Liz Twelves from AQuA presentation on getting support for Quality Improvement projects

1. Getting support for
your QI project

2. Your facilitator today is:-
Liz Twelves
Academy Programme Lead
liz.twelves@srft.nhs.uk
www.aquanw.nhs.uk
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3. What is AQuA?
Advancing Quality Alliance
• North West quality improvement organisation
• Established 2010
• Membership: 70 organisations - Acute, Primary care,
Community, Mental health and Ambulance trusts
across North West England
• Core team of around 30 staff plus Associates and
Affiliates
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4. Expectations?
What motivated you to come to this
session?
What issues have you experienced with
trying to implement change

5. Learning Objectives for the Session
By the end of the session you should be able
to:
Understand the reasons why introducing
change is so difficult
Have some strategies to improve your
chances of success
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6. What happens to
change efforts in reality?
In order of frequency:
1. The effort effectively “runs out of energy” and
simply fades away
2. The change hits a plateau at some level and no
longer attracts new supporters
3. The change becomes reasonably well established;
several levels across the system have changed to
accommodate or support it in a sustainable way.
Source: Leading Large Scale Change:
a practical guide, NHS Institute

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10. Change is situational: new site, new boss, new
team roles, new policy.
Transition is the psychological process people
go through to come to terms with new
situations
William Bridges
Change is different from transition
Change can be instant, transition takes time.
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11. Elizabeth Kubler-Ross The Change Curve

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15. Stakeholder GridInfluenceorPower
Interest
Key
Player
Meet
Needs
Inform Consider
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16. Readiness for Change – Influencing
Source: NHS III
• Identify who might be for, or against your project and
proposed changes.
• You can then plan necessary influencing activities.
Name In Favour Neutral Opposed
Ward Manager
HCA AJ
Catering Manager

17. WIIFM?
Key
people or
group
What’s In It For Me
(WIFM)?
What could they do
to support or
prevent the
improvement
initiative?
What could/should
we do to reduce
non-compliance
activities or
support compliant
ones?
+
Impact
-
Risk
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Key
people or
group
What’s In It For Me
(WIFM)?
What could they do
to support or
prevent the
improvement
initiative?
What could/should
we do to reduce
non-compliance
activities or
support compliant
ones?
+
Impact
-
Risk
Catering
Team
*Reduces phone
calls received/
disruptions
*Reduce food
waste
*Change to
current working
practice – takes
up time
*Will be reliant
on ward staff
completing
forms correctly
*Could ignore the menu
cards or refuse to consider
them.
*Could encourage use of
menu cards if can see
benefits
Explain benefits and
acknowledge risks

18. Repeated use of the PDSA cycle
Testing and
refining ideas
Implementing new
procedures & systems
- sustaining change
Bright
idea!

19. Influencing
• Personal narrative and storytelling
• WIIFM (What’s in it for me?)
• Ghengis Khan

20. Why People Engage
• Regulatory mandate
• Risk management issue
• “If you knew, or should have
known, and don’t act…”
• Evidence
• Data
• Logic
• Business case—
Return on
Investment
• Stories—recent, local,
real
• Videos? Bring a
patient along?
• “How many people will
be affected?”
Source: Reinertsen

21. The most successful projects:
• Clearly defined purpose & Aim statement
• Visible ownership and support from senior mangers
• Clear and relevant measures to demonstrate progress
• Part of Strategic Focus
• Strong stakeholder involvement (Service Users)
• Good data management
• Good team & internal/external communications
• Planned handover (project planning to operational)

22. NHS Scotland 10 key factors for successful spread and sustainability

23. Thank you and ….