25 April 2025

April 2025

Welcome to the Spring edition of the Improvement Academy news.

In this issue, you will find the following:

  • The adoption of QI and how to embed into clinical practice

– articles from around CNWL

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The Adoption of QI: How to embed change within your service

For anyone who has taken part in any of our Quality Improvement (QI) projects at CNWL; or benefitted from our training programmes, they will know the importance of testing change. This testing happens through Plan, Do, Study, Act (PDSA) cycles. However, what happens after that testing comes to an end and we have a good understanding of what changes have met their outcomes as planned? This is the time when it is important to think about adopting the change. How that can be achieved will be slightly different for each setting and specialism. Adoption of change, sometimes referred to as sustaining improvement, can be a challenge for any improvement project.

 In this edition, we caught up with Claudia Taylor the Ward Manager at Nile Ward Psychiatric Intensive Care Unit (PICU) who has reflected on the work the team did during the Seclusion QI programme. Nile Ward chose to focus on exit plans for patients that were secluded. The team’s theory was that having a clear exit plan documented at point of entering seclusion would empower both staff and patients to support decision making to step down from seclusion. This change idea had significant success with data demonstrating improvement. It was also soon being tested by neighbouring wards.

What do you think is the key ingredient in developing a successful change idea?

We intend to makeexit plans as short and simple as possible so that it is easy for the patient to understand and for staff to read (we print these double sided and make them visible on the seclusion panel to both the patient and the observing staff). The rationale for these plans is to promote consistency during reviews where the team are able to effectively communicate to the patient why they are secluded and what the goals are to enable seclusion to be terminated as soon as possible. Furthermore, these plans are to empower all staff to be able to feel confident in making decisions about seclusion termination and not waiting for the manager/consultant to make this decision. We engage the patient with them during every review and also allow the patient to contribute to the plan if they wish to. 

How responsive have team members been to the change idea?

Since we have implemented these plans, both staff and patients have been very responsive and like the plans. The simplicity of them means that it is not creating more work for the nurses to do and ensures every staff member is aware of the rationale for seclusion and what the expectations are before considering seclusion termination. We involved patients from the commencement of the plans and encouraged them to work collaboratively to modify and personalise their own plan. Patients have also found them beneficial and have responded positively to them. It supported us during the QI work to drastically reduce the overall length of stay in seclusion. 

What do you think lead to the success of sustaining your improvement?

Due to the simplicity of the plans, it was feasible to establish this as part of the duties required when seclusion was commenced - was not overburdening staff with additional work. Furthermore, staff saw the immediate benefit of the plans: it was easy for all staff to understand why the patient was in seclusion and what the expectations were to enable seclusion to be terminated. Staff felt empowered to make decisions about terminating seclusion without relying on management/consultants before the patient could come out of seclusion. Furthermore, staff liked that the plans helped to provide consistency within the team and to the patient whilst in seclusion and during reviews. This supported making the learning from this QI project business as usual on Nile Ward. 

During the project, the five remaining wards and the HBPOS at St Charles also adopted our change idea and also started using the seclusion exit plans. The seclusion exit plans have become business as usual across St Charles. Since the project we have shared our learning with the wider trust to consider implementing the exit plans. 

Bridget Browne, Head of Quality Improvement supported the Seclusion QI Programme with Kim Cox, Divisional Director of Nursing. We caught up with Bridget to ask her why she thinks the change was so successful and other wards were so quick to adopt the change.

“Nile Ward have a lot of experience of QI having been a part of a number of QI projects in the past. I think the key ingredient to success was the simplicity of the change idea. It was easy to see the benefit for both staff and patients. The visual nature of the change meant that other wards could see the change in action and became curious about the impact. We have since looked at how this change idea could be embedded into core practice across the Trust. This means the change idea truly has become business as usual.”

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Celebrating Success – Improvement Stories from around CNWL

A recap of our Safety Month

The Central and North West London NHS Foundation Trust (CNWL) dedicated January to safety priorities, featuring daily lunch and learn sessions. The focus was on the Patient Safety Incident Response Framework (PSIRF), emphasizing kindness, compassion, and system-based learning. Key presentations included high-risk medicines, patient safety incident investigations, and methods for reducing pressure ulcers. Notable projects aimed at reducing the length of stay through team collaboration and early identification of discharge barriers were highlighted. The Improvement Academy Safety Awards showcased over 170 poster entries, with awards presented for innovative approaches in mental healthcare, safe patient care, and integrated electronic platforms for ADHD medication initiation. The month concluded with a 'Kindness and Compassion' day, encouraging staff to reflect on compassionate care practices. Read more here.

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Improvement Academy poster awarded First Place at the Joint Foundation Sharing Best Practice Event

The Foundation Year Psychiatry Development Program at CNWL, led by Dr. Hassan Mallick and Dr. Kallpana Dhas, won first place at the Joint Foundation Sharing Best Practice Event. The program, co-designed with foundation year doctors and service users, includes hybrid teaching and "Flexi Slots" tailored to trainees' interests. It has significantly increased interest in psychiatry and improved confidence and understanding among trainees. The program's success is marked by a 34% increase in interest in psychiatry and an 84-85% satisfaction rate. It is now embedded across all CNWL sites, emphasizing equity, co-design, accessibility, sustainability, and continuous improvement. Read more here.

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Willow Ward and Healthwatch Milton Keynes win national award for improving patient care

Willow Ward at the Campbell Centre in Milton Keynes, in collaboration with Healthwatch Milton Keynes, received a national award for improving patient care. Following a Care Quality Commission (CQC) inspection, Healthwatch Milton Keynes engaged with patients to address issues such as staff attitudes and safety concerns. Key improvements included trauma-informed care training for 80% of staff, the introduction of a Peer Support Worker, new guidance for ward rounds, and personalized one-page profiles for patients. These changes significantly enhanced patient-staff relationships and overall patient experience. Read more here.

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CAHMS Quality Improvement Project using AI technology wins first prize

The CAMHS Quality Improvement Project at CNWL utilized Anathem AI ambient voice technology to enhance patient engagement and reduce clinician workload. The pilot, involving ten clinicians, won first prize at the Royal College of Psychiatrists Better Data, Better Care Conference. AI AVT reduced documentation time from 27 to 10 minutes, increasing clinician capacity by 20%. Despite technical challenges and potential de-skilling, the technology was well-received by patients and carers. The second phase began in December 2024, focusing on medication reviews and progress notes. This initiative aligns with the NHS's long-term plan to improve clinical service efficiency. Read more here.

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Recent Publications

 

Elevating Interest and Expertise: Integrating Co-Design and Co-Production Into Foundation Year Development Initiatives During Psychiatry Rotations

The initiative at CNWL NHS Trust aims to enhance foundation year (FY) trainees' interest in psychiatry through a bespoke development program. It includes a 12-session online teaching curriculum, integrating co-design and co-production principles. Data collection methods improved over three cohorts, with the latest cohort showing 95.3% satisfaction and a significant increase in interest in psychiatry (from 30.4% to 76.2%). The program's iterative learning approach and robust feedback mechanisms contribute to its success, offering a unique opportunity to recruit undecided foundation doctors into psychiatry.

See the rest of the article here.
References

[1] https://doi.org/10.1192/bjo.2024.291

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Expert by Experience (EbE) updates

Would you like support to involve EbEs in your improvement work?

The QI and Involvement Teams facilitate a collaborative working group called the EbE Improvement Forum. This group comprises of EbEs who have used CNWL services and are passionate about improving services. 

Our EbE forum members bring unique perspectives and insights to your improvement work which help ensure that your improvement work is going to be meaningful and have the best impact for those who use your service.

These forums are held on the third Monday (excluding bank holidays) of every month via Microsoft Teams. The two available slots for each forum are allocated on a first-come, first-served basis and the next available date is:

  • Monday 19th May 2025, 1.30-3pm (30 mins slot per team)

Interested teams can book one of the three available 30-minute slots by contacting the QI Team via cnw-tr.improvementsupport@nhs.net.

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EbE Newsletter

The latest edition of our EbE newsletter can be accessed via this link

The April 2025 Expert by Experience (EbE) newsletter from Central and North West London NHS Foundation Trust highlights the importance of capturing the impact of EbE involvement in Quality Improvement (QI) projects. About 80% of projects on LifeQI demonstrate EbE involvement, emphasizing patient-centered care. Documenting EbE contributions fosters cultural change, shared learning, and reinforces the value of EbE partnerships. A case study on the Therapeutic Observations and Engagement Improvement Programme showcases the positive outcomes of EbE involvement, including reduced close observations and improved patient-staff relationships. The newsletter encourages active collaboration with EbEs in planning and delivering workshops.

To read the full newsletter, please click here.

 

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Upcoming Training Opportunities

Level 1 (Bronze) QI training: Bitesize QI (CPD Accredited)


This 3.5-hour interactive session provides a practical introduction to Quality Improvement (QI) and the Model for Improvement. You’ll gain the skills to participate in any QI project—no prior experience or current involvement required.

✅ Open to all staff roles and bands in CNWL
✅ Also open to Experts by Experience (EbEs) actively working on QI projects
✅ Fully CPD accredited
✅ Highly interactive and beginner-friendly
 

📅 For more information, or to book your space: Level 1 Bitesize QI Training
 

Level 2 (Silver) QI Training: How to Run a QI Project

This workshop-based course, delivered over two days with an additional lunch time virtual learning session, is aimed at CNWL staff who wish to develop practical skills on how to run their QI projects. 

✅ Open to all staff roles and bands
✅ Perfect for those looking to run a QI project
✅ Applicants should have an improvement idea before starting the course

📧 For more information, or to book your space: Level 2 QI Training

Level 3 (Gold) QI training: Leading Improvement for Senior Leaders (CPD Accredited Training) 

Are you a senior leader (Band 8a and above) looking to lead service improvements and sponsor QI projects? This CPD Accredited, full-day workshop will equip you with the tools and knowledge to do so.


✅ Adopt an improvement approach to your role
✅ Sponsor QI projects
✅ Support teams in using improvement methods

📅 For more information, or to book your space: Level 3 (Gold) QI Training: Leading improvement for senior leaders

 

Quality Improvement (QI) : Improvement methods to support productivity 1/2 day (in person)

 

Are you part of a team (clinical or non-clinical) looking to streamline processes? This training complements Level 1 and Level 2 QI Training and introduces tools to:


✅ Review and improve processes
✅ Use creative thinking to identify and reduce waste
✅ Focus on what adds value to improve efficiency and innovation

📅 For more information, or to book your space: Course: Practical approaches to improve productivity  

 

All QI training provided by the Improvement Academy can be booked via LDZ. For full information and resources relating to QI in CNWL, visit the Improvement Academy Microsite.

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Book time with us to discuss everything QI!

The QI Clinic is here to support your improvement ideas. Any CNWL team who would like help with their QI project can book. We have two slots every Friday, 12 and 12.30pm.

 

To book, send a request stating your preferred date 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! 

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Useful Links

 

CNWL Improvement Academy Microsite:

 

 
 

https://www.cnwl.nhs.uk/ia

 

Keep up to date with CNWL IA work by following us on X (Twitter)

https://x.com/CNWLImprovement

Life QI:

(Organisation: CNWL)

www.lifeqisystem.com/

 

If you have any feedback about this newsletter, or you would like anything including in the next edition, please get in touch as we would love to hear from you!