Luton violence collaborative – video

Luton and Bedfordshire adult mental health wards were the last to trial the Trust’s violence reduction package, spread from Tower Hamlets ward-by-ward across the Trust. Their aim was to reduce physical violence on inpatient wards by 30% by September 2018.

Over 18 safety huddles a week and we’re just getting started

Luton and Bedfordshire adult mental health wards were the last to trial the Trust’s violence reduction change bundle, spread from Tower Hamlets ward-by-ward across the Trust. Their aim was to reduce physical violence on inpatient wards by 30% by September 2018.

Between July and September 2018, progress was rapid. Wards started holding regular safety huddles and completing data recording more reliably, yet not reliable enough to be confident of quantitative improvements.   What was clear was that the whole MDT were starting to huddle, wards were sharing learning with each other, service users were becoming increasingly involved and staff were seeking out best practice activities and improving ward environments.

The wards describe how they came to feel really different. Wards felt calmer and less reactive.  Moreover, there were unexpected benefits from the time and energy that has been released, including more time with service users, reduced length of stay and lower staff sickness.  The violence reduction work has now ramped up, with half the wards now huddling over 18 times per week, more active experimentation and new insights.

This month we are going to reflect on how it all started in Luton and Bedfordshire, the challenges they faced and overcame, the new things they’ve tried and what next.

Where did they start?

In December 2017, seven adult mental health wards across Luton and Bedfordshire joined a collaborative to be a part of the Trust’s violence reduction work.

Collectively they were experiencing an average of 51 physically violent incidents per month. Each incident was affecting the victims and witnesses and the ward’s morale.

What did they do?

In December 2017, the wards began to trial the safety package (namely the safety cross, daily safety huddles, Broset Violence Checklist and safety discussions in weekly community meetings).

In the first six months, the work existed but was struggling to create momentum. Then Borough Lead Nurses and ward leaders gave the work a fresh push, starting fortnightly breakfast meetings for all ward MDTs.  The Forensics directorate kicked off the first breakfast by sharing experiences of their journey, followed by an open conversation.  Then each ward was scheduled to present at each upcoming breakfast.

Through these meetings, the challenges started to be vocalised and wards also committed to what they would try. These commitments included understanding how violence makes people feel, having set times for safety huddles, wider MDT engagement and including service users in the process.

Then light began to appear starting with the safety huddles. Gareth Steiner, Ward Manager for Jade PICU Ward describes how the huddles changed staff so that they planned how to reduce any conflict in real time and now rely on each other to act cohesively and early:

“In the past, I would see early warning signs and want to do something about it, but I felt anxious about the implications of tackling it on my own. Before that there is a large amount of anxiety because you never know how it is going to go.  However, the minute you get organised and prepared, that goes straight away.  If someone is kicking the door, I call a safety huddle and in less than three minutes we talk about immediate concerns, what the plan is going to be, and you are no longer holding this alone.”

Gareth goes on to describe an example of being proactive by creating an escalation plan for an individual with the team:

“We have a very volatile person on the ward. Historically if something happened we would respond, restrain and take him to seclusion.  But the safety culture change bundle has really impacted how we now approach things.  In this case, the staff called a huddle and agreed ‘If this happens, the first step is to have 1:1 talk with him. If that fails, we’ll offer him PRN. Next step is we take him off the ward to the quiet room for a 1:1 with the MDT around. Failing that, if violence increases, we’ll look at seclusion’.  The staff followed the plan and were able to deescalate the situation at step three, before it got to seclusion.  As a result, no one got hurt, no hands were laid on anyone.  It is a really good example of what can be achieved as a result of this work”.

The frequency of huddles increased dramatically. They went from being held only a few times a week (when Gareth describes “staff didn’t really understand why they were valuable”) up to a consistent two or three times a day across many of the wards (at least two a day and in some cases one at night).  For example, Ash, Onyx, Crystal, Willow and Jade Wards have recently achieved 19-21 huddles per a week; two in the day and one at night seven days a week.

Bedfordshire wards led the trust in utilising visual management boards specifically to quality control the outcome measure and safety change bundle processes. Willow ward helped other wards in the trust to create their boards, through sharing their whiteboard template.

Bedfordshire inpatient wards’ first visual management board session

Successful MDT involvement has been key. Lorraine Esther-Armstrong, Matron on Crystal Ward, describes why that has been so helpful:

“In huddles you’re assigning specific tasks to individuals. So it is great to have the doctors in that meeting, for example, because then they will act immediately”.

A spirit of celebration emerged. When the Institute for Healthcare Improvement came to visit in October 2018, Luton created this video describing the violence reduction package they had implemented.  It includes their own addition tested by Crystal Ward of a tabard to protect staff doing observations from distractions:

Then the conversation around violence continued to improve through increased service user involvement. Service users were initially involved through safety discussions in community meetings.  Daisy Mudoni, Borough Lead Nurse for Luton describes how this expanded to involvement in the huddles and the collaborative:

“Instead of violence being a staff issue, it affects everybody. Service users needed to know what is happening with the collaborative and contribute their views.  Now service users are involved in some huddles and wards have brought service users along to their presentation at the collaborative. This is the beginning of the next step – how do we work in partnership?  Instead of something staff do to service users, how do we work together with the same priorities?”

What has been the impact and how does it feel?

Reliability of data recording still needs to improve to have confidence that there has really been quantitative improvement. However, the staff have experienced a meaningful improved experience on the wards.

Tracey Morrison, Life Skills Recovery Worker on Crystal Ward describes the wider impacts of the work:

“Proactively reducing violence has freed up staff to spend more time with service users. As a result, service users have usually been more settled, creating a much calmer, more therapeutic ward, reducing length of stay and reducing staff sickness.  Improving on violence has had a knock-on effect on every aspect of the ward.  Once people see the benefits, they are so wide.”

Lorraine Esther-Armstrong, sees the shift too:

“Once the momentum starts going and you start seeing the benefits, it changes everything. I don’t think there is anyone who openly says this is rubbish or doesn’t want to be part of it”.

Gareth Steiner further captures the change in staff attitude and describes how it has changed his view of QI also:

“Staff went from saying ‘another unnecessary meeting’, ‘this will never work’ and ‘too much paperwork’ to ‘it was easy to introduce’, ‘we can see a reduction in incidents’, ‘the paperwork is not that much’ and ‘doctors are coming to the huddles’”.

“When I started at ELFT, I tried to keep aloof of QI.  But through this work I now see why people get passionate about it because you enjoy working again all of a sudden and are not dreading coming into work”.

The past six months

Momentum has continued to escalate. The active experimentation by staff and their enthusiasm about what have learned and adopted is really striking. Learning has been both short-term on the best way to support individual service users and longer-term on how to risk assess, de-escalate and create ward conditions conducive to low conflict.  Examples of changes they have implemented and tests they have run to de-escalate violence include:

• • Psychologists introducing self-soothing boxes on the wards
  • A mood management group providing distraction through meaningful activities
  • Displaying the Safewards de-escalation tips chart
  • Picture boards to giver service users personal recognition by displaying their artwork
  • 1:1 OT sessions to understand triggers and develop strategies with service users, including increasing community activities outside the wards
  • Reviewing enhanced observations in safety huddles to ensure people are not on enhanced observations for longer than necessary
  • Three times a day a nominated service user liaises with all other service users to discuss the ward’s atmosphere and RAG rate the shift on a blank safety cross in the patient area; they can also inform staff of any concerns on the ward
  • Reaching out to other wards to get advice, e.g. on a service user that ward cared for before or advice from the PICU
  • More proactive support from the Duty Senior Nurse
  • Coaching junior staff to risk assess
  • Introducing t-shirts saying ‘Go Green for December’.

Next steps

We will continue to further work with service users in partnership to understand and reduce violence together. Staff have made great progress with recording data reliably, with reliability growing across the wards. The next step is to support staff to more frequently use of data as part of decision making, for example by building training into Away Days, and to clarify the quantitative impact of the work.

The wards are continuing to experiment to reduce violence further. For example, work will continue to reduce restrictive practices including improving de-escalation to avoid chemical and physical restraints.  A new project on improving the reporting of violent incidents to the police aims to ensure violence on wards is treated equally as violence everywhere.  Another project is looking to increase carer involvement on the wards.

The wards have a better handle on how to work together to make a safer therapeutic and work environment. It is really exciting seeing all the work they have done together and what they have achieved.

Bedfordshire & Luton QI Celebration

On Tuesday 22 May our Bedfordshire and Luton Directorates held their annual QI celebration event at Kings House.

The event brought together 120 staff, service users, carers and external partners to share learning and achievement in quality improvement over the last year.

Presentations included an overview of QI in the Directorates and plans for the coming year, where we premiered the QI in Bedfordshire and Luton collections on the QI microsite, along with their interactive training dashboards.

Our service user led QI project ‘Bridging the Bedford Gap’ shared their work on raising awareness of the Bedfordshire Recovery College, and all delegates worked on a Force Field Analysis to help us think about more ways to get our service users and carers involved in QI.

We heard about Inpatient Innovations from ward staff in Luton and Bedfordshire. Psychology teams shared their work on reducing waiting times for first appointments, and reducing referral to assessment times in Luton and Bedford Community Mental Health teams.

Following a video message from our Chief Executive Dr Navina Evans, our keynote speaker Dr Helen Bevan, Chief Transformation Officer at NHS England, gave an inspiring presentation on ‘Rocking the boat and staying in it: Bringing change to health and healthcare’, followed by a panel discussion with Helen and local leaders.

One of the highlights of the day was a performance of ‘Change is gonna come’ by Marie Miller, who brought the house down singing an adapted version of the song with QI lyrics (thanks to Charmaine Elliot), check it out on Twitter!

You can find access all slides on the QI microsite and see highlights from the event in the short video below. We look forward to more great QI work coming out of Bedfordshire and Luton in 2018!

Click image to find more photos from the day

QI Celebration in Bedfordshire & Luton – 22 May 2018

Please find slides available from the Bedfordshire & Luton QI Celebration event on Tuesday 22 May 2018. Thank you to all presenters at the event. Our keynote speaker was Dr Helen Bevan, Chief Transformation Officer at NHS England, you can find her presentation ‘Rocking the boat and staying in it: Bringing change to health and healthcare’ within this file.

Bedfordshire QI Coaches & Sponsors

Improving the Conversion Rate in Luton Wellbeing Service

Please learn more about this completed ELFT QI project from the adjacent poster.

ELFT staff, service users and carers can access full details of this project on Life QI .The project code is 101214 please log onto your Life QI account before clicking the logo below.

Bridging The Bedford Gap

Learn more about this QI project presented at the ELFT Quality Conference in April 2018

Please find the team’s poster available here>>

Reducing Wait Times

Learn more about this QI project presented at the ELFT Quality Conference in April 2018

Please find the team’s poster available here>>

Reducing Wait Time for First Contact with Psychology in Luton

Learn more about this QI project presented at the ELFT Quality Conference in April 2018

Please find the team’s poster available here>>

Luton Wellbeing Service: achieving enjoyment at work through engagement and communication

In this blog, the Enjoying Work QI team at Luton Wellbeing Service share their journey towards increasing the percentage of staff having a good day at work from 55% to 75% in four months. Words by Kelly Gale (Improvement Advisor) and Sharon Gugerly (Project Lead).

Luton Wellbeing Service was one of services at East London NHS Foundation Trust that volunteered to be an early prototype team for Enjoying Work, which is aimed at helping increase staff experience of work using quality improvement methods.  The team comprised of Sharon Gugerly (Project Lead), Douglas Hiscock (Coach), Brian Toye (Sponsor), Jen Taylor-Watt (Improvement Advisor), Giap Huynh, Sandra Brown, Syed Ali Naqvi, Faz Parker (Team Members) and  Shefa Begum (Business Partner – Human Resources).

The project was launched in June 2017 and the first task was to gather baseline data using the online survey tool Survey Monkey.  The survey asked all staff to rate their day using the Likert Scale:

To what extent do you agree with the following statement?:

Did you have a good day at work yesterday?

The answers on the Likert Scale were:  “Strongly Disagree”, “Disagree”, “Agree”, “Strongly Agree”.

All staff members were asked to complete this daily for the month of June and 185 responses were collected. Of those, only 55% said they “Agreed” or “Strongly Agreed” that they had had a good day. Using that baseline as starting point, the team created their driver diagram and identified which factors they needed to work on.

The team used a board to communicate with staff.

From the responses to the survey and from engagement sessions with the whole staff team, four themes emerged which were contributing to people not have a good day.  They were: Stress, Work Environment, Management Communication and IT.

The staff engagement session had developed many change ideas, so all staff were invited to rank them in order of importance, so that the project team could start on identifying change ideas that meant the most to most staff.

Some ideas were tasks, things they could just get done without the need to test first. Staff were also asked to rank these in order of importance to them. The results from the staff ranking were acted upon and a communications board was placed in the main staff area so that everyone could be informed and kept updated as to what was happening.

Changing the way the whole team meeting was used and executed was ranked as the number one change idea, so the team started a PDSA (Plan, Do, Study, Act) cycle on how they were going to do this.

Changing the time of the meeting was the first thing that they tried; this was quite successful with the team. The next change they agreed on was to add a lunch break in the meeting as it was conducted over the whole of the lunch period.  Their third cycle was to have a much more structured meeting with an agenda and a way of providing feedback about the meetings.

The team created a Kanban board, the board was a great success as the staff team were able to see what had been completed, what was in the process of being done and what was lined up to do next.

Kanban board

The whole team were asked to continue completing the survey throughout the project to see whether the changes and improvements being made were having the desired affect and whether this would be reflected in the data.

The percentage of staff members who responded with “Strongly agree” or “Agree” that they had had a good day increased from the baseline of 55% to 75% and this was being maintained.

Towards the end of 2017, the service was commissioned to a different provider, which meant that it would be transferred from ELFT. Staff enjoyment at work was subsequently affected and the project team decided it was not viable to continue with the project in its current format.

Although they were not able to run the project in its entirety as they intended to, they used the learning and structures they had developed to refocus the work on supporting staff during this period of change. They also took time to capture and share some of the outstanding work and valuable learning from their original project.

The lessons from the project are:

Complete the small tasks first – this shows that things will be done and encourages others to become involved and builds the momentum for the others to join in.

Involve the whole team:  the project was designed to help everyone in the team and the more of the team involved, the better the ideas generated and the outcomes will be.

Clear communication:  Let everyone know what is going on, get everyone involved and keep them updated.

If you are part of ELFT and are interested in taking part in an Enjoying Work project please click here to know more.

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Learn more about this project on Life QI – Project Code #103865

East London NHS Foundation Trust (ELFT) has been using the Life QI platform since June 2015 to manage our Quality Improvement (QI) portfolio. Projects are proposed, approved and worked on through the platform. Learn more about how important this platform is in this blog by our Data Manager Forid Alom. 

QI Project Story: Bridging the Bedford Gap

Read about how the team overcame challenges and are celebrating achievements in this blog by Felicity Stocker, Satwinder Kaur, James Patrick, Kamila Naseova, Kay Sookun and Evri Anagnostara.

Left to right: Satwinder Kaur, James Patrick, Kamila Naseova and Felicity Stocker.

The Bridging the Bedford Gap project aims to raise awareness of the Bedfordshire (and Luton) Recovery College (RC), and improving access to it. It aims to encourage diversity, promoting People Participation and learning about Quality Improvement. The team is also committed to being together and having fun, and to look after each other.

The team consists of a Recovery College manager, Ward managers, people participation lead and three service users: Felicity Stocker (Project Lead), Satwinder Kaur (Tea Party Poetry workshop facilitator) and James Patrick. The whole project is very much service user led.

The project started by inviting a number of service users and carers to an initial meeting in the summer of 2017, where we introduced the QI concept and asked all those that attended what we should focus on. We did a brainstorming session in which everyone put one idea on a post-it note and we then scored this according to our priorities.

The project that got the highest rating was the Recovery College. We all felt strongly that patients who are on the wards, which are located in Luton, can feel they are far away. The project then would work on ways to link them back to the Bedford community and the fantastic RC.

We decided to start on Oakley Court, which is formed of two wards: Ash and Willow. They both offer care for male patients from Bedford Borough and Central Bedfordshire, and are based in Luton. We had a fantastic response from the staff who gave great encouragement to the patients who wanted to take part in the initial project.

Before delivering workshops we gathered initial data for four weeks to gauge the knowledge of Recovery College by patients and staff. Then we started the first PDSA (Plan, Do, Study, Act) cycle: a Tea Party Poetry Workshop led by Satwinder Kaur. We plan to offer other sessions on People Participation, Recovery College Brochure walkthrough or work on discharge packs.

Since the beginning of the project we have faced several challenges, such as getting initial approval for the project and communication between team members. Travel to Oakley Court from Bedford takes time both by car and public transport. Also, patients are admitted and discharged, so the continuity is not as good as we would like.

On the other hand, we have certainly seen some achievements. We have had excellent feedback from ward patients following the Tea Party Poetry sessions, and also buy-in from ward staff. Satwinder Kaur, the facilitator said: “It has been a long journey from losing my identity to mental illness to finding my voice through my passion of Tea Party Poetry. Service users look forward to future sessions”.

In the light of all this, we can now say that being familiarised with the ELFT QI methodology has enabled us to learn about how to communicate within the team and with the outside world, to meet new people and to overcome anxiety. We have also been supported by our QI coach, Anna Smith. She is creative and encourages us to test our ideas. We are certainly feeling much more confident now.

We are now keen to see how our PDSA cycles are influencing the initial data and want to see how we can share our findings across the Trust.

Learn more about this project on Life QI – Project Code 106961

East London NHS Foundation Trust (ELFT) has been using the Life QI platform since June 2015 to manage our Quality Improvement (QI) portfolio. Projects are proposed, approved and worked on through the platform. Learn more about how important this platform is in this blog by our Data Manager Forid Alom.

Reducing Time Taken to Complete Neuropsychological Assessments in Memory Assessment Services in Luton and Bedfordshire

Memory Assessment Services in Luton and Bedfordshire have been working hard to reduce time taken to complete  neuropsychological assessment. Read more about their journey and achievement below.

The Psychology members of four multidisciplinary Memory Assessment Service (MAS) Clinics across Luton and Bedfordshire, collaborated on a cross-clinic project to reduce the time taken to complete a neuropsychological assessment to six weeks.

The team, made up of Clinical Psychologists, Trainee Psychologists and Assistant Psychologists used a nominal group technique to build their driver diagram. The team found this method to be inclusive of everyone in the team and an efficient way to decide on the important factors which made up their primary drivers.

Click on the image to see the flow chart ion full size

Since the QI Project spanned over four MAS Clinics, it was vital that operational definitions were clarified so that the data collected were comparable across teams. To do this the team decided to flow chart their assessment process to ensure that all teams were following the same procedures and to clarify when and how data would be collected.

Through process mapping it became apparent that each Clinic had difficulties in different parts of the process. Therefore, the teams decided on testing some ideas across all teams, as well as some change ideas which were specific to their Clinic.

The teams started with change ideas in areas which they felt they had most control over. For example, they wanted to reduce the delay between the assessment taking place and the draft report being available by allocating specific time for this as close as possible to the assessment appointment. Initially this was trialled with one Assistant Psychologist, using a number of Plan Do Study Act (PDSA) cycles to refine the changes to account for competing priorities, before scaling up to all Assistant Psychologists utilising this method.

Implementing this change led to greater efficiency in writing reports, as the information was clearer in mind. Assistant Psychologists report that the new structure helped to manage the workload and clear backlog. Since testing this change, all four MAS clinics have seen reductions in time from assessment to draft report ranging from 52% – 92%.

Click on the Image to see the charts in full size.

The teams have also been testing team specific change ideas through PDSA cycles and have already seen significant reductions in the time from referral to final report. Mid Bedford are already averaging 38.5 days; Luton at 42 days, Bedford is averaging at 39 days and South Beds is at 44 days. Although the aim was to reach 42 days, teams believe more can be done to reduce this time further and are now looking to gain service user feedback to inform their next change ideas.

The project team used a force field analysis to reflect on challenges they faced, such as the changeover in Assistant Psychologists. They also identified that working in small teams meant having to take on multiple roles and manage workloads with competing priorities. However, they found the QI meetings to be a useful platform to discuss these difficulties, which helped the team stay focussed and motivated.

Initially the team struggled to understand the progress of the project in the context of the wider team. However, having clear operational definitions helped them to develop a consistent data collection plan, which led to having visible data to illustrate how the changes had affected their system. This helped them to celebrate their successes and to consider the bigger picture by taking into account balancing measures to provide more clarity on how the system was performing.

The team also shared learning on their experience of running a project across four different Clinics. They recognised that each Clinic had differences in their process, which had to be considered when thinking of change ideas and developing a data collection plan. The project team found QI life to be a useful platform, as it could be accessed from anywhere. Together with Skype and disseminating minutes QI project meetings were made more accessible.

The team also appreciated the energy and enthusiasm bought to the project meetings by the Assistant and Trainee Clinical Psychologists. Project Lead, Emma Ellis has also bought forward great leadership skills to the team, moving the project forward through setting meetings and keeping on top of the process. We look forward to hearing how the project develops over the next couple of months.

Improving access to Learning Disability Occupational Therapy services in Beds and Luton

Please learn more about this completed ELFT QI project from the adjacent poster.

ELFT staff, service users and carers can access full details of this project on Life QI

The project code is 101269 , please log onto your QI Life account before clicking the image below.

Improving the triaging process

Creating a new triage tool leading to better risk management…

This clip was shown to delegates attending the 2017 Annual QI Conference in Bedfordshire & Luton

Congratulations to Wave 5 ISIA Graduates

On Tuesday 14 March 2017 our Wave 5 Improvement Science in Action (ISIA) trainees in Bedfordshire & Luton graduated from this six month QI learning programme.

Over this period they have been working on a variety of quality improvement work across the two Directorates. The final learning set and graduation day was a great opportunity to learn from each other and share the progress that has been made since ISIA training began in September.

Special thanks to the four QI project teams who presented their work to the whole group. It was also great to be joined by Jonathan Warren, Chief Nursing Officer, who passed on his congratulations and gave his encouragement for the continued progress of QI across Bedfordshire & Luton.

The training commenced in September 2016 and the first three days were led by Robert Lloyd, Vice President, Institute for Healthcare Improvement. Bob couldn’t be with the group for graduation but sent us this message.

Congratulations to all of our Wave 5 graduates. We look forward to seeing how your improvement works continues to progress.

See how keen they all were to graduate here!

Bedfordshire & Luton QI Journey 2016-2017

A quick review of the year in quality improvement for our Bedfordshire & Luton Directorates. Looking back at everything that’s happened since our QI launch event and conference in March 2016.

This video was first shown at the second annual QI conference in Bedfordshire & Luton on Tuesday 7th March 2017

2017 Bedfordshire & Luton QI Conference Slides

Download the slides for the second annual Bedfordshre & Luton QI Conference, held on Tuesday 7th March 2017

A look back at QI in Bedfordshire & Luton in 2016

By Ishrat Love-Chowdhury, QI Lead for Luton

It’s been an exciting year for QI in Bedfordshire and Luton. With much preparatory work taking place with senior leaders early in the year, the official launch for QI took place in April 2016 with the Annual Conference in the Rufus Centre, followed by a series of roadshows and events in a host of venues across town. Over 200 people have been involved in these events and 95 people are currently undergoing their 6 month Improvement Science in Action QI Training programme. With the help of structured training in QI Methodology, staff have developed 28 exciting QI Projects so far. These projects are looking at improving a wide range of issues identified by staff and service users for better access to services, to reduce violence and aggression on in-patient wards and improve physical health.

Over the course of next year, even more staff are signing up to be trained in Pocket QI, a shorter course on the methodology and tools for QI so that even more projects can get started in the months to come. Click here to see dates of upcoming training.

There has also recently been 2 “Intro to QI” sessions held in Bedfordshire and Luton encouraging  Service Users and Carers to learn more about why we use QI in the Trust and get more actively involved in the improvement work happening across the directorate

Service Users and Carers complete their Quality Improvement training in Luton

We’re excited to see what 2017 will hold!

Active QI Projects – June 2019

This is the monthly report generated from Life QI, showing all active projects within all the directorates.

Bedfordshire & Luton Wave 5 ISIA

Bedfordshire and Luton staff share their thoughts on Wave 5 Improvement Science in Action (ISIA) training.

From 14th-16th September 2016 over 100 staff joined Dr Robert Lloyd from IHI and the QI team for their first face to face training workshop of the 6 month ISIA programme.

The ISIA teaches QI project teams to refine their aims, use Driver Diagrams to understand their system and prioritise change ideas, measure data for improvement, test changes using Plan Do Study Act (PDSA), and introduces many other concepts and tools that teams can use throughout the project’s lifecycle.

Bedfordshire & Luton Wave 5 ISIA

Bedfordshire and Luton staff share their thoughts on Wave 5 Improvement Science in Action (ISIA) training.

From 14th-16th September 2016 over 100 staff joined Dr Robert Lloyd from IHI and the QI team for their first face to face training workshop of the 6 month ISIA programme.

The ISIA teaches QI project teams to refine their aims, use Driver Diagrams to understand their system and prioritise change ideas, measure data for improvement, test changes using Plan Do Study Act (PDSA), and introduces many other concepts and tools that teams can use throughout the project’s lifecycle.

90 Seconds with Neil Lad

We spoke to Neil Lad, Clinical Practice Lead for Onyx Ward and QI Coach in Luton,  about his role and his thoughts on quality improvement…

Neil Lad (Neil.Lad@elft.nhs.uk) QI Coach for Luton

Thank you for agreeing to be interviewed today. Firstly, could you give us a brief summary of your role and what a typical day at work is for you?

As a clinical practice lead my role is to provide clinical leadership in front line delivery of care alongside my colleagues. Onyx ward is a busy and unpredictable 20 bedded female ward in Luton so there is no typical day! No two minutes are ever the same, definitely keeps you on your toes! 

What do you enjoy most about your role?

Working with service users. Every individual has their own story and are an inspiration in their own right. It’s the one thing that will continue to wake me up in the morning to come in to work.

What do you do in your day-to-day work to support us to continually improve?

In my day to day work I encourage the team to continually take feedback from service users and carers and how we can look to improve on what we already do. I’m a perfectionist so I’m always looking for ways to improve our delivery of care and encourage others to do so.   

What would you say to someone who feels that QI is a box ticking exercise and is unsure about the benefits of QI to us as a whole Trust and themselves individually?

The stories of success for service users and staff speak for themselves! Who wouldn’t want to work in an environment where there was less violence or where service users are continually receiving the right care at the right time in the right place?! If QI was a tick box exercise it wouldn’t be receiving the acclaim that it is and actively improving service user and staff experience.

Do you have a story of something inspiring that has occurred through QI?

The most inspiring thing that I see are service users and staff being able to channel their passion into improving services. QI truly embraces a bottom up approach which is vital in ensuring inclusivity and collaborative working.

What do you see as the biggest challenge to embed quality improvement, and what can we do to tackle this?

The biggest challenge is making it business as usual. However, the array of options for training and involvement with QI now can reach a wider audience. For example, not everyone can commit to the 6 month ISIA programme therefore pocket QI may be beneficial. Plus, to be involved with QI you don’t need to have completed the training, there is such an extensive support structure in place that there really is no excuse!

Where do you see us as a Trust in 3 years’ time?

I see the trust building upon its growing reputation and becoming a centre of excellence!

Finally, could you sum up what quality improvement means to you and why you feel it is so important to us as a Trust to embrace.

To me QI is a way of working that allows anyone, irrespective of job role or experience to help improve the lives of service users and staff. If you’ve got an idea or a theory about how something can be improved QI encourages you to try this out. It’s inevitable that not every idea will work; however, it allows us to learn and grow as individuals, teams and as an organisation.   

A Carnival Atmosphere for QI in Bedfordshire & Luton!

The quality improvement programme

ISIA training was held at the UK Centre for Carnival Arts

in Bedfordshire and Luton is now well underway with the start of Wave 5 Improvement Science in Action (ISIA) training. From 14th-16th September over 100 staff joined Dr Robert Lloyd from IHI and the QI team for their first face to face training workshop of the 6 month ISIA programme.

Over the last few months training participants have been developing service improvement ideas that are now becoming fully formed be QI projects as the training progresses.

The ISIA teaches QI project teams to refine their aims, use Driver Diagrams to understand their system and prioritise change ideas, measure data for improvement, test changes using Plan Do Study Act (PDSA), and introduces many other concepts and tools that teams can use throughout the project’s lifecycle.

Around 30 QI projects across the two Directorates are now up and running, see some of the themes below. Look out for the improvements they will bring for our service users!

ELFT have now trained over 500 staff, service users and carers in ISIA, equipping them with core skills to lead improvement to all our services. If you’re interested in ISIA or any other QI training, have a look at this to see what best suits you.

Delegates on Wave 5 ISIA training