BEH QI Y2 journey begins


Welcome to the live blog from the first learning session in year two of the Barnet, Enfield and Haringey (BEH) Mental Health NHS Trust QI collaborative.

BEH teamed up with Haelo in September 2016 to mark an exciting new era in their improvement journey. In year one, a team of improvement experts supported a full programme of work that included a team-based improvement collaborative across the Trust. You can recap on the action from the summit celebration and launch of year two in this event blog.

Today we bring to the first learning session in the second year. Follow the activity on twitter follow Haelo, BEHImprove and the #BEHImprove


With opening words from Richard Milner, Director of Improvement and Mary Sexton, Exec Director of Nursing, Quality & Governance the journey begins for the teams embarking on wave 2 of the collaborative.

Mary opens by simply stating “we are here today because it’s the right thing to do, to be the best we can be, to continually improve as part of Trust commitments”. The collaborative will build individuals skill set “to improve every single day in every thing you do.” By learning the methodology to adopt, share with colleagues and spread across organisations we can improve staff and patient experience. Mary continues: “I will always want more. I’ve got quality in my title, there will always be more we can do.”

The pair introduce the BEH faculty who will be supporting teams in year two, including fantastic alumni from year one teams, whilst also outlining the three work streams; patient involvement, violence and aggression and staff experience. Reviewing the agenda for the day, objectives include: understanding the essentials of QI, refining team aim and driver diagrams, appreciation of measurement for improvement and the value of small scale testing.

Richard outlines how the collaborative approach gives you space and time, giving you the best time to succeed in your project, stating that “You’ve got the concepts and ideas – we’ll support you to bring them to life and prepare implementation away from here and in your place of work.” The BTS Collaborative Model consists of three learning sessions and consecutive action periods before the final summit. As we progress through the collaborative, it becomes less about teaching and more about teams. The importance of getting the right people in your team is highlighted, a good team needs: an executive sponsor, clinical leaders, day to day leaders, technical leader and subject matter experts.

Next up, violence and aggression QI alumnus Kirk Hopewell, Ward Manager Suffolk Ward presents ‘How to deliver a project while running a Mental Health Ward’. In a reality check, Kirk says how he felt lost this time last year and not to worry. Running through their team aim, diver diagram, changes ideas and PDSAs, Kirk states how we’re very good at focusing on the negative when it’s important to see your achievements, what you have learnt and what barriers there are to overcome. Of the many top tips, Kirk states that respecting the competing demands of team members, realising the value of regular meetings and taking ownership saw great success.

Kirk closes by reminding the room there is no right or wrong and to make sure they use the faculty and support available – a problem shared is a problem halved!

Jackie Stephen, Deputy Director of Organisation Development and Haelo’s Senior Improvement Advisor, Bob Diepeveen are up with the Introduction to Improvement Science methodologies including the Lens of Profound Knowledge, with a focus today on Driver Diagrams and aim statements.

Exploring the four components, the QI duo relay the importance of understanding the system you are working in so that we don’t just keep doing the same things as the same results will keep happening. Psychology raises questions about you and your teams mind set, exploring fixed vs growth. Bob asks teams where they are now and how to open their mind up to making mistakes to learn and how to keep in that mindset following the session today and take it back to their workplace. In the final component, the Theory of Knowledge, Jackie defines subject and profound knowledge before exploring the Model For Improvement, developed by API, consisting of three questions and a cycle. Within this, teams are challenged with the first question, “What are we trying to accomplish?” to set their aim with SMART criteria. The second question, “how will we know that change is an improvement?” comes down to data, and finally “what changes will result in an improvement”, discusses driver diagrams as a visual tool to write down how things might be better, setting out your learning journey.

Next up in ‘Managing our Improvement Knowledge’, Jackie Stephen is back with Fiona Cameron from My Care Academy to discuss the internal sharing platform but specifically about their secure online messaging and knowledge management tool. The messenger will support teams and individuals exchange knowledge, network and share best practice via private QI groups.

Presenting ‘How do we know we are making a difference’ is Alex Manya, BEH Project Manager, data lead in the patient involvement work stream faculty. Why bother? Alex walks the room through why we use data in QI, beginning with the second question in the Model for Improvement and the types of measurement: research, judgement and improvement.


Alex introduces Run Charts and Statistical Process Charts used to show data over time, comparing their use like going from ‘merely interested to being excited by data’. And we agree, data is a fantastic tool to motivate and involve your team.

Using previous data from year one teams, we can see how charts can tell a story over time, how to spot statistical change and the importance of annotations to indicate change and add rich detail. Closing on what makes a good measure, Alex tasks the next session of group work, to think about what measures are available, what can be used for you’re work stream and similarly your project.

After a short break, Stuart Clough, Haelo Programme Manager and Simon Harwin, Head of BEH PMO, Improvement faculty and lead for the patient involvement work stream presents ‘Time to Experiment’. Simon leads a session on PDSA’s, the cycle within the Model for Improvement, used to test hunches, theories and ideas at a small scale before spreading and implementing changes that result in an improvement. Outlining keys to success, Simon discusses the benefit of running multiple PDSA’s and gaining team consensus on change ideas to motivate and include. With his final message Simon tells teams to keep it simple and failure is OK – we learn from it!

Stuart picks up with the PDSA form, a worksheet for testing changes. Using the IHI Spinning Coins exercise, teams get to grips with theories, predictions, and PDSA cycles before breaking into group work to start planning their first PDSA to run tomorrow!

Richard Milner, energised to see such engaged teams as we enter action period one, closes the day celebrating how far we’ve come together and what’s next for the collaborative. Teams are reminded to use the QI faculty, alumni and Haelo as a ‘phone a friend.’ The collaborative will meet again in February for the second learning session, we look forward to hearing from you and watching your progression through the theory today.


The Haelo Faculty include Katharine Goldthorpe, Director of Improvement, Stuart Clough, Programme Manager, Bob Diepeveen, Senior Improvement Advisor and Data Analysts Laura Jackman and Nick John. To find out more about the programme, contact the team.

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