Posted on: 8 February 2022

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February 2022                                                                                        

Welcome to our second Improvement Academy Newsletter for 2022.

In this edition, our feature article will be on the power of storytelling with some useful top-tips and downloadable guides to support you and your teams with your improvement work. Our first improvement story of the year to share with you is from Dr Arthur Wong and the Integrated Sexual Health Services team. Each month we will be sharing great examples from across CNWL where individuals and teams are improving systems and processes to ensure that we deliver the best evidence-based service user and carer experience where ever teams are delivering care across the trust. We also have exciting updates from the Improvement Academy and share great educational opportunities that are coming up.

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The power of story-telling

Stories have been used to hand down learning and knowledge for millennia. A powerful story can engage our emotions and our imagination. Traditional forms of storytelling will be familiar to many of us in the form of fables, fairy tales and legends. These oral and written stories evolve with time as they are re-told and brought to life in different forms.

Storytelling is recognised in many industries as an important way to connect with any audience. In health care, stories have been proven to be a useful tool in engaging people with improvement work.

Telling the story of one service user’s or one carer’s or one frontline staff member’s experience can illustrate improvements or problems in a particular care pathway in a way that can be profoundly memorable to the audience.

Both qualitative and quantitative data play an important role in monitoring and understanding service delivery and driving improvement, but the right story can also have the power to bring a key issue to life, inform debate and discussion and ultimately influencing a change in thinking.

Stories give us the opportunity to learn from the experience of another and it can shape, strengthen or challenge our opinions and values. We are also more likely to retain the message and meaning within the story than if it was presented to us in plan facts and data.

We respond to stories, especially when there is emotional detail and we retain information that is provided in story format in a much more vivid way. Stories can take many forms but usually have multiple common ingredients.

 

Top tips for impactful storytelling:

  • Identify an individual or two as the main character for your story
    • The fewer protagonists in the story the more impactful it will be
  • Paint a picture through descriptive details that will bring colour and context to your story 
  • Build emotion or curiosity into the story in a way that will make people care &/or want to know more about the main character
  • Lead your audience to a resolution or a focused call to action
    • This will inform the listener as to what they should do next

 

 

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Infographic on Top Tip on Story Telling

 

During our last CNWL Practicum learning session we shared a model to support teams in developing their stories to support their improvement projects.

The S.I.R. model contains the following three elements:

  • Situation
    • Explain the situation or problem in simple terms
    • Include your role &/or the role of your service user or carer
    • Ensure to describe how this situation feels to those involved
  • Impact
    • Explain the impact of this situation or problem on service users/carers and staff
    • Include any data or feedback that you feel would best support your story such as a human or financial cost
    • Describe who can benefit from any improvement
  • Response
    • Explain what you hope to do about the situation or problem and what help you need from your audience

As we all know, stories can be used for a variety of reasons, such as to engage, promote or celebrate. Therefore, it is key to know why you are telling your story as this will help you to shape the narrative. These skills can be used in multiple forums ranging from the informal impromptu corridor or ‘water cooler’ conversation through to a more formal setting where you are presenting your improvement work to a project sponsor or member of the divisional or executive boards. Here are some examples of where storytelling has made a strong impact @CNWL:

 

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Storytelling is an art form and a skill that can be developed. We hope that these top tips have been helpful. In the mean-time if you would like any support with fine tuning your improvement story then please do not hesitate to speak with an improvement coach or book a slot at our QI clinic where we can help you create the impactful story that will help you to best engage and inspire your audience.

To book a QI clinic slot, please email us at cnw-tr.improvementsupport@nhs.net and we look forward to hearing from you. Additional details re QI Clinic and other educational opportunities are below.

If you would like to read more about how to use storytelling then please see the following ‘quick guide’ link from The Health Foundation: https://www.health.org.uk/sites/default/files/Using-storytelling-in-health-care-improvement.pdf

References:

Cooper A, Jonathan G, Wilson, Lines C, McCannon J, McHardy K, 2015. Exploring the role of communications in quality improvement: A case study of the 1000 Lives Campaign in NHS Wales, Journal of Communication in Healthcare, 8(1): 76-84 accessed 25 January 2022: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4391293/

Mendoza, M, 2015. The Evolution of Storytelling, Reporter online, accessed 25 January 2022: https://reporter.rit.edu/tech/evolution-storytelling

Improvement Stories

Due to the unprecedented success of our 2021 CNWL Safety Conversation Day poster competition, we would like to support teams and individuals by shining a light on the many great examples of improvement work that is happening across the trust.

Our first story is by Dr Arthur Wong who won Best Trainee Award at the CNWL Safety Conversation Day for his and his team’s improvement project. 

Integrated Sexual Health Services (ISH): Improving offering & uptake of HIV Pre-exposure Prophylaxis (PrEP)

We knew we had a problem with offering PrEP to eligible men who have sex with men (MSM).  As a starting point we collected baseline data and found that current uptake of PrEP was just 78%.  Based on the most current evidence we knew we needed to improve the offering and the uptake.

We iteratively tested many change ideas through PDSA cycles, which helped us understand what worked well and what we needed to adapt.  Based on this we found that reminding staff to offer PrEP was one of our most promising change ideas.

We did this through setting up a reminder prompt in our electronic patient record system, sending individual reminders to staff and we also held daily clinic huddles where PrEP was on the agenda.

Through these reminders and other change ideas, we improved the percentage of MSM who were both offered and accepted PrEP from 78% to 95-100%.

A part of the project that I really enjoyed was getting the whole team’s input.  I think this was central to the success of the work. The project team also fed back that

"We have learned throughout this QI Project the importance of providing a variety of teaching environments in order to empower our staff to feel confident offering & commencing someone on PrEP. We deliberately catered to a range of staff groups using a variety of modes of delivery (from 1:1, to small groups to whole-service teaching) so no one feels left out."

Going forward we want to build on this and explore the barriers and leavers to PrEP uptake with the people who use our service.

Since creating our poster, we have continuously measured our outcome and found we have sustained our improvement.

If you would like to know more specific details about this project then please click on the link HERE to see this winning poster or email us at cnw-tr.improvementsupport@nhs.net and we will be very happy to connect you with Dr Arthur Wong.

 

The Improvement Academy

This has been an exciting first month with the launch of our new Improvement Academy website www.cnwl.nhs.uk/ia and twitter handle @CNWLImprovement. We have also held our first Improvement Academy Programme Board.

Looking Ahead

Improvement Awards

Brief reminder to all CNWL improvers!! Do you think your improvement project is worthy of an Oscar?

We have introduced new Improvement Awards for teams that can evidence sustained improvement in CNWL services. These will be awarded on a six-monthly basis by the Improvement Academy faculty, the awards are recognition of excellence in improvement achievements. Winners are awarded a special certificate which acknowledges their accomplishments.

It is less than 8 weeks until the deadline of 25 March 2022 to submit posters for the first Improvement Academy Awards. All teams that have made improvements are encouraged to submit a poster to celebrate your improvement work and share your learning with others across the Trust. To apply for an award, teams will need to submit a poster which details their sustained improvement to cnw-tr.improvementsupport@nhs.net

Examples of posters can be found HERE and a poster template can be found HERE.

 

News from the Practicum 2021/2022

#CNWLQIPracticum2021

The latest round of workshops for project teams on the QI Practicum took place on 18 & 20 January with teams sharing success and valuable learning and insights that they have gained during the testing of their change ideas. These were valuable opportunities for teams to learn together in a collaborative learning environment together with both service users and carers that generated much positive discussion. 

As a brief ‘icebreaker’ to our workshops to support our teams to get into a more relaxed and creative headspace before commencing the main part of the workshop, we completed a 5 minute self-portrait session with some very impressive results (below) More updates from our #CNWLQIPracticum2021 can be found by following us on twitter by clicking HERE @CNWLImprovement.

 

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Upcoming education opportunities

The QI Clinic is here to support your improvement ideas:

** Session times increased for 2022!! **

Book time with us today to discuss

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We are excited to announce that we have listened to your feedback and have increased our QI Clinic time slots from 20 to 30 minutes. So take the opportunity today to book a QI Clinic slot while they are still available!

We look forward to hearing about your improvement ideas and look forward to supporting you in bringing these improvement ideas to life in your workplace.   

The QI Team have regular 30minute sessions that are bookable in advance to help staff with any questions or issues relating to your improvement work. You will have exclusive access to both an Improvement advisor and coach to help you think through your messy problem. The QI Clinic runs every Friday with bookable slots at 12.00 noon & 12.30 pm

To book, send a request stating your preferred Friday and time to cnw-tr.improvementsupport@nhs.net and we shall confirm back to you with a diary invite and link to your QI clinic slot.

We look forward to speaking with you!

Level 1: Bronze - Bitesize (Intro to QI) New dates for 2022!

Dates for the ever-popular monthly 3-hour virtual QI training on the model for improvement and how to set out on a QI project are bookable on LDZ at: https://cnwllearning.org/login/index.php

Search for ‘Bitesize QI’ to find the course, which is available on these dates all starting at 9.30am:

  • Tuesday 15 February 2022
  • Tuesday 15 March 2022
  • Tuesday 10 May 2022
  • Tuesday 14 June 2022
  • Tuesday 12 July 2022
  • Tuesday 9 August 2022
  • Tuesday 13 September 2022
  • Tuesday 11 October 2022
  • Tuesday 15 November 2022
  • Tuesday 13 December 2022

Level 2: Silver – QI Project Team Leader Training

The first cohort of level 2 training commences on 3 February 2022 is now fully booked.

Further dates for our next cohort will be released in early spring 2022 for training dates in summer and autumn.

This course is aimed at CNWL staff who wish to use improvement methodologies in their role and need to develop skills as a QI project leader. The course is a workshop-based programme, delivered over 4 months with 1.5 days formal training and also forms part of the 21st Century Leadership Programme (Level 2).

Level 4:  Improvement Coach Development Programme

This course is now fully booked and commences on 1 February 2022.

Annual Conference

The Safety Conversation Day 2022 – Date to be confirmed

Useful Links

Contact information for Improvement Advisors:

Diggory Division

Peter Toohey

peter.toohey@nhs.net

Goodall Division and Corporate

Peter Smith

petersmith3@nhs.net

Jameson Division

Bridget Browne

bridget.browne@nhs.net

CNWL Improvement Academy Microsite:    https://www.cnwl.nhs.uk/ia

Life QI:  www.lifeqisystem.com/

If you want to get in touch please contact us here:

cnw-tr.improvementsupport@nhs.net

And follow us on twitter by clicking @CNWLImprovement.