Posted on: 4 January 2021

Ellington Ward in Harrow completed their Quality Improvement (QI) project to reduce patient falls on their ward by 20% in September 2020.

Here Maggie Lee, Occupational Therapist on Ellington Ward, reflects on the project and discusses how they will use ‘Big I’ for the wards next project.

In QI ‘Big I’ refers to patients working alongside staff in partnership for the duration of a QI project. ‘Little I’ refers to patients being consulted for their ideas or opinions at various points along a QI journey. Big I involvement is encouraged because patients are able to affect the care they receive, making it more catered to their needs.

Maggie Lee said

“At the start of our QI journey the team and I were mindful about how we could involve patients to create change ideas. We followed the QI principle of ‘little I’ but next time we want to make it Big I! Our QI experience has made us realise we can make more significant changes by involving patients from the outset in a project. It’s important we remember patients are able and willing to help us shape practices and that we create the opportunities for this to happen”.

During Ellington Ward’s QI project, a flyer with prompts on how the ward could reduce falls was taken to community meetings where patients used their own experience to give suggestions on how to reduce falls. These were held as group meetings before Covid-19 and then changed to one to one discussions.

Maggie Lee said, “In the discussions it was touching that those who considered themselves not at risk, seemed keen that the information was shared with those who were and together we generated some new ideas”. One of those ideas was to introduce new adjustable beds, so the height could be customised to suit each patient’s needs.

Alison Butler, Trustwide QI Programme Director said, “Being honest about limitations during a QI journey doesn’t take away from a project’s success and teams shouldn’t feel disheartened when things don’t go according to plan. QI is about testing changes, learning when things don’t improve and developing plans together to improve them. I encourage all QI projects to be as open as Maggie is about the ways they could improve their QI journey.” 

Ellington Ward is looking to start a new QI project soon with Big I involvement.