Do not underestimate the importance of cultural and behavioural conditions to learning. The Quality Management System Framework emphasises the importance of leadership beliefs, attitudes, skills and behaviours.
Leaders should promote a focus on issue analysis without blame, recognise and celebrate success and embed coaching and compassionate leadership into management practice.
The IHI White Paper A Framework for Safe, Reliable and Effective Care identifies 9 components of culture and the learning system and how they interact.
Leadership – Facilitating and mentoring teamwork, improvement, respect and psychological safety
Psychological safety – Creating an environment where people feel comfortable and have opportunities to raise concerns and ask questions
Accountability – Being held to act in a safe and respectful manner, given the training and support to do so
Teamwork and communication – Developing a shared understanding, anticipation of needs and problems and agreed methods to manage these and address conflict situations
Negotiation – gaining genuine agreement on matters of importance to team members and service-users
Transparency – openly sharing data and other information
Reliability – applying best evidence, minimising variation with the goal of failure-free service delivery over time
Improvement and measurement – improving work processes and patient outcomes using standard improvement tools including measurement over time
Continuous learning – regular collection of intelligence and learning from successes, challenges and defect/failure
Source: Frankel A et al, A Framework for Safe, Reliable, and Effective Care, IHI White Paper
Understand if this is a new innovation or a change in methodology
To determine best next steps and to support turning knowledge into action, it is important that learning system participants take the time to analyse and make sense of new information/data/evidence. Clarity about what the learning and data suggests will support decisions related to further promotion and dissemination.
Consider the following questions:
- How do we harness the collective intelligence to identify key learning and inform next steps?
- Is this an innovation or does it impact a process? Is there data to show this?
- Can this intelligence further inform our approach to data, be it collection, collation, analysis or dissemination?