Posted on: 9 June 2021
June 2021 
76 QI projects showing improvement across CNWL
Photo: Rhododendron in Kew Gardens, Peter Smith
Supporting QI in CNWL
Welcome to our June 2021 edition. As we move into Summer, a range of QI activities are starting to re-emerge, not least the CNWL QI Practicum, which commences this month. So, this month, we concentrate on how QI project teams can be supported to make the best conditions for improvement projects to flourish and be successful.
Creating the right environment for a QI project from the outset is vitally important. As a project team starts to form and go about defining their problem or issue to be improved, creating a SMART Aim and defining their system in a Driver Diagram, the team need to know that they have the backing of senior managers and to know where to go to get help and support. This is where the roles of a sponsor and a QI Coach can make a huge difference. We explore what each of these roles is and is not in two articles this month and our readers will see that although neither role actually does the work to bring about improvement (that is the project team’s task), they can provide the team with authority to act, assurance to keep the team on track and help in overcoming issues as they arise through the lifetime of a project. Time spent in identifying your sponsor and a coach, if you need one, will reap benefits as you progress your project.
Also, this month, we report on an exercise to tidy up projects that have become latent on the Life QI system and news from the CNWL QI Practicum.
Rounding off this edition, we have the return of our QI tip of the month on how to add a coach to your project team on Life QI and our usual roundup of the available dates for virtual Bitesize QI training.
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.
QI Coaching: What’s it all about?
Staff across CNWL will have probably heard about the need to include a QI Coach (or Improvement Coach) in a quality improvement project. But what does a QI Coach do and what can you expect of them? This article aims to demystify the role, detailing what they can and cannot do for you in a project team.
A QI Coach is a highly trained colleague who provides expert advice on improvement methodology and technical advice on using the Model for Improvement. They will work closely with the project lead and/or project team to support them to progress their project, especially where the team needs support to use tools or new approaches to explore their area of interest.
Early on in the project the coach may expect to attend team meetings, either in person or virtually, and to provide relatively intensive support. This should reduce over time as the team gains knowledge and confidence in using the Model for Improvement.
The Coach:
- Is the point of contact for the team lead and provides support as required to facilitate the team meetings, particularly in terms of QI methodology
- Is the ‘go to’ person for all questions on QI methodology and Life QI in the first instance
- Will challenge and support the team as they go on their improvement journey
- May provide support to the team to develop their story board and to tell their story to others – via posters, presentations etc.
- May approach the project Sponsor if there are concerns about the progress of the project or the way in which the project team are engaging with the improvement work
The QI Coach is not responsible for:
- Doing the work to bring about improvement
- Managing team members and team dynamics
- The success or failure of the project
The diagram below can help us to also understand the difference between a coach and a consultant or mentor.
A good QI Coach will ask questions; usually lots of questions, some of which may either seem obvious or even very challenging. But their style of supporting a project needs to be about asking the team the right questions at the right time to keep the team focused on their improvement aim and looking forward. Another aspect of the QI Coach role is to always be looking forward to the next step, so that a project team moves onwards in its work. To do this, a coach will often be heard asking the questions ‘So what does that mean?’ (reflecting on data or knowledge) and ‘So what do you need to do next?’ (inviting action from the team).
Being a QI Coach is a very rewarding role. Helping and watching a QI project team develop, as their confidence in using the model for improvement grows, is very satisfying. Coaches are a very valuable asset, so engage with them and allow them to aid your improvement success!
How does being a QI Senior Sponsor support a QI project team?
The Project Sponsor is usually a senior member of staff who has oversight of the service, ward or team involved in the improvement project. It is ideal to have a sponsor who has some direct managerial responsibility for the service in which a QI project is to take place. This means that the sponsor does not need to be the ‘most senior manager in the Division’, but someone who is closer to and knows about the service.
The role of the sponsor is to work with the team lead to agree the focus of the improvement work and sign off the project at the outset. Sponsors do not generally attend project team meetings, but do need to get regular updates on progress to ensure that work is progressing as planned, and if any issues arise, to unblock these quickly. Sponsors may well be the link between the project team and local governance structures, such as care quality groups or senior management teams.
The mechanism by which project teams can efficiently communicate what is going on in their project is the use of highlight reports, which detail whether the project is on track, the major risks, what was done in the past month and what is planned for the month ahead. This can all be on one page, so it does not need to become a time-consuming job.
Sponsors also provide encouragement to the team helping them to feel that their efforts are valued. They may also agree that protected time is available to team leads and/or members to allow them to do the work that the project may involve. The more informal ‘project chat’ can also be very helpful and encouraging for teams; sponsors who show interest in QI activities when out and about or meeting with a team, often referred to as ‘walking the walk’, can help to reassure a project team that their improvement work really matters.
Sponsors are:
- Senior members of staff with a connection to the project team
- Supportive, but also hold teams to account for progress
- Regularly updated on progress and may intervene if work is not going as planned
- Ultimately responsible for the team’s performance.
- Responsible for escalating any problems to Divisional management; this can include issues or concerns that are beyond the scope or influence of the team to be able to change
Sponsors are not:
- Command and control officers who direct how the team does the work
The infographic above is useful to think about the behaviours of a good sponsor. The behaviours should not be unfamiliar; they are the characteristics that are seen in any supportive leadership position. But it is good to remind ourselves to practice these behaviours in our improvement work.
News from the Practicum 2021
#CNWLQIPracticum2021
Lots of background work is taking place in the QI Team to get ready to start the first QI Practicum that is wholly delivered within CNWL, with the initial Launch Call set to take place on 24 June 2021.
As we ‘go to press’ team members, project team leads, sponsors and coaches have all been identified and the first communications have gone out to everyone involved. This will be followed up with the sending out Delegate Packs to staff attending.
Once the Launch Call has happened, the Practicum will officially have started and we shall be reporting back regularly, starting with the Launch event.
Life QI: a good tidy up
Over the first three years of the QI Programme in CNWL, all staff have been encouraged to use the Life QI system to record their improvement project work by registering a project on the online platform. Life QI is designed to complement the model for improvement and using it has many benefits, not least that each project structure is faithful to the model for improvement. It also takes care of a lot of hard work to analyse and interpret project data, so that run charts on the system alert project teams to the rules for spotting non-random variation in data over time.
But after a while, and particularly after the difficulties of working over 2020, there may be projects that are either not progressed or have come to a natural end. Many of such projects have remained active on the system, with no activity in the past six months. This means that our monthly total of active projects is not an accurate reflection of the number of projects that are being worked on.
So, to bring the system up to date, the Divisional Improvement Advisors have been working with Improvement Coaches in the QI Team to review all projects that are marked with an active status on the system to identify and conclude projects that are no longer being worked on.
This has resulted in a reduction in the number of reported active improvement projects. The eagle-eyed readers may have noticed that the number of projects at the head of our newsletter has been decreasing and this is a result of the work to tidy up the system.
The QI Team are also aware that some projects may have become ‘latent’ and teams may wish to continue work. This is quite possible, as changing the status on Life QI can easily be reversed if a team wishes to continue working on a project and no projects are deleted from the system as we tidy up.
If your project is still active and is changed to completed or concluded, all you have to do is change the status on the system, or if you need some advice, please contact your Divisional QI contact, details of which are at the end of the newsletter.
QI Tip of the month: Adding a coach to your Life QI project
It’s not only easy to add a coach to your QI project, it’s really important that you do so. Improvement Coaches are a valuable resource and it’s important that Life QI accurately records which improvement coach is working on any particular QI project.
Step 1. On your projects front-screen click on ‘Project team’
Step 2. Click on ‘Invite new members’
Step 3. Type the name of your coach in the name field
Step 4. In the ‘Role’ field choose ‘coach’ from the drop down menu, then click ‘Invite’.
Upcoming Training Dates
Bitesize QI
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 June 2021
- Tuesday 13 July 2021
- Tuesday 17 August 2021
- Tuesday 14 September 2021
- Tuesday 12 October 2021
- Tuesday 16 November 2021
- Tuesday 14 December 2021
Useful links
Contact information for Improvement Advisors:
Diggory Division: Michele Dowling - michele.dowling@nhs.net
Goodall Division: Peter Smith - petersmith3@nhs.net
Jameson Division: Geetika Singh - geetika.singh@nhs.net
CNWL QI Microsite: www.qi.cnwl.nhs.uk
Life QI: www.lifeqisystem.com/
IHI Open School: www.qi.cnwl.nhs.uk/training-and-events/online-qi-training
If you want to get in touch please contact us here: cnw-tr.improvementsupport@nhs.net