Innovating for Improvement Round Five Launch

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Welcome to the event review for the Innovating for Improvement round five: launch event, held on Thursday 2 March 2017 at the Royal College of Nursing, Cavendish Square, London.

Haelo has been commissioned by the Health Foundation as expert support providers for the Innovating for Improvement programme. The Health Foundation is an independent charity committed to bringing about better heath and heath care for people in the UK.

You can join the conversation or see tweets from the day with #THFinnovate follow us @_Haelo and @HealthFdn.

Now live: Spot yourself in the round 5 launch event film!

Today we host all 22 clinical teams across a vast variety of improvement projects. Over the next 15 months, the programme will support teams to develop their innovative ideas and approaches, put them into practice and gather evidence about how their innovation improves quality. Projects are based in any health or health and social care provider organisation in the UK where health care services are delivered free at the point of delivery.

All attendees have arrived, been checked in and are equipped with their materials for the day. Crucially, delegates have collected their name badges, which, aside from the usual information of name and role requests that attendees include an ‘ask me about’ and a ‘tell me about’ and their sticky labels. These badges, designed by Haelo’s Events Team are intended facilitate networking with the ‘ask me about’ being a key skill that each attendee is happy to share; similarly, the ‘tell me about’ signals a subject that the delegate is willing to learn about. The purpose of the sticky labels, each sheet with an individual delegate’s name and email address will be revealed later! Delegates gather in the wood panelled ‘Council Room’ for coffee and networking which was originally designed by Sir Edwin Cooper in 1922 as a Dining Room for College staff. Haelo staff open the doors and welcome teams to the Cowdray Hall (named after Annie, Viscountess Cowdray. a benefactor to the Royal College of Nursing) at 9:50 am. The high ceiling-ed hall is decorated with three stained glass windows depicting ‘Love, Fortitude and Faith’ – the symbols of the nurse.

10:00 a.m. Frances Wiseman, Senior Improvement Fellow at the Health Foundation, opens the event and begins with an overview of who is in the room today.

 

Frances gave an overview of the Innovating for Improvement programme – it’s one of the most popular of The Health Foundation’s award schemes, receiving around 160 applications during its last round. Frances emphasised that one of the most important aspects of Innovating for Improvement is ‘learning together’ – this programme provides an opportunity for The Health Foundation to learn about how innovation works ‘on the ground’. Frances highlighted the value of this award scheme in helping The Health Foundation foster innovative interventions which help improve the health and healthcare landscape.

10:20 a.m. Abigail Harrison, Haelo’s Associate Director for Digital and Innovation is next to take to the stage to give an overview of the day ahead.

Staying true to the ethos of ‘innovation’, Abigail introduced the delegates to ‘Poll Everywhere’, a text-based interactive polling platform which allows delegates to provide instant feedback on the day’s events. Using ‘Poll Everywhere’ Abigail asked attendees ‘how did you get here today?’: responses ranged from the fantastical ‘by magic carpet’ to prosaic, ‘public transport’ to heroic, ‘two trains and tube’.

Now that delegates had been initiated into the use of text polling, the software was used to ask the room ‘what are you most looking forward to today?’, providing attendees with an opportunity to voice their expectations for the day. Replies such as ‘networking…independent advice’, ‘talking about measurement’, ‘hearing about other programmes’, ‘talking with like-minded innovators’, ‘getting insights from others’ revealed that ‘measurement’ and ‘networking’ were high on the list of delegates’ aims for the day.

Abigail talked delegates through the day’s agenda, emphasising that this is an opportunity for delegates to learn from each other and to share the expertise amongst the room. The day’s agenda is packed, with sessions from Haelo’s Kurt Bramfitt, table work facilitated by Haelo staff and an interactive session on ‘co-creation’. Abigail welcomed Frances back to the stage and invited her to provide delegates with an overview of The Health Foundation, its aims and its work.

Frances, an experienced manager who has clinical, managerial and improvement expertise delivered a presentation about what delegates, as part of the extended Health Foundation network, could expect to receive as part of this community. The core purpose of The Health Foundation is to ‘learn about what works – to connect what works on the ground with effective policy making’ in order to ‘shine a light on how to make successful change happen’. The Health Foundation seeks to ‘learn what works to make people’s lives healthier and improve the health care system’. With Innovating for Improvement, The Health Foundation wants to add to the body of knowledge by finding out ‘what helps, what hinders’ innovation; ‘what does it take to scale and spread an innovation’ and ‘what are the elements which allow innovation to happen?’.

Frances explained to delegates that the focus of this round of Innovating for Improvement is primary care – ten of the main award holders from this round are from primary care based organisations. This presents The Health Foundation with a valuable opportunity to understand how, by targeting innovations at all stages of the health economy, innovations can be successfully sustained and spread.

Frances continued by detailing the impact of the projects which had previously received funding through ‘Innovating for Improvement’ and its precursor, ‘SHINE’. 40% of projects had won an external award, 40% of teams reported that their project had been picked up nationally with 20% stating that their work had been recognised internationally. This means that teams not only have a great platform for spreading their work but are able to connect with a network of successful healthcare innovators.

Frances then welcomed Anna Markland, Innovation Project Manager from The Health Foundation to the stage.

Anna began by introducing the teams to their specific Health Foundation Project Officers. Anna then provided teams with an overview of the key dates during the programme; there would be a mid-point event and a celebratory event punctuated by three masterclasses. The focus of these masterclasses would be designed in conjunction with delegates.

Anna’s overview continued with a breakdown of what delegates could expect from their dedicated Haelo support consultant and what The Health Foundation would like to learn from teams’ experiences. Key to Innovating for Improvement is the navigation of the innovation journey together; understanding and creating sustainable change is difficult – both for teams and for The Health Foundation. Anna suggested that teams speak with Haelo about how to promote teams’ work through the use of social media and film and access the resources published by The Health Foundation such as the ‘Communications Guide’.

Importantly, Anna emphasised Frances’s presentation by urging delegates to connect with the wider Health Foundation community and networks. If teams would like any more information on how to access these, they were recommended to contact their dedicated Health Foundation Project Officer.

The Health Foundation recognises that innovation and improvement can be challenging and that teams could be faced with myriad demands – importantly, don’t ‘suffer’ these in silence; speak to your Haelo support consultant, other teams, your Health Foundation Project Officer. Teams have an extensive network of support which they are encouraged to access!

10.40 a.m. Anna exits the stage, and the room is back with Abigail for a quick introduction to Haelo and a breakdown of the bespoke support model that Haelo will be using to help teams navigate their innovation journeys. Haelo is an innovation and improvement science centre, nested in Salford public services, whose mission is to positively impact peoples’ lives and accelerate the pace of change across health systems and health care. Haelo has particular expertise in digital communications and using film and media to capture knowledge and to spread improvements.

Haelo has been commissioned by The Health Foundation to provide support to each of teams; Abigail emphasises the form this support takes will be decided on through a collaborative process. Support consultants will be very much led by teams – this is not a prescriptive model – and Haelo is seeking to as much learn from teams as it is to facilitate teams’ learning. Haelo’s support offer crosses three areas: coaching and support; social learning; knowledge management.

Abigail outlined the extent of the expertise in the room and explained that Haelo would be seeking to harness as much as possible of this capability during the programme’s lifetime and to connect delegates to each other and Haelo’s wider networks, sharing learning and experiences. Central to this connection will be the coming together of teams around common challenges to develop common solutions. This will be facilitated by the ‘Hub’, an interactive digital platform developed by Haelo which allows teams to share resources, provides a dedicated space for teams to work on their projects and has a curated library of improvement science journal articles and resources.

Abigail greeted Kurt Bramfitt, Haelo’s Senior Improvement Advisor to the stage. Kurt, as the Head for Haelo’s ‘Measurement and Capability’ Function and Lead for Haelo’s flagship IS4 programme is well placed to explain to teams the form and the content of the support they’ll receive. Support will be provided via site visits in which the Haelo support consultant will come to the teams, to understand the environment and system in which they are working, web catch-ups, telephone meetings and complemented by email correspondence. Haelo’s areas of expertise encompass measurement; evaluation; leadership support; improvement science methodologies; scale up and spread techniques; communications and knowledge management. The support consultants will be considering ‘innovative approaches to improvement’ to aid teams on their innovation journey.

Kurt detailed some of the overarching theory that would be guiding the support consultants, namely W. Edwards Deming’s ‘Lens of Profound Knowledge’. Kurt emphasised that he and the Haelo Support Consultants are happy with and know that teams would be using their own methodologies such as Lean. This individual support would be bolstered by a series of masterclasses and an action learning set which would seek to bring teams whose projects had a common thread together to learn collaboratively.

Kurt then introduced the room to the Haelo support consultants; Abigail Harrison, Nadine Payne, Bob Diepeveen, Nick John and Kurt himself, as support consultants were able to meet their teams ‘in person’; the remainder of the support consultants were introduced virtually!

10:50 a.m. Abigail returned to the stage to talk delegates through the communications logistics. Teams should contact their dedicated Health Foundation Project Officer for finance and budgetary reports. Andrew Palmer, the Innovating for Improvement project manager from Haelo and teams’ individual support consultants will be the main point of contact for site visit logistics, project reports and events. As a part of the flexible support offer from Haelo, teams would be able to contact their support consultants via email regularly. At this stage, Abigail invited teams to feedback on what they’d heard and let the Haelo staff know their thoughts on the support offer using the text polling software they’d previously used.

Abigail requested that one member from each team text in answers to the following questions:

  • Is the support offer what you were expecting?
  • Is there anything missing that you need or want?
  • Should the action learning sets and masterclasses be face to face or virtual?
  • What themes should they focus on?
  • What are you most looking forward to?

There is chatter in the room as teams discussed their answers to the questions.

Abigail also talked delegates through the ‘networking bingo’ that was going to take place during the upcoming break. Each delegate has been given cards with various categories: the object of ‘networking bingo’ is to ensure that you speak to fellow attendees from each of the categories – and this is where the sticky labels from earlier come in! Once delegates have spoken to someone with the requisite skill / interest, that person ‘confirms’ this by way of his / her sticky label. The first delegate with a full bingo card wins a copy of the ‘Improvement Guide’!

11:00 a.m. Break. Delegates exit the room, ready to partake in some networking bingo! Abigail informs attendees that the next session will be a facilitated table discussion on the follow topics:

  • Conditions for success: scale up and spread
  • Evaluation: understanding the impact of your innovation
  • Measurement strategies…for the real world

During the break, fuelled by tea, coffee and biscuits, delegated enthusiastically endeavour to complete their networking bingo card! There’s no time limit on the bingo – it could run all day or be completed in this break. Once a delegate has a full card, s/he is to find a Haelo ‘green-shirt’ who will confirm his / her win.

Delegates re-enter the ‘Council Room’, whose architectural features includes a glass domed ceiling, echoing the Georgian splendour of the building and low relief busts of Florence Nightingale, Edith Cavell and Viscount and Viscountess Cowdray, members of the aristocracy who purchased the house for the Royal College of Nursing the 1920s.

This provides an opportunity for some delegates to meet their support consultant. During the break, delegates mingle and connect with each other, sharing their ‘ask me about’ skills and interests and learning from others their ‘tell me about’ requests. Abigail Harrison takes this opportunity to speak with some delegates individually about their experience thus far.

11:40 a.m. ‘And we have a winner..!’ Delegates re-enter the Cowdray Hall and take their seats at tables discussing either ‘Evaluation’, ‘Measurement’ or ‘Conditions for Success’. On being seated, Abigail takes to the stage and informs the room that networking bingo has ended, with Dr. Keith Grimes winning (on his birthday) a copy of the ‘Improvement Guide’.

Before the facilitated table discussions begin, Abigail invites delegates to watch a film produced by previous recipients of an ‘Innovating for Improvement’ award, Trust Innovation in partnership with Hadrian House.

The film is spotlight on the success of a previous team, offering a glimpse of the future for participants in the room and showing the positive effects innovation can have for patients. This leads in to the next stop on our agenda, facilitated group work. On stage, Abigail suggests to teams that, in order to ‘break up’ the provision of feedback to the room, delegates choose a particular ‘presenting’ style – will tables choose to be a newsreader, a children’s television presenter, a television cook?

  • Conditions for success: scale up and spread
  • Evaluation: understanding the impact of your innovation
  • Measurement strategies…for the real world

During this discursive session, delegates introduce themselves to their tables, provide an overview of their individual projects, and detail how either evaluation, measurement or conditions for success is relevant for their work and why the particular area may prove difficult.

The objective of this session is for teams to discuss any particular challenges and for their fellow table members to help them come to a solution. The Haelo ‘green shirt’ on each table is there to facilitate the discussion and pose questions to the group which may help them consider new approaches for addressing these challenges. Around the room, tables relish the opportunity to discuss projects in further details, to meet with others, and help others through any challenges.

12:30 p.m. Abigail invites tables to feedback to the room their discussions…first up is one of the ‘evaluation’ tables which chooses to summarise their discussion in the style of a pantomime! Key themes emerging from this are the need to ensure that the evaluation contributes to the progression of the project; that there is a learning cycle between the evaluation and the project, and the need of the evaluation to provide answers to ‘what works, for whom, and in what context?’. This echoes Haelo’s preferred formative evaluation methodology, Rapid Cycle Evaluation.

Next to take to the stage is one of the ‘Measurement’ tables who choose to report their discussions as a children’s television presenter – sitting cross legged on the table itself! ‘Takeaways’ from this discussion included ensuring that your data tells a story, that your measures are simple and clear and – crucially – to ensure that you collect your data over time!

A table discussing ‘Conditions for Success’ chose to use the medium of a ‘reality cop show’ to present their conversation to the room. Essential for the successful ‘scale up and spread’ of improvement and innovation is the effective packaging of knowledge, a comprehensive communications strategy and ensuring that your improvements and innovations can be adapted for the local context. Other formats chosen by teams to present to the room varied from a weather presenter to Miss Piggy!

https://twitter.com/MadiHoskin/status/837287100013821953

13:00 p.m. Networking and lunch break. Delegates exit the Cowdray Hall to continue their networking, visit the Haelo stand where Innovation and Science Manager, Nadine Payne, is on hand to explain the use of social media as a knowledge management tool, and reflect on the morning’s experiences. The Haelo team are busily placing three cakes on each table with very strict instructions ‘not to eat’! All will be revealed later..!

14:10 p.m. Our teams are back refreshed after the break, ready for the afternoon. Our exciting key note session today is on co-creation and comes from the South Yorkshire Housing Association (SYHA)

Juliann Hall, Director of Care, Health and Wellbeing and Morwenna Foden, Programme Lead, Quality Improvement present: ‘Co-creating Health – The myths, the methods and the magic’. SYHA is a not-for-profit, registered social landlord with charitable status, with approximately 6,000 homes across Sheffield. 60% of SYHA’s current activities are around providing care and support, ‘helping vulnerable people to remain independent’. The LiveWell department is responsible for some of this work, providing services to ensure that customers are provided with the tools to flourish and be happy in their environment.

The award-winning LiveWell services are overseen by Juliann Hall and combine housing, health and care expertise to provide person-centred, integrated health and housing solutions. The Co-Design and Improvement team to deliver a range of co-created health integration projects, including Over2You, EatWell and Ageing Better.

Juliann begins with providing delegates with an overview of co-creation, detailing how the SYHA co-creates their projects to ensure that the end users are prioritised throughout.

Juliann explains that co-creation is an ‘end to end’ process, in which you challenge yourself at every point in the process to involve people. Importantly, co-creation does not simply mean involving end users, but should encompass key stakeholders, partner organisations, networks. Juliann emphasised the need to ‘think beyond the usual suspects’ and integrate and involve as many people and organisations throughout a project’s inception, implementation and evaluation. Co-creation means that interventions and projects are co-designed, co-produced, co-delivered and co-evaluated.

This approach of co-creation has been employed by SYHA in their ‘Ageing Better’ programme which is funded via an award of £6million from the National Lottery and seeks to reduce social isolation in a high-risk over 50 population. This programme presented challenges in how to access the ‘truly isolated’; by employing a range of co-creation methods (i.e. on-the-buses interviews, 1920s themed cocktail parties, peer mentoring, champions, free counselling, transport access ambassadors and intergenerational skill swaps) the team was able to access more people.

Co-creation is also the driving focus for the ‘Over2You’ programme in which local people are trained in evaluation skills and test the quality of the interventions and services. This allows local people to understand what good care looks like and for commissioners and providers to gain a fresh, in-depth insight into what customers think about services.

The SYHA also has a ‘Co: Create’ team which is Department of Health funded. This team seeks to ‘develop good commissioning practice, and help design personalised and responsive services that effectively integrate the needs and expectations of customers’ by designing services with those that use them on a daily basis. The essence of ‘Co: Create’ is to connect the human story with strategy, by bringing to life what it means to be a patient to commissioners and providers. Their work involves:

  • Co-producing engagement events involving different communities in evaluating, designing and testing new ideas for services.
  • Working at grassroots level to involve and engage people and groups, including those most disadvantaged and disengaged.
  • Connecting third-sector partners and community groups in the co-production of health and social care services.
  • Working side-by-side with councils and health and social care bodies, to help them gain a fresh insight into what their customers need from a service.

Juliann welcomes her colleague Morwenna Foden to the stage; Morwenna is the Programme Lead for Quality Improvement and leads on the ‘Co: Create’ programme. Morwenna reveals to teams that this is where the cakes come in!

Morwenna challenges teams to think about their projects and detail at which stage on flip chart paper delegates have involved patients / services users in their projects. If there were stages with no service user / patient involvement – could they be involved? Teams were asked to then think about how much of their project had had service user / patient involvement – and to represent this using the cakes! Teams were only allowed to eat the amount of cake that was representative of the co-production involvement! Using cakes in this way was a fun, impactful representation of the potential in a project to involve service users and gather patient feedback.

Morwenna then provided the team with some tools and techniques to ensure that the views of stakeholders, service users and patients were represented, even if teams were not able to interact with them individually. Morwenna suggest that teams use empathy and ask ‘what’s on his / her kitchen side? What’s on his / her desk?’ By getting teams to think about what the paraphernalia that defines a person is and which items reveal the ins and outs of a person’s character, delegates would be able to consider their service users ‘in context’.

This session appeared to engage participants and lots of discussion was triggered; teams seemed to be participating in the interactive session and ‘put themselves’ in the shoes of others.

Morwenna followed this up with how to use storyboards and Lego to picture teams’ co-creation journeys.

15:30 p.m. Following the fast-paced and packed ‘co-creation’ session, Abigail returned to the stage to facilitate ‘Taking it Home’, in which teams are given time to reflect and agree next steps. Together teams will discuss their learning objectives and what Haelo support they might need over the coming months.

This session was fuelled by a final round of teas and coffees and a last opportunity for networking. Abigail asked that teams consider their key reflections, their plans for measurement, evaluation, spread and co-design, and consider how Haelo and The Health Foundation can best provide their support.

Teams were also encouraged to take a ‘team photo’ and to post them on twitter, #THFinnovate.

There was a tangible sense of excitement and a gentle hum of conversation as teams discussed their next steps. There was also a final flurry of networking with delegates exchanging contact details. These sessions are important for teams before they get swept away back in their day job, to reflect on the day’s learnings and to discuss their action plan.

15:45pm As the event comes to a close, Abigail Harrison from Haelo summarises the day and the actions for delegates. The next steps are:

  • Teams to work with their support consultants and arrange dates for site visits.
  • Teams to submit project budgets to The Health Foundation
  • Teams to submit their end of set-up phase report
  • Teams to complete the ‘pulse’ survey

Abigail showed the delegates the Hub, explaining how teams could use this as a shared space to store project documents, to access improvement science resources and to connect with other teams in the cohort.

Frances Wiseman from the Health Foundation thanked the teams for ‘looking at the project through a different lens’ and for interacting with the day’s activities.

16:00 p.m. And that’s it! The programme has launched! The first event of Innovating for Improvement, round five appeared to have ended positively, with teams looking and sounding engaged and excited for the next stage of their innovation journeys. Some teams had met with their support consultants and had eagerly arranged their next contact; others had been connecting with fellow delegates to share learning.

If you’re interested in joining the programme, the Health Foundation have opened round six recruitment, visit the Innovating for Improvement page to find out more.

Haelo are the official support providers for round five and round six, Innovating for Improvement. Since the launch, round 5 have met for their mid point event in September 2017. To find out more about round 6, take a look at the launch event blog and film.

Resources

Find a list of references from the event:

Health Foundation resources on ‘Communications’

More information on W. Edwards Deming’s ‘Lens of Profound Knowledge’ can be found here:

Evaluation

  • Parry, G.J., Carson-Stevens, A., Luff, D.F., McPherson, M.E., Goldmann, D.A. (2013) Recommendations for evaluation of health care improvement initiatives. Academic Paediatrics 13(6 Suppl): S23-30.
  • The Health Foundation, ‘Evaluation: what to consider. Commonly asked questions about how to approach evaluation of quality improvement in health care’

Measurement

Conditions for Success

Event support

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