“In the end, culture will trump rules, standards and control strategies every single time, and achieving a vastly safer NHS will depend far more on major cultural change than on a new regulatory regime.”
A promise to learn – a commitment to act, 2013
For a little over a decade, the NHS has been wrestling with the shift in culture needed to sustain continuous quality improvement. But during the current crisis we have observed, through social media and the various improvement resources that have emerged to support the COVID-19 efforts, how staff across not only the NHS, but across the world have responded with a change in behaviours and focus that appear to demonstrate the green shoots of a more collaborative and cohesive approach.
Delivering improvements across health and social care has become increasingly fast paced, staff are finding new ways to do things, bridging historical divides to make important decisions more quickly while at the same time dealing with the emotional impact on themselves and those around them.
With so much rich learning we have captured the key observations in a Learning Package which we hope will enable our members and partners to recognise and refocus their quality improvement strategies in the post COVID period and share their own examples.
In the Learning Package we share the key enablers that we observed to be driving rapid improvements, and show how staff adapted and amplified aspects of improvement theory to meet the pace of change whilst ensuring that changes to practice stay safe, effective and help to save lives.
Highlighting the enablers in this way we can work together to assess how relevant this has been locally and target specific activities to build on existing improvement capability, practice and engagement going forward.
Capturing the depth and breadth of system wide learning will support the Safe Restart and provide a clearer path for improvement on a larger scale and “Retrofitting” theory to embed the organic growth in improvement capability will be a key asset for many organisations providing a wider foundation than they had previously.
The COVID-19 response has highlighted the agility and willingness of staff across health and care systems to collaborate and address improvement in their working practices. Reducing the barriers to change around business and governance practices in the system has enabled improvement to thrive. Embedding it in practice and culture will allow organisations to Hold the Gains towards continuous improvement.
The system will need to adapt ways to Rethink Delivery Models. Sustainability will depend on adopting these brave new practices, better than those that went before. The learning provides a start point for the behaviours and interactions between staff, organisations and system partners that will support improvement collaboration as we move forward into the new “normal” and avoid going back to a system that was creaking under the weight of demand.
If you are looking for a way to make sense of the impact of COVID on quality improvement efforts in your own organisation, please join our Community of Practice for our series of Webex discussions that cover the topics that you tell us are important to you.
COVID-19 will eventually pass. But understanding the experiences and changed behaviours in a systematic way will help to prevent a return to old ways of working, support Workforce Wellbeing and might just deliver the “major cultural change” we have been striving for.
KX Learning Labs
If you would like explore more about how staff have adapted and amplified aspects of improvement theory to meet the pace of change, we invite you to join our first KX Learning Lab session on Tuesday 2 June.
The session, Enablers for Rapid Change during COVID-19, will be delivered by Sarah and Chris, who co-produced the learning package.
If you would like to join us for this session and/or future sessions, please register here: https://www.eventbrite.co.uk/e/kx-learning-lab-series-tickets-106341755052
Our weekly series of webinars will cover a range of topics and have been developed to support you during COVID-19 and beyond. These short sessions will run at 4pm every Tuesday for 45 minutes and will be split into 4 series. The webinars are free and open to anyone working in health and care.
Series 1 is focused on ‘Hold the Gains’ and will cover:
Personalised Care End of Year Report
Aqua is Accepted on to the NHS Faculty Framework
Advancing Quality (AQ) Programme Shortlisted for HSJ Digital Award
Embedding a Culture and System for Continuous Improvement: A Practical Guide
Why Should Patient Safety be a Priority for Systems?
The Hewitt Review: An Independent Review of Integrated Care Systems