As I become one of Haelo’s newest ‘Improvement Advisors’, I have had the luxury of time to reflect on my ‘improvement journey’ to consider how I got where I am now and what I’ve learnt along the way.
I’ve worked at Haelo on various programmes over the past 2 years, including Improving Medicines Safety, Safer Salford and NHS Quest, but like many of us, my route to healthcare improvement wasn’t straightforward – my CV includes a Law degree, 2 years of travelling, and 8 years’ experience working in the public and third sector, focusing on development, implementation and communication of policy before joining Haelo. When given the opportunity to participate in the Institute for Healthcare Improvement’s (IHI) Improvement Advisor development programme in Boston, USA, I admit that I took it without quite realising what I was taking on.
The course provides the “advanced knowledge and skills you need to excel in the art and science of improvement”, but what does that mean and what is it actually like to participate?
Even with a great foundation of knowledge from the in-house training and development work we do at Haelo, each workshop was an incredibly challenging learning experience. We covered topics such as Deming’s Theory of Profound Knowledge, understanding variation with SPC charts, planned experimentation, creative thinking and developing business cases for improvement. Over the course of each 4 day workshop, I switched from not really having a clue what we were talking about, to learning from others during practical exercises, to moderate confidence when presenting back to the group, to having a mad flurry of enthusiasm to apply my new learning – something the go2physio team learnt to fear each time I returned from a workshop with new ideas and plans! After the second workshop looking at using SPC to understand variation, I found myself hunched over my laptop on the overnight flight home, building a whole new measurement dashboard for the project – when you know how to use and interpret it, data can be bizarrely energising.
Why did I have to go all the way to Boston for this, when we have such great expertise in Haelo? Boston is a beautiful and global city hosting MIT and Harvard University; it is where the greatest minds aspire to go to solve the biggest problems. The IHI is a world leader in its field, and our facilitators were excellent, but it was my colleagues – an international community of improvers – who I learnt the most from.
I heard from Yasser an incredibly powerful story which resulted in a nurse losing her job for an error caused by a system failure, which made him think “there has to be a better way to stop bad things from happening”. I saw improvement being delivered in a range of different contexts: Eric, who is working in a busy paramedic service in the city of Charlotte, Zeenath, who is working alongside public health partners in Brooklyn to improve health outcomes for people with HIV, and Jesse, working to improve internal processes within the IHI. I heard from Mercy what it is like to be at the front-line of healthcare delivery in neonatal units in Malawi, where due to electricity shortages, sometimes mothers would be left to manually ventilate their babies for hours. I saw how different people approached improvement and learnt from their challenges as much as my own, seeing Willie using data so expertly and with medical precision, seeing how Arianna worked with and developed her team, and hearing about Gus’s resilience and rigour in testing small on one patient, before spreading his learning further.
So, as Haelo’s newest improvement advisor, what next? In short, the sky is the limit. In addition to picking up the theory, the bulk of my learning stems from shared experience of using improvement science in so many different settings and ways; I now feel like I have a huge wealth of knowledge to draw from which has helped me understand improvement much better. I am determined to see that my learning is now used to deliver real improvement in our health and care services, and will be focusing on this in Salford and further afield!