Developing a standardised quality improvement core content for

NHS Wales

Core Content Implementation Group Meeting

Tuesday 2nd October 2012: Meeting Notes

An attendees list is provided as an Appendix 1.

  1. Welcome and Introductions

AW provided introductions and welcomed the group.

  1. Notes from the previous meeting

The group agreed the notes as a true and accurate record of the meeting on 3 September.

  1. Matters Arising
  1. Staff Survey

TH agreed to discuss with the Welsh Government group leading on the staff survey the inclusion of a question relating to quality improvement skills. The question proposed for inclusion is:

“Have you had any training, learning or development in how to deliver a good patient / service user experience (e.g. Monitor the patient / service user experience, and use the feedback to make improvements).”

The bi-annual survey could provide a helpful baseline and monitoring process for staff development in quality improvement.

ACTION:

All to discuss the suggested approach within their organisations and the appropriate wording for the question. Discuss with Directors of Workforce and OD to feed back to Welsh Government

  1. Welsh Risk Pool Indemnity cover for training

AO has liaised with the Welsh Risk Pool who provided the following response:

“The quick response to your query is that as the need to deliver training to contractors is mandated by the Welsh Government within the Quality Delivery Plan and therefore we would consider it to be a core activity. On this basis it will fall within the indemnity arrangements of the WRPS scheme.”

  1. Developing Implementation Plans

Representatives from nine organisations provided an update on their progress with their implementation plans. This information is summarised in the paper ‘Organisation Updates.’

Following the organisation updates, AW summarised four key areas that featured in the majority of updates:

  1. Belief and Culture: the need to achieve a sense in the organisation of the direction of travel and that this is supported by Welsh Government. CEOs and local faculties can help articulate and develop what the culture and belief is. 1000 Lives Plus will support through providing communication tools.
  2. Conversion of prior learning: there is a need to identify the significant courses and their associated populations. Criteria will need to be agreed for each level which focuses upon the application of learning. In reality these numbers will be small but there may be significant numbers from the Transforming Care programmes.If cultural change is to happen, people need to be supported in demonstrating their skills e.g. through team meetings, appraisals. Nationally delivered courses will also need to have read across e.g. LQI.
  3. Measuring the impact: Welsh Government has confirmed there will not be a strict performance management approach.Welsh Government will want assurance that organisations have a plan and Boards will be accountable for this. It is likely to be preferable that core content is incorporated into locally owned and designed, team based development rather than a “rush for the number target”. The Quality Delivery Plan has several actions and this is only one that will contribute towards quality driven organisations.
  4. Existing training programmes are being delivered or planned for delivery: These should not be postponed or put on hold as the conversion process will apply where appropriate. From January 2013, the new content will be ready for inclusion.

ACTIONS:

  • All to feed back what local programmes are running in their organisation, what level they translate to approximately and the numbers attending these programmes e.g. VIP in Velindre. These will be addressed on a case by case process.
  • All to feed back what training has been delivered in terms of previous skills development and the numbers who have gone through each programme.
  • All to feed back what existing programmes including QI are on hold or planned until the end of December in their organisation and what are the numbers of participants in each programme.

AW also noted that the Directors of Workforce and OD had written to raise concerns relating to the work, specifically the 25% target, the wider context of organisations being unable to meet training and development needs across a variety of areas, and the need for alignment with local implementation plans. The letter suggested the following as a way forward:

  • A targeted approach to improvement methodology training to support the drive forservice change, quality improvement and operational efficiency within individualorganisations.
  • The current working groups focus on developing competence assessment approaches.
  • An achievable, realistic target aligned to assessment outcome rather than training.

ACTION: AW to speak to Welsh Government to respond – particularly to the issue of the 25% target.

  1. A Communications Strategy to support your implementation plans

AC presented the paper ‘QI Core Content Communications 02.10.12.’

Key points discussed included:

  • Using the NHS Wales brand.
  • Unpicking what is meant by the bronze, silver and gold level material – e.g. local programme X is ‘bronze level’ matched.
  • Agreeing an overarching title and ensuring appropriate language, e.g. the Improving Care Together Model / Framework.
  • Building in the concept that everyone has the permission to participate.

The group agreed that:

  • Nationally produced communication materials for local adaption would be helpful in disseminating the key points across organisations.
  • A place on the 1000 Lives Plus website should host the materials.
  • Local launches telling the story of what improvement means for all levels across the organisation would be beneficial.
  • Communication materials will need to be developed that are appropriate for different levels of seniority or different clinical specialties.

ACTIONS:

  • All to feedback on the name ‘Improving Care Together’.
  • AC to develop a short, all Wales communication on the work so far for circulation.
  • AC to develop a communications strategy incorporating the key points from the discussion.
  1. Reporting Requirements

It was agreed that the next meeting would focus on the implementation plans to share learning and ensure organisations are maximising joint opportunities.

The group agreed that internal reporting through ESR would be key and this would require discussion with the OLM group. The names of the levels will need to be included in the ESR system.

ACTIONS:

  • FB to add implementation plans to the next meeting agenda.
  • FB and DB to take forward links to ESR through the OLM group.
  1. A.O.B
  1. Train-the-trainer continuous support and quality assurance

DB noted that a network to support the Trainers and ensure shared learning will be developed.

ACTION:

DB to bring a paper to the next meeting on developing a Trainer network.

  1. Developing a QI Core Content Masterclass on 7th November

As part of the series of masterclasses to complement the national learning event on 8th November, there will be a session on the work so far to develop the core content. The open session will provide an overview of the project including the foundations for the work in other countries including England, Scotland and Sweden. It will provide the opportunity for a wider audience to find out more about the quality improvement core content framework, learning outcomes and assessment criteria developed with the service in NHS Wales. The session will also offer the opportunity for local executive leads for implementation to discuss challenges and opportunities in implementing the core content to skill up the workforce and transform the culture and way work is done.

ACTIONS:

  • FB to share event details and information on registration.
  • All to ensure an organisation lead for implementation attends the masterclass and will be able to discuss their implementation approach with their colleagues.
  1. Date of the next meeting

Wednesday 14th November, 09.00 – 11.30 in a Cardiff venue.

Workshop: What could cultural change achieved through teams learning QI skills and working together on quality improvement look like? (TH)

The group watched the Cardiff & Vale University Health Board - Enhanced Recovery After Surgeryfilm clip as an example of the benefits of team vs. individual learning. The following points were drawn out as key to a supportive environment for quality improvement:

  • A clinical champion seeking change
  • Multi-professional engagement
  • Patient focus
  • A single purpose – aligned with the organisation’s goal and purpose.
  • Doing what we already recognise as good but in a reliable way that is measureable.
  • Taking into account progressive engagement – transforming resistance and ensuring that once the change has happened, staff will not want to opt for the ‘old way’ of doing things.
  • Identify the resource to start the change
  • Use measurement for improvement as the language to make the case for change at all levels – especially mid-organisation level.
  • Evidence the impact of the change through outcomes on a small scale.

Following the discussion, the group agreed to highlight areas where the improvement methodology has been successfully applied in their organisation and to look at designing in examples to the implementation of the core content. Case studies were agreed as a way to share learning and help understand the approach to improvement, and storyboards were recommended as a helpful demonstrable tool.

ACTIONS:

  • All to identify examples and submit these.
  • AC to identify examples collated at a national level.
  1. Action Points

EL = Executive Lead and OL= Operational Lead

Action / Lead
Discuss the suggested approach to include QI in the staff survey and the appropriate wording for the question. Discuss with Directors of Workforce and OD to feed back to Welsh Government / EL / OL
Feed back by Friday 19th October what local programmes are running in your organisation, what level they translate to approximately and the numbers attending these programmes. / EL / OL
Feed back by Friday 19th October what training has been delivered in terms of previous skills development and the numbers who have gone through each programme. / EL / OL
Feed back by Friday 19th October what existing programmes including QI are on hold or planned until the end of December in their organisation and what are the numbers of participants in each programme. / EL / OL
Liaise with Welsh Government to respond to the letter from Workforce and OD Directors (ASAP) / AW
Feedback on the name ‘Improving Care Together’ by Friday 12th October. / All
Develop a short, all Wales communication on the work so far for circulation by Friday 12th October. / AC
Develop a communications strategy incorporating the key points from the discussion by Monday 5th November. / AC
Add implementation plans to the next meeting agenda by Monday 5th November. / FB
Take forward links to ESR through the OLM group regarding internal reporting (ASAP) / FB / DB
Develop a paper for the next meeting on developing a Trainer network by Monday 5th November. / DB
Masterclass overview and registration details to be circulated with information on Key Contacts by Monday 8th October. / FB
Organisation leads to be identified to participate in the masterclass on Wednesday 7th November and register via Key Contact. / EL / OL
Confirm attendance at the next meeting on Wednesday 14th November, 09.00 – 11.30 in a Cardiff venueby Monday 5th November. / EL / OL
Identify examples of successful implementation of the improvement methodology in your organisation and email the example to FB by Monday 5th November. / EL / OL
Identify nationally collated examples of the successful application of the improvement methodology by Monday 5th November. / AC

Appendix 1: Attendees list

Alan Willson / 1000 Lives Plus
Felicity Barclay / 1000 Lives Plus
Andrew Cooper / 1000 Lives Plus (invited presenter)
Tim Heywood / 1000 Lives Plus
Glynis Hudson / NLIAH (one representative to be agreed)
Bethan Johnson / NLIAH (one representative to be agreed)
Dominique Bird / NLIAH
Linda Reid / ABMU Health Board
Louise Joseph / ABMU Health Board
Sue Ball / Aneurin Bevan Health Board
Anwen Crawford / BCU Health Board
Diane Read / BCU Health Board
Lesley Jones / Cardiff & ValeUniversity Health Board
Kim Tovey / Cardiff & ValeUniversity Health Board
Mark Gibbs / Cwm Taf Health Board
Cheryl Raymond / Hywel Dda Health Board
Dr Sumina Azam / Powys Teaching Health Board
Louise Williams / Powys Teaching Health Board
Karen Wright / Velindre
Richard Lee / WAST
Apologies:
Debbie Morgan / ABMU Health Board
Anne Phillimore / Aneurin Bevan Health Board
Julie Rowles / Aneurin Bevan Health Board
Nia Thomas / BCU Health Board
Mark Sykes / BCU Health Board
Ian Stead / Cwm Taf Health Board
Angie Oliver / Hywel Dda Health Board
Janet Wilkinson / Hywel Dda Health Board
Claire Barley / Public Health Wales NHS Trust
Ruth Davies / Public Health Wales NHS Trust
Maria Andrews / Velindre

1000 Lives Plus Core Content Implementation Group Meeting Notes v1 FINAL