This document discusses embedding quality improvement and sustainability in the future workforce in Wales. It provides background on the quality improvement journey in Wales' National Health Service, including establishing a common language and training 25% of the workforce in quality improvement by 2014. It describes the Improving Quality Together framework, which aims to support a change in mindset where individuals see improvement as part of their daily work. It also discusses engaging higher education partners to integrate quality improvement training across professions and institutions in Wales. The goal is to improve patient care by focusing on processes, communication, and empowering students to lead continuous improvement from the start of their careers.

1. Embedding Sustainable Change in our future
workforce – a story from Wales
Emma Thomas,
Improving Quality Together Lead for Higher Education,
1000 Lives Improvement

2. Wales
Population 3.1 million
7 integrated Health
Boards
3 NHS Trusts
Approx 70,000 staff

3. National Quality Improvement Journey
Where we are in Wales
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
IHI 100,000
Lives
Campaign
Safer Patients
Initiative
+ =
1000 Lives patient
safety Campaign
1000 Lives Plus
– national
programme in NHS
Wales
Bespoke support
for Health
Organisations in
Wales

4. We must achieve a common and
consistent language and approach
to improvement across Wales
1000 Lives Plus will be the core NHS
improvement programme
Current National policy context
Double Goal, Quality Assurance and
Quality Improvement
25% of the workforce to be trained
in Quality improvement by 2014

5. • Recognise with clarity and courage the needed for wide
systemic change – all improvement begins with
recognition of the need to improve.
• Reassert the primacy of working with patients and carers
to set and achieve quality goals.
• Use quantitative targets with caution.
• Recognise that transparency and open communication is
essential.
• Give the people of the NHS – top to bottom – career
long help to learn and apply modern QI/QA methods.
• Make sure pride and joy in work, not fear, infuse the
NHS
Berwick Report...

6. “Improving Quality
Together is patient-driven.
It’s also staff-driven. By
improving quality, we can
take away some of the stress and strains
on staff.”
Chris Rowland

7. Aims
Measurement
Ideas, hunches,
other people etc.
Three
fundamental
questions for
improvement
How to make change
happen
Langley et al (1996) – cited 1000 Lives plus (2012)
So what framework do we use?

8. Improving Quality Together aims to support a
change in mindset in NHS Wales, where each
individual demonstrates a belief that:
 They have one job and two roles: to do and improve.
 Small step changes can make a big impact.

9. Audit
Posters
International
Forum for Quality
& Patient Safety
2013

10. Process &
System
Improvement
Posters
International
Forum for Quality
& Patient Safety
2013

11. • Common language of improvement
• Focus on person-centred care
• Consolidation of quality improvement in NHS to date
Framework of quality improvement skills:
• Quality improvement backbone for NHS Wales
• Integrated in learning & development
• Integrated into practice

12. IQT Framework
• 3 levels of development:
• Bronze – what
• Silver – how
• Gold – teach
• Complemented by Board level
development.

13. So where are we?
• 1507 Completed IQT Silver online
• 2 Silver cohorts across Wales
• 50 improvement projects underway across Wales
• Integrating into Pharmacy, Nursing, AHP, Medical
curriculums

14. So where are we?
• Three network events held to date:
• 40 - 50 staff attended
• Higher Education Partnership Group set up
• All universities in Wales engaged and attending
• Preceptorship, mentor and student members
• share and coordinate best practice across education
• vehicle for the structured integration of IQT across
Wales
• ensure equity and parity across a Pathway to IQT
Silver across all professions and institutions.

15. So what is success?
• Success requires collaboration and innovation
from team members working together
• Combining professional knowledge with
improvement knowledge is very powerful for
providing safer and better care

16. So what is success?
Success is ...
• improving how students safely and humanely meet the
needs of our patients
• focusing on processes, not blaming others
• allowing students to have positive learning experiences
with quality improvement
• enabling students to communicate with and engage
staff and creates continuous improvement

17. What did we do?
Over the last 18 months ...
• Engagement with key professionals within the universities
• Changed learning to suit students who may not have been
into the workplace
• Focussed on communication and teamworking skills
• Empowered students to ‘lead’ improvement right from the
start of their careers
• Made links between quality improvement and required
staff skills