2 July 2021

July 2021                                                                                                                          

75 QI projects showing improvement across CNWL


Photo: Passiflora alata in the Temperate House, Kew Gardens, Peter Smith

New beginnings

The CNWL QI Practicum has begun with a launch call for project team members from 24 projects across CNWL.  This month we report on the launch call and introduce some topics that will not only be useful to teams in the Practicum, but helpful for anyone contemplating or starting a QI project.

Our lead article covers the importance of getting to know your problem; it is often tempting to ‘dive in’ and start making changes for improvement without first gathering your knowledge about the issues.  We learn from the article why it is important to get to grip with your problem before progressing and discover some ways of exploring the problem.

We also discuss some useful tools for helping you understand what it is that you want to improve.  The Fish Bone Diagram (or cause and effect diagram) is a great way of thinking around your problem, whilst our QI tip of the month, The 5 Whys Strategy, can help you get to the root cause.

And not to forget our usual recap of Bitesize QI dates, open for any staff to book via LDZ.

We welcome your feedback and if there is anything you would like to see in future editions of the newsletter, do please get in touch by e-mailing cnw-tr.improvementsupport@nhs.net.


Starting your QI project: Knowing your problem

Once you decide that you want to get going with a QI project, it can be easy to dive into the work and start doing lots of ‘stuff’.  Awash with change ideas we are raring to go and starting doing things that will solve our problem.  Or will they?  Do we know enough about our problem and the system we are working in to dive straight into our project?

Improvement projects almost always need to be led and carried out by staff who are also carrying full workloads, so you don’t have any time or energy to waste by focusing on red herrings or simply staying in your comfort zone.  QI methodology is based on understanding the systems and processes that we work in and making changes to improve these systems and processes.  The nature of our work can mean that we are very familiar with parts of a system, but not always the wider system and how it links together.  We might think we know exactly where our problem lies, but often there are other factors at play that we are less familiar with.  Because of this, it is always recommended that teams starting out with an idea for improvement take some time to explore and define their problem.  Front loading this work can save you time, energy and frustration in the longer run. 

Fishbone Diagrams (aka Cause and Effect diagrams)

The Fishbone diagram gets its name from its distinctive shape - it looks like the bony shape of a fish. 

Fishbone diagrams allow teams to identify, explore and display all possible causes related to a problem or issue.  They are a great team exercise, getting people talking about what might be sitting behind your area of concern.   They can be used when you start out on your journey, and again as you learn more about your system and what might be making a difference.  They are best done with a group that knows something about the area you are exploring.

Example of a blank Fishbone template: