BEH collaborative meet to improve


Welcome to the event blog for learning session three for Barnet, Enfield and Haringey Mental Health NHS Trust (BEH) Quality Improvement Collaborative on Thursday 7th June 2018.

Haelo have been busy supporting quality improvement (QI) teams in a collaborative series as part of the BEH Live, Love, Do initiative. Now into it’s second year, a new wave of QI teams are embedded into the improvement programme which aims to equip front line teams with the tools required to improve the delivery of health care services. Year two teams attended a launch as part of the first year graduation event, have attended learning session one, learning session two and we now eagerly await learning session three.

Welcome and introductions from Richard Milner, Acting Chief Operating Officer and Director of Improvement.

Richard introduces a skills assessment takes place at each learning session so we can measure and reflect on skill development of individuals and teams. The results are plotted on a graph so we can track progression and tailor future teaching to the areas required.

Richard compares this phase in the programme to teams as the ‘second album stage’, where we’ve had the initial buzz with the start of learning and taking this back to the workplace (first album) and then we start the hurdles with testing, data collection and engagement so we work hard to continue momentum and want the next lessons and workshops to pull us through. Today we’ll be collecting those issues into themes and running ‘clinics’ this afternoon with expert faculty.

Teams presentations are next on the agenda, this session opens the stage to teams to present their progress, challenges and results. Faculty and teams are then able to feedback to the team, ask questions and offer guidance. Team project are split into three themes, which determines your faculty support, the three work streams are patient involvement, violence and aggression and staff experience.

The ‘Report It’ project, sits in the Staff Satisfaction group and is a Bullying and Harassment project, identified from the staff survey. The project aims to raise awareness and increase reporting to deal with bullying and harassment at the point of entry. The team created a short engagement film featuring staff, for staff, to understand what bullying and harassment is in the workplace and to report it.

From the Patient group, the Enfield Early Intervention in Psychosis Team aim to increase service user participation in the planning and delivery of the service. The team use ‘champions’ to engage peers and increase the opportunity for feedback.

From the Staff group, a workforce team present their project to reduce the number of over payments to employees by 50%. Addressing behaviors and processes, the team use QI methodology really well to identify and test changes, from screen savers to attending management meetings to agenda key challenges.

From the Violence and Aggression, Thames Ward team present on their journey to reduce violence and aggression by 20% by July 2018. Using safety crosses engage staff and to validate interventions.

Next leading a Creative Thinking session, Stuart Clough, Haelo Senior Improvement Advisor is presenting to the room. Stuart leads activities to encourage ‘blue sky thinking’ to get teams looking outside the box and using different approaches to generate change.

Lead Improvement Analyst Laura Jackman and BEH Project Manager and Data Advisor for the collaborative Alex Manya present a data refresher; a practical session on using their data as opposed to chart types and signals. the duo recap types of measures and selecting measures, asking:

  • Is what you’re looking at measurable and realistic?
  • What data do you have already available?
  • How will you carry out measurement?
  • How frequently will you measure?
  • Will your measure be able to show if you’re are making a change?

Laura reminds the collaborative how important data is in successful improvement programmes. Now in learning session three, we should be at the stage where we’re collecting raw data, analysing and feeding the results back into the improvement project

“Data collection is pointless if we don’t do anything with it”

Laura recaps on special cause rules, they are useful indicators to show you have made a systemic improvement. Also in the session, the value of annotations to tell a story are highlighted with examples such as:

Over a networking lunch, a poster showcase is set up to exchange learning and results between teams.

Into the afternoon, Stuart is back to the front to refine the testing and implementation stages of improvement projects. Teams who are working on tests of change that they are preparing to implement.

The approaches to implementation can be identified in three groups:

  • Just do it Simple change, tested successfully, relatively low risk
  • Parallel approach Phased in changes operating side by side with existing systems 
  • Sequential approach Implementation of some or all changes

When it comes to implementation, Stuart recommends a checklist that supports team to make their implementation stick and becomes  ‘the ways we do things around here’ by looking at: standardisation, resourcing, training and measurement.

Now revisiting the PDSA cycle on the Model for Improvement, Stuart explains how we use  cycles to increase of degree of believe through testing small changes so we can begin implementation. Using the coin sliding exercise, teams test small changes to reduce variation in the system. Teams plot their results and use the data to track special cause, before refining the test to implement.

Richard is back to the front to open the final session of the day. The faculty have been split among themed troubleshooting tables, with each expert being assigned one of the common challenges teams face from communications and engagement to data and theory.Attendees are invited to visit a table they require direction or advice in, so teams can leave with a practical guide and actions.

The final session brings the third learning session to a close. Richard closes with a summary, actions to go forward and expectations as we plan to meet again in September.


BEH Improvement Alumni Directory | The alumni resource captures the knowledge and work from year one and offers support to teams in year two who can benefit from the experience, expertise and advice of peers. The directory also hopes to celebrate and raise awareness of QI work both internally and externally, whilst encouraging team engagement in the innovative QI programme.

The Haelo Faculty include Katharine Goldthorpe, Director of Improvement, Stuart Clough, Programme Manager and Lead Improvement Analyst Laura Jackman. To find out more about the programme, contact the team.

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