Creating the conditions for improvement
Before starting any quality improvement project, consider the following:
- Forming your team
When collaborative teams started their improvement projects, they found it crucial to understand the desire for the forthcoming work and the vision for the work moving forward.
Improvement teams were established in the early stages of the work to answer these questions and set the stage for the work to come.
Think about the following when establishing your improvement team:
- Who is required to be in your improvement team? Are there external partners or other key players who should be involved in this work? For example, education, social care, and the third sector.
- When are you going to meet and how regularly?
- How will you communicate with each other?
- How will you communicate with the wider service team?
- How can you involve people who have experienced your service in the team? How will you capture their stories?
Teams working in the collaborative emphasised the importance of working not just with staff, but with external stakeholders including those with lived experience of the service.
This NHS Ayrshire and Arran CAMHS example (PDF) demonstrates their focus on stakeholder engagement. Other teams also used creative ways to connect with stakeholders, including the NHS Dumfries and Galloway Neurodevelopmental Project Team who co-designed their work with a parent and used Lego! (see below).
Our Community Engagement colleagues produced guidance on digital stakeholder engagement, and the QI Zone web page on stakeholder analysis can provide additional information on identifying your stakeholders.
- Building mutual understanding and trust
When a team is initially formed, building mutual understanding and trust is key to ensuring good working relationships.
Kahler’s 5 Drivers is a tool designed to help teams understand an individual’s behaviour and build relationships more effectively. Securing local improvement support and training opportunities within your NHS board or health and social care partnership (HSCP) can also support staff to participate in QI, test changes and develop a shared ownership of the work. Further information regarding QI training can be found on the QI Zone website, or by contacting your local QI lead.
Using a readiness tool
Establishing whether the conditions are right for change is crucial including how well your team is positioned for improvement work and areas you may wish to develop before commencing this work.
The MHAIST collaborative teams used various methods to establish their state of play and one team went on to develop a readiness tool afterwards. A readiness tool (PDF) like this one can help establish:
- the current state of play within your team
- motivation of staff within your team to develop, test and implement new processes, and
- team resources and abilities to develop, test and implement change.
Using a project charter
A key stage of the teams’ improvement projects involved agreeing the scope, objectives and people who would participate in the project.
Teams found using a project charter helpful in providing direction and a sense of purpose to their improvement project. A project charter is a document that outlines various aspects of the project, including the scope and members of the project team.
Download a project charter template (Word doc)