and Learning
Practitioner Programme Insert image of you here My learning aim: (reason for signing up for QSIR) I have recently joined the Transformation Team at DCH and thought this was a good opportunity to learn about NHS Transformation and what tools and methods were used in an NHS setting. Lightbulb moment: What were the key things you learnt during the course? PDSA – I’d heard the term but wasn’t sure what it meant. The exercise we did cemented how to use it and I will definitely be using it and I am already planning which areas of projects I will be using this in . QSIR Champion: What advice would you give future delegates/ their line managers/ teams Do it!!! It is a fast-paced course which is really enjoyable. Be prepared to join in, the more you put in the more you will get out. The exercised that accompany the learning are really helpful and fun! Name: Job Role: Date completed QSIR Practitioner: Impact: Putting your learning into action: How has attending helped in your job role? What difference will you manager/team see? What do you plan to do next in….? • • It was really useful, having never worked in the NHS before, to learn about all the different tools and methodologies that are used. Learning about all these tools will help with all my projects and I have already started using some of the tools which the Project Team have found really helpful. It will also help me to understand what my team are talking about when they mention some of the tools and help me integrate into the team. • • • Early application: What have you already used? (please share your examples with us) I used the Fishbone Diagram to understand the problems with Children and Young People attending ED with Mental Health issues. We were due to have a new care model workshop to design the new care model but were concerned that the workshop would focus on all the problems so the project team felt that if we completed a Fishbone Diagram prior to the meeting we could start the meeting with a quick review of the diagram and then move forward positively with the new care model vision without people referring to what currently happens and doesn’t work…..it worked!! 3 days I will be looking to map the variation in waits for Children awaiting an ASD diagnosis and how the different methods of managing this list affect the variation. 3 weeks I will be undertaking my first PDSA, testing an idea from a workshop to improve the management of Diabetes by reducing the unnecessary administration of insulin to people in the community. I will be reviewing a PDSA which someone else has completed to look at what we learnt and compare it with the old process and see if there are still further improvements we can PDSA. • 3 months • I would expect to have several PDSA’s happening across my various projects. • I will have become more familiar with the tools and will be using them when appropriate in my projects.
Practitioner Programme Insert image of you here My learning aim: Lightbulb moment: What were the key things you learnt during the course? Date completed: Impact: - - Putting your learning into action: How has attending helped in your job role? What difference will you manager/team see? (reason for signing up for QSIR) To improve my skills and knowledge of quality, service improvement and redesign tools, theories and techniques so as to support and lead on quality improvement initiatives within therapies and wider organisation. Name: Job Role: What do you plan to do next in….? Improved my ability to put together a project plan with clear, SMART objectives with a strong focus on who are the key stakeholders. Strengthen my understanding of different ways of presenting data and the impact data can have on the successful outcome of a project in terms of sustainability. Improved my understanding and ability to populate a useful driver diagram and utilise this achieve key objectives and as a way to articulate progress. The power of data to lead quality improvement, service development and influence decision making. Early application: QSIR Champion: What advice would you give future delegates/ their line managers/ teams To ensure that staff who are looking to attend the QSIR training to have a specific, SMART project in mind prior to beginning the training so that the most can be gained from the sessions. What have you already used? (please share your examples with us) Project template Driver diagram hints and tips Stakeholder template to gain insight into stakeholders within larger projects as a learning tool for future projects How do we balance capacity and demand guidance sheet. • 3 days Review project plan and driver diagram for job planning and demand/ capacity tool. Take stock of progress and timeframes for achieving objectives set. • 3 weeks Work with key individuals to ensure all job plans in place for senior physiotherapists and capacity calculated. Ensure accuracy of BI report to report on Demand Staff feedback on process. Further staff training if required. Rolling agenda item in supervision . • 3 months Timeframe for all registered staff to have a job plan in place and for Capacity to be calculated for each outpatient service mapped against demand. This will support business planning for specialist areas that require additional resource.
Practitioner Programme Insert image of you here Name: Job Role: Date completed QSIR Practitioner: Putting your learning into action: Impact: My learning aim: To help support my quality improvement work within Infection Prevention and Control. Find a way to correctly document a QI project. Lightbulb moment: What were the key things you learnt during the course? It was helpful to have access to the trust documents and driver diagram information. The driver diagram should evolve and develop as the QI project progresses, I was not aware of this continued process, and this was a lightbulb moment. Great trust networking and support. QI work is a journey, it may take time and progress maybe slow, and it may change direction as this is ok! How has attending helped in your job role? What difference will you manager/team see? Understand the key aspects of a QI project in more detail Section by section. Helped me have the confidence to lead bigger QI projects. Understand SPC charts and how they might be helpful within my department. Found the trust networking very helpful. What do you plan to do next in….? 3 days • Read over the work booklet and digest the information. 3 weeks • Continue to progress through my QI project and linking with the stakeholders as needed. 3 months • As the project develops and then draws to a conclusion, I will reflect on the process, what went well, what could I have done differently and ensure I share the learning trust and system wide. QSIR Champion: What advice would you give future delegates/ their line managers/ teams Make sure you have identified your project aim before the start of the programme. Talk to your team about the course. Talk about your ideas.
Job Role: QSIR Practitioner Programme Date completed QSIR Practitioner: My learning aim: Impact: (reason for signing up for QSIR) How has attending helped in your job role? What difference will you manager/team see? • To help build my knowledge and skills in quality improvement methodology to help me with practical application, and to identify efficiencies to develop the department I lead. Lightbulb moment: What were the key things you learnt during the course? • • Driver Diagrams!! so many ways in which you can apply them. Ensuring that the idea/programme isn’t too wide to ensure tangible measurements.. PDSA…. Pilot smaller areas and then go big!! Putting your learning into action: It has better helped guide the programmes & projects I am involved in making them more efficient /streamlined It has given me to space, time and tools to expand my strategic thinking, improving my ability to develop the senior team and department I work in Early application: QSIR Champion: What have you already used? (please share your examples with us) What do you plan to do next in….? 3 days……….. Already used some of the tools such as driver diagram tool to map out future plans and prgrammes. 3 weeks………. Identifying ways to improve data around Mandatory compliance learning, to help inform teams across the trust 3 months…… A number of the tools will help inform the strategy and plan of the department…… Asking all of the senior team to attend this programmes to develop joint /joined up thinking What advice would you give future delegates/ their line managers/ teams This course is a must!! It opens the mind to a wider perspective, develops your strategic thinking and uses tried and tested methodologies. There is also a wealth of experience within the QSIR facilitators to tap in to! Rag rating…… a thing of the past!!
Practitioner Programme My learning aim: Our project “Outpatient Electronic Prescribing” aims to change 100% of outpatient clinics at Dorset HealthCare from paper based FP10 prescribing to electronic processes by April 2025. Lightbulb moment: The benefits and importance of; • Stakeholder engagement & prioritising • Driver diagrams evolve • Process mapping • Act, Plan, Study, Do • Experience-based co-design Name: Job Role: Date completed QSIR Practitioner: Impact on my team: Putting your learning into action: The programme has equipped me with the knowledge and practical skills to confidently engage in quality improvements across the organisation. It has given me the know how to help design and implement more efficient and productive services using the tools available. When I become involved in future projects, I will use the QSIR 6 stages to ensure project success. 1. What is the opportunity/problem. 2. Define the current situation. 3. Measure the benefits and impacts. 4. Design and plan the future. 5. Pilot, planning, testing and reporting. 6. Deploy, Monitor and BAU. • In the 3 days I will: Functional and user acceptance testing. Study the outcome of this and review the issues log. Are there any changes required? Are there any showstoppers? Make changes if possible or mitigate these. • In the 3 weeks I will: Pilot the new system and processes for up to a month. Study the outcome of this pilot and capture any learning. Reflect on how well the pilot is going. Are there any changes required. Act on these if required. Continue in pilot if any changes are made and re-study the outcomes. If positive outcomes, then continue to deploy. • In the next 3 months I will. Review deployment, study the outcomes, analyse the data and capture learning. Are there any changes required? Continue deployment. Review benefits. Early application: QSIR Champion: QSIR training equips you with the skills to lead transformational improvements across your area of work. I would recommend this to anyone involved in projects or change management. If you believe in improvement a structured QSIR approach is a must. Tools I have used: • Fishbone diagram • Driver diagram • Data collecting • As is process mapping • To be process mapping • Testing
Practitioner Programme Insert image of you here My learning aim: (reason for signing up for QSIR) I signed up to the QSIR Course to expand my skills within Service Improvement. Using this knowledge, I wanted to help everyone in my team by introducing new skills and techniques which I could use to support a wide range of projects. Lightbulb moment: What were the key things you learnt during the course? A technique that stood out to me the most was the PDSA cycle plan, do, study, act . In some cases, when resolving issues or working with projects steps to this process can be missed. But using this technique gave a planned approach to understand why changes may or may not be working. Name: Job Role: Date completed QSIR Practitioner: Impact: Putting your learning into action: How has attending helped in your job role? What difference will you manager/team see? What do you plan to do next in….? Attending the QSIR course has helped me identify process and techniques that I’ve not been exposed to before. With these new learnt skills, I have been able to apply this learning to my Quality improvement project. With my improvement project I hope to reduce the amount of time that is taken on average to complete job requests within the CSST. Doing so should: • Improve staff morale. • Help prioritize time, making senior staff more available for projects. • Quicker completion of job requests. Early application: QSIR Champion: What advice would you give future delegates/ their line managers/ teams When first attending the course, I was quite apprehensive due to a lot of clinical examples being used for learning. Where I am in more of a technical role the examples used were not always relevant to me. After each day, I could see how I could apply these improvement techniques to my own scenarios, as each sections was very well explained by the educators. • 3 days Continue to work through the “Do” process of my current PDSA cycle for a one-month period to record the same time frame as recorded before the implemented change. • 3 weeks Study the change I implemented and identify if this has reduced the average time it takes the CSST to complete job requests. With this data I want to then compare this to the average time it would take to complete jobs before the change was applied. From here I will then be able to identify is this has affected the average time. What have you already used? (please share your examples with us) My project aim is to reduce the average time that is taken for the Clinical Systems Service Team to complete Job Request by 25% within a 6 Month period. I am currently working through a PDSA cycle for a change that we have put forward within my team. The change is allowing staff members dedicated time of the phones, with this time they can solely focus on Job requests and not get distracted by a constant flow of phone calls and emails. I am waiting to trail this change for a month initially, and then repeat this process again to identify the best possible change. Before this change was implemented, I also ran a report from our Job request systems to identify our current average time on job completion. • 3 months At this point I want to have been able to work through multiple PDSA cycles to help identify the best possible change. All data I’ve collected can then be presented to my management via a run chart, to then show that the average time to complete a job request has reduced by 25% (Hopefully)
Practitioner Programme Insert image of you here My learning aim: (reason for signing up for QSIR) To implement a pathway to discharge end of life care patients from hospital. Lightbulb moment: What were the key things you learnt during the course? How to specify the aim of project so its not so vast. Being aware of stake holders and how other areas may be affected. Learning to identify sustainability of project. Name: Job Role: Date completed QSIR Practitioner: Impact: Putting your learning into action: How has attending helped in your job role? What difference will you manager/team see? What do you plan to do next in….? Aware of how changes may impact others and how daunting it can be To listen and respond to feedback positively, co-operating and being receptive to change from others Work collaboratively for a common goal To be aware of my own actions as a role model towards others and how this can impact on projects • • 3 days Develop a questionnaire to identify knowledge regarding end of life care discharges from nursing staff • • 3 weeks Discuss results from questionnaire with stakeholders to identify areas for improvement in how we can increase this to utilise what is available already • 3 months QSIR Champion: What advice would you give future delegates/ their line managers/ teams Be receptive to others ideas and points of view Work together for a collaborative goal Highlight the practicality of a project and how feasible it is to bring into practice Early application: What have you already used? (please share your examples with us) Ensured I developed a SMART aim that is achievable Developed a pin point plan in order to highlight a focus for my project Used a FISHBONE diagram to develop my plan Identified stakeholders within my project and how we can work together to progress the project Develop a step-by-step discharge pathway for nursing staff to use in order to discharge end of life patients home or to more suitable places more effectively
Practitioner Programme Insert image of you here My learning aim: (reason for signing up for QSIR) After many years as a programme and project manager outside of the NHS, I wanted to learn about the NHS way of approaching quality improvement to have this in common with my team. I wanted to understand NHS tools for continuous improvement vs transformational change. Lightbulb moment: What were the key things you learnt during the course? The session on leading change was insightful, including how to nurture innovation and how to create an environment where people are willing to identify problems and share ideas. This linked to process mapping and the importance of mapping the process that actually happens, which depends on people feeling able to be open and honest. QSIR Champion: What advice would you give future delegates/ their line managers/ teams I’d advise future delegates to bring a problem that needs solving to work on, and not a project that already has a solution in mind. I’d recommend taking time on each day of the course to reflect on earnings and write them down, and to plan time after each day of the course to start using some of the tools straight away. Name: Job Role: Date completed QSIR Practitioner: Impact: Putting your learning into action: How has attending helped in your job role? What difference will you manager/team see? What do you plan to do next in….? It’s great to have the QSIR learning and tools in common with other members of my team and department so we can understand each other better and have common techniques we can readily apply on a project. We have already used tools like the 9C’s to help us expand stakeholder analysis for projects in progress. Attending has changed the way I approach my project, about bringing together ways of working across several teams, as I have realised that I need to reposition myself more neutrally across the teams and show that I am listening to the diverse views of the combined group, rather than being seen to champion the ways of working already establishing in my own area. It has also made me think differently about being an ‘intrapreneur’, applying the PDSA cycle and being prepared to fail fast to test out my thinking in a project. Even where projects have established solutions, I’ve realised I need to be prepared to speak up if those solutions are not working out. • • 3 days Following day 1 of the QSIR course I used some of the techniques including the fishbone diagram and elements of leading change, to plan and facilitate a workshop between the teams whose ways of working need to be brought together. We had good engagement and a productive day with some outputs we can use straight away that contribute to our goal. The resistance to change topic was useful for this workshop. • • 3 weeks Following day 4 of the QSIR course, I planned and led a team day with 2 colleagues who have recently completed the course, where we shared some of the QSIR learning with our team (e.g. comfort zones) and used the tools to look at our own ways of working within the team. • • 3 months I plan to review our current live projects vs the sustainability model to consider what’s going well and not so well, what we need to focus on and what we can learn for future projects. At the moment we are not always thinking about sustainability through the full life of the project and I believe we need to do more from the start. Early application: What have you already used? (please share your examples with us) I have used the fishbone diagram to explore my project in more detail and to collate the feedback I’ve received from others into a more structured format. Previously I have always used the affinity diagram for this type of activity. Whilst the affinity diagram is great to use when people are gathered face to face, I have found that it is not well suited to Teams calls. The fishbone diagram worked better in the Teams environment as there was a visible structure we could work on together. Using the fishbone diagram made me think harder about all the possible causes of the issues we are trying to resolve and to look at the problem more broadly and thoroughly. It also helped unite people behind finding solutions.
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