Posted on: 28 April 2020



289 active QI projects

32% Service User and Carer involvement    

1799 staff trained

Message from the QI Team

This year we have focussed our improvement work on improving safety with two central programmes aiming to reduce falls and violent incidents on our inpatient units. A great deal of hard work has been undertaken by teams as part of the QI practicum. It is the safety of patients and staff that will be at the forefront of all our minds as we work to manage the Covid-19 outbreak and in line with guidance, we will be scaling back our group QI activities over the next few months.

In times of necessity, innovation will be required to ensure continuation of high quality service provision. Innovation via rapid tests of change is central to the model for improvement so we ask that you commit to drawing on the skills, tools, and methods you’ve acquired while collaborating with CNWL colleagues on QI over the upcoming weeks.

March Improvement Practicum:
The Power of Storytelling

On the 5th and 6th of March quality improvement (QI) projects from across CNWL gathered for the Improvement Practicum headed by the Institute for Healthcare Improvement (IHI). The practicum encouraged QI projects from across the Trust to use storytelling alongside their improvement data to share the impact they’re making in services and on wards. 

The Trust’s Chief Medical Officer Dr Con Kelly was in attendance and said, “We embark on QI journeys to ensure we give the highest level of care and support to patients and carers, and to improve the working conditions for staff. Telling stories about the improvements experienced by staff, patients and carers is an important measure to show that QI projects are making a difference across the Trust.”

The Institute for Healthcare Improvement identified four different perspectives QI projects can use to tell their stories.

The four different perspectives are:

•    Patient experience (a story about an improvement a patient has experienced since the start of a QI project and why it matters to them).

•    Staff experience (a story detailing an improvement a staff member has noticed since a QI project began and why it matters to them).

•    Burning platform (a story about how a team came together to improve an issue).

•    Personal motivation (a personal story that expresses what made someone want to start a QI project in a service or on a ward).

During the Practicum, Caspian Ward staff gave a presentation on their QI project which aims to reduce incidents of physical assaults involving staff and service users by 30%. This project has Big I involvement because patients and staff at Caspian Ward have been working collaboratively. Patients have assisted the team by suggesting change ideas that will help them to feel safer and give feedback on change ideas staff have made.

From the perspective of a patient, the Caspian Ward team talked about how a patient responded to the change idea of tea and talk time. This change idea involved patients and staff getting together over a cup of tea to talk about their concerns and get to know each other. A patient said, “it’s refreshing to get some quality time with the nurses for a whole hour, I’m really happy with that.”

Marcus Maguire, Violence Reduction Programme Manager said, “hearing stories like this from patients shows the positive changes QI projects on violence reduction are making. I’m pleased the work we’re doing is improving the experience patients have on our wards.“

Harrow CAMHS’ Big I Project

On the second day of the Improvement Practicum, Harrow Child and Adolescent Mental Health Service (CAMHS) delivered a presentation discussing their Quality Improvement project. 

Harrow CAMHS undertook a previous quality improvement project in 2019. The team successfully completed this project which reduced the time from referral to consultation by three weeks. 

Harrow CAMHS’ current project aims to improve the efficiency of referrals to treatment in order to reduce the waiting list by 25% by September 2020. 

The team has made significant progress on their current QI journey including testing out change ideas. Saurabh Dhingra, Team Manager at Harrow CAMHS said, “when we identified our change ideas, we tested them all at the same time because we were eager to start the project. However, this had an impact on staff morale because a lot of change was happening all at once. When we began to implement gradual change, we started to identify which change ideas will help us reach our aim. Our staff have gradually got used to change and we have been getting results.”

The team at Harrow CAMHS have been involving parents in their QI project by setting up the parent/carer involvement forum. In this forum parents/carers have been asked their opinion on change ideas. Involving parents/carers in this way is an example of Big I involvement. Brian Murray, Lead Therapist at Harrow CAMHS said, “Involving carers makes us as a service think why we’re doing what we’re doing. Getting their insight helps us to question ourselves and allows us to take onboard their input and perspective.”

If you would like to contact your Divisional QI Lead or find out more information about QI in CNWL visit our microsite.