Training and improvement programmes
- Two forms of Quality, Service Improvement and Redesign (QSIR) training are now offered to staff; a one-day course (QSIR Fundamentals) as well as a more intensive course taking place one day a week over five weeks (QSIR practitioner) which runs four times across the year.
- Two improvement programmes have been wrapped directly around the five-week course, bringing clinicians together from the three sites to work on specific issues whilst completing the intensive QSIR training process. This has allowed teams to work collaboratively, learning from each other whilst using the practical Quality Improvement (QI) skills gained from the course on a real QI project.
- Another system-wide and Integrated Care Board (ICB) funded initiative has been in place until this year, running for five years with five cohorts. This included staff from different sectors and areas, including Voluntary, Community, and Social Enterprise (VCSE) and local council participants. This again involved the five-day QSIR training, as well as four supported leadership days through The Staff College.
- As part of this, participants were put into three teams of eight and assigned a 'wicked problem' for the system to work on across the year, for example around reducing health inequalities, with support from a Senior Responsible Officer (SRO) and a QI coach. They saw some strong outcomes from this initiative across the five-year period, such as early access to support for carers, and are hoping for this to be funded going forward now that the ICB has been restructured.
- A further programme which is currently in progress, and which involves the QSIR practitioner training, is an ambitious project that the improvement team are leading to work with sixty wards across the three sites, adding five wards on each of the three sites every three months up until December 2024.
- The process will involve a diagnostic phase, where they will look at available data and staff survey results for the ward, before organising an engagement event where staff can share and download their issues.
- Staff from each ward are also nominated to complete the five-day QSIR training, with the aim of embedding QI skills on the frontline. Problems raised are then categorised by the staff into three categories – fix, improve, change. This process highlights that there are many small issues that can be addressed directly by staff themselves and empowers teams to begin to see where they can make changes without requiring additional resource or permission.
Data and quality management system
- Data and access to data plays a fundamental role in quality improvement. Mid and South Essex NHS Foundation Trust (MSEFT) have developed a Quality Learning System (QLS) which all clinical staff, regardless of role or speciality, can access. This means that teams can look at the data around interventions that have been implemented in other areas and think about how to embed them in their own services.
- The QLS is managed centrally by the data analytics team, and they are responsible for engaging with clinical staff to help them understand what data sets are available for them to assess.
- Separately, the improvement team's data analyst plays a fundamental role in helping staff on the frontline to interpret the data by breaking it down into an accessible format and supporting them to make sense of it for their own purposes.
- As a next step, the team are planning to look at data around health inequalities as part of their QLS, in order to understand barriers to access and other factors and include this in their improvement plans and programmes.