps://qi.elft.nhs.uk

  • 11/29/2016


    Connecting with staff, and seeing them grow and develop

    Spending time discussing our common purpose

    Delivering outcomes for patients

    Helping others, and making a contribution to national policy

    Joys of leading QI

    Building credibility with staff and managing

    initiative fatigue

    Capacity and capability

    Constancy of purpose and behaviours

    Managing upwards to commissioners and regulators


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    How to influence and change

    behaviour at executive level

    Re-visit your common purpose with the Board, staff, patients and stakeholders

    Talk about quality before anything else, and with everything else

    Link quality planning and quality improvement

    Make quality explicit in all strategies and plans

    Make quality your business strategy

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    All executives to have a formal role (i.e. executive lead, directorate lead, workstreamlead, project sponsor)

    Personal commitment to role

    Model behaviours with our teams

    Roles and role modelling

    Be an umbrella for your staff shield them from external demands

    Show others how it can be done

    Just say no!

    Influence national policy

    Managing the external world

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    At your table, have a discussion on what you are currently doing and what you might like to try, in order to engage all executives in quality improvement

    1. How can executives support an organisation wide QI system and movement?

    2. What are the key drivers and barriers?

    Executive leadership

    Table Discussion

    qi@elft.nhs.uk @ELFT_QIhttps://qi.elft.nhs.uk

    Engaging staff and building an infrastructure to support QI at scale

    with Dr Amar Shah (Associate Medical Director for QI)

    James Innes (Associate Director for QI)

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    And our QI Rap..

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    AIM:To provide the highest

    quality mental

    health and community

    care in England by


    Build the will

    Build improvement



    QI Projects

    1. Newsletters (paper and electronic)2. Stories from QI projects - at Trust Board, newsletters3. Annual conference4. Celebrate successes support submissions for awards5. Share externally social media, Open mornings, visits,

    microsite, engage key influencers and stakeholders

    1. Build and develop central QI team capability2. Online learning options3. Pocket QI for those interested in QI4. Improvement Science in Action waves5. Develop cohort and pipeline of QI coaches6. Bespoke learning, including Board sessions & commissioners

    1. Embed local directorate structures & processes to support QI

    2. Align projects with directorate and Trust-wide priorities3. Support staff to find time and space for QI work4. Support deeper service user and carer involvement5. Support team managers and leaders to champion QI6. Align research, innovation, improvement and operations

    Reducing Harm by 30% every year1. Reduce harm from inpatient violence2. Reduce harm from pressure ulcers

    3. Other harm reduction projects (not priority areas)

    Right care, right place, right time1. Improving access to services2. Improving physical health 3. Other right care projects (not priority areas)

    AIM:To provide the highest

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