Event blog: IS4L Cohort 3 Workshop 3


Improvement Science for Leaders (IS4L) Cohort 3 return to Haelo HQ for the final three workshop days of the programme. Course facilitator Jess Roberts blogs for Haelo.

Day 1

It’s a snowy week in Salford Quays, and we have pushed back the start time on day one to 10am so that our participants can negotiate the public transport system and roads with plenty of time to spare.  By the time people start to arrive, the faculty have warmed up and the coffee is hot, although it looks like the snow will continue to fall throughout the day!

IS4 Course Director Kurt Bramfitt greets participants and opens day one, which focuses on engagement. Haelo’s Director of Improvement Katharine Goldthorpe starts the day with a session based on her ten years experience as an improver in the NHS. She outlines the importance of patient inclusion, executive engagement and clinicians using the methodology, as the key to removing those blocks we stumble on when we try to improve.

Read more of Katharine’s top tips in her blog, here.

Next up, data guru and IS4 coach Nick John builds on the idea of engagement by exploring the six sources of influence. Using a combination of four or more of these massively increases our chances of success, whether our goal is to lose weight or get people to wash their hands before eating! Teams reflect on the sources of influence that they might use in their own projects, as well as what works for them on a personal level.

After lunch, Senior Digital & Events Lead Lauren Heaton and Multimedia Content Producer Stephen Miller talk about the power of digital media and using film in improvement. Lauren tells us about the incredible growth of digital media in recent memory, and then focuses on how the NHS have used film to effectively build real engagement with improvement work.

Stephen then sets the IS4L cohort a challenge: to make their own film with just their own phones. Participants spend the rest of the afternoon scoping out the office and raiding Haelo’s supply cabinets for sets and props! We look forward to seeing the results on Friday morning…

Day 2

Storm Emma approaches from the south but our intrepid IS4L participants have battled through the elements to arrive at Haelo HQ for day two of Workshop 3.

First we hear from Nadine Payne, knowledge management and evaluation expert. Nadine asks;

How do we know we are ready to scale up and spread?

Nadine continues by discussing understanding how our improvement works. Teams work on logic models for their own projects to try to understand why improvement might take place.

After a break, we have our first team presentation from the Dedicated Ward Pharmacy at East Lancashire, led by Alistair Gray. Alistair’s team have had some great successes but are struggling with engaging new members of staff with their project, and the cohort discusses ways of embedding the improvement project in induction.

I’m up next to introduce our topic for the afternoon, planned experimentation, or the design of experiments. Starting with the history of planned experimentation, I explain that experiments didn’t always look like they do now but pioneers like James Lind, R. A. Fisher, and George Box designed more effective experiments to discover really quickly what works best and in which combinations.

Nick John joins me to talk through some more examples of planned experimentation, specifically factorial design. This is how we understand interactions between various different interventions.

After lunch, Nick sets a challenge: using factorial design, teams must plan an experiment to determine how to blow the ‘best’ bubbles. Teams are given two different bubble solutions and two workers from each team are assigned to blow. Later, some of the workers are given specialist bubble blowing training. Will the training, the solution, or the worker make the most difference? Which combination will produce the most effective results?

The teams plan their experiments and use response plots to chart their results.

After this activity, Nick tasks the cohort with reflecting on how they could use factorial design in their own improvement work.

To finish the day, we have a presentation from the NWAS Imps, updating us on their team’s progress. The team are working on improving the completion of serious incident reports. They’ve really started to embed a culture change in their organisation.

Day two draws to a close. Teams will reconvene in the morning for the final day of the final IS4L workshop.

Day 3

The snow has finally melted and it’s on with the show, literally! We begin today with a cinema session, with Stephen Miller premiering the films that teams made on the first afternoon. Teams have created excellent short films and Stephen spent yesterday editing them to produce some fantastic results.  We hope that teams will continue to use film in their improvement journey. Here’s one of those films, produced by the Home(rt) on the Day team.

Next is a presentation from the QI Warriors at Pennine Acute, who are working on ward round standards. The team are now looking to implement their project across further wards, but are finding that there is some resistance from wards who think that the improvement won’t work in their situation. Katharine Goldthorpe is back later on to discuss the ways in which we can combat this resistance to scaling up our projects across other wards or organisations.

The team from Wrightington, Wigan, and Leigh present their project on safer patient flow next. #WISH have piloted the SAFER care bundle and even resorted to bribery of a chocolate nature to implement their project!

It’s fantastic to see the cohort feeding back to one another and sharing their knowledge. Teams invite one another to visit their wards to see what they’ve done with their projects. The cohort are now becoming improvement coaches themselves, and we hope that they will return to their organisation as improvement science evangelists, diffusing their improvement knowledge and expertise.

After a break, Katharine discusses scale up and spread. She touches on things that have worked, and why, as well as things that haven’t been so successful.

Finally, we have the Home on the Day team from Homerton to present. They show us some interesting responses to the patient survey they’ve been testing and ask questions about factorial design versus quick PDSA cycles.

The workshop then comes to a close with teams given time with our expert faculty. Nick’s on hand for data queries, Katharine for engagement, scale up, and spread, and Stephen’s here with more filmmaking tips. We hope that the cohort enjoy the final action period. We reconvene for graduation on Friday 18th May.

Suggested further reading

Box, G. Improving Almost Anything: Ideas and Essays. Rev. Edition. Wiley-Interscience, 2010.

Gladwell, M. The Tipping Point: How Little Things Can Make a Big Difference. New Ed Edition. Abacus: 2002.

Grenny et al. Influencer: The New Science of Leading Change. 2nd Edition. McGraw Hill: 2013.

Langley et al. The Improvement Guide: A Practical Approach to Enhancing Organizational Performance (any edition!)

Pawson, R. The Science of Evaluation: A Realist Manifesto. Sage Publications: 2013.

Rogers, E. Diffusion of Innovations. Fifth Edition. Free Press: 2003.


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