Module 1: Overview and QI Context

Tuesday 15th December, 10:00 – 11:30

Welcome SCLIP Cohort 19

 Your Hosts Today

Fran Kerr, Senior Educator, NES Jack Marshall, Admin Officer,

Quality Improvement Team NES Quality Improvement Team
Troubleshooting

Any technical issues, please contact:

Qualityimprovement@nes.scot.nhs.uk
This session is
being recorded
 Be fully connected

Headsets are preferable to hands free – but you might want to give your ears a break every
once and a while…..
Session Objectives

How to use MS Teams

Introductions
Programme overview
Improvement Science and the Scottish context
To Do list….
Introduction
to MS Teams
Online Meeting Etiquette

Set microphones to mute when not speaking

Webcams on where possible

Use hand icon to indicate you would like to speak

Use the chat box to add questions or thoughts

Smile and nod to let the facilitators know you are

listening
 Online Meeting Etiquette Tools

1. Turn your camera on and off 5. Raise your hand

2. Mute and unmute your audio 6. Open and close the chat panel
3. Share your desktop, or a 7. Open and close the participant
presentation panel
4. Access more in-meeting options 8. Leave the meeting
Fastest hand on the buzzer!

When I say go, use the hand up function as fast as you can

Tip: Remember to put your hand down by pressing the

same button before we move on
Chat Box

In one word, please describe how you're

feeling about participating in SCLIP?

Use the chat box to post your response to

the question

Type your message here

Press send
Reacting to comments in the chat…

Using the messages just entered into the

chat box can we ask you to react to a
comment.

Hover your mouse over their comment

Click on the reaction you would like to

make
Let’s use GIFS!
Choose a GIF that best describes
your personality
Open up the chat box

Click on the GIF icon to open up the GIF library

Use the search function to find an appropriate GIF

… Or you can browse popular GIFS

Click on the GIF you would like to share and the hit send
Poll

Please open up the chat box, where I’m going to

insert a poll

Select your answer by clicking the relevant

bullet point

Once you’re happy with what you’ve selected,

hit “Submit Vote”
Our ways of working

Please be on time when sessions are due start and

when coming back from breaks.

Switch off any notifications/noises (e.g. email, mobile

phones, social media)

Please be patient when you have raised your hand or

asked a question in the chat box

Have fun!
Introductions
 SCLIP 19 Faculty

Frances Kerr, Senior Shaun Maker, Principal Mark Johnston, Specialist

Educator, NES QI Team Educator, NES QI Team Lead, NES Organisational
Development Leadership &
Learning
 Participant
Introductions

Who you are and what you do…

Your Twitter handle

What are you passionate about

improving?

Into the chat box…

Introductions and Programme Overview
 Programme Aims
• Develop core managers
coaching, leadership and
improvement skills

• Core Managers help embed

improvement strategies
within their organisations.
 Identify
Implement
Develop specific
Create Understand where Spread
aim and change
conditions current tested, where
change ideas, test
for change system make it relevant
theory and refine
stick
using pdsa

Leadership, organising projects, communication and measurement

SCLIP Driver Diagram Continuous improvement of content to meet learner
Programme content needs
supports participants to
develop Coaching, Leading
and Improvement skills
and knowledge Balance of leadership coaching and improvement
content to meet learner needs

Core Managers are

empowered and
enabled to support
Programme delivery Adult learning approach
teams to improve
approach maximises
services and embed learning
improvement Application of learning to support teams to improve
strategies in their services
organisations

Personal responsibility and planning

Participants committed
and enabled to apply
learning to improve
services Participants have protected time to consolidate and
embed new skills
 SCLIP so far

Coaching Leadership QI

SDI Motivational value system

Systems thinking
Coaching conversations Team fundamentals
Developing project aims
Project management and
CLEAR Model Project charters Driver diagram and family of
measures
Constructive feedback 7 step meeting process
Measurement & Data
Art of reframing Productive zone of discomfort
Testing change ideas
Courageous conversations
Team Coaching Spread
Wicked issues & clumsy
Working with Teams solutions Developing change ideas
Leadership capabilities
 SCLIP 19: Timeline
Module 8
(2 days)

Module 3 Module 7
Module 5
(2 Day) (1 day)
(90 mins)

Module 1 Module 2 Module 4 Module 6

(90 mins) (1 day) (90 mins) (90 mins)

December January February March April

Action Plan
Course Certification

Attend all full-day modules

Attend or catch up on all other modules

Share your learning and insights

Apply knowledge and skills to support teams

deliver Improvement

Submit an action plan

Support
 Key reading

The Improvement Guide The Coaching Manual

 Baseline Knowledge - Resources Available

https://learn.nes.nhs.scot/741/quality-improvement-zone
https://learn.nes.nhs.scot/3870/quality-improvement-
zone/elearning
What questions do
you have about
the SCLIP course?
Improvement Science
and the Scottish Context
 Session Objectives

Understand key points in the history of

improvement science

Acknowledge key influencers and their

contribution to development of improvement
science

Explain how we are applying this approach across

Scotland’s Public Service
 The nae money slide
(Fall in Government expenditure)
With Challenge comes opportunity….
 How did we get here?

Improvement
Improvement Framework for
Route Map for Scotland’s
Health & Social public services
Scottish Patient 2013
Safety Care services
Programme 2011
IHI 1991 2007

Roots of
improvement
science 1920’s –
1990’s
 Step 2: Create the conditions - 6 questions to be
asked of EVERY change programme…
1 2 3
Aim Correct changes Clear change method
Is there an agreed aim that is Are we using our full knowledge Does everyone know and
understood by everyone in the to identify the right changes & understand the method(s) we will
system? prioritising those that are likely to use to improve?
have the biggest impact on our
aim?

4 5 6
Measurement Capacity and capability Spread plan
Can we measure and report Are people and other resources Have we set out our plans for
progress on our improvement deployed and being developed in innovating, testing, implementing
aim? the best way to enable and sharing new learning to
improvement? spread the improvement
everywhere?
 Building A Quality Management System
For Scotland’s Public Services

http://www.healthcareimprovementscotland.org/previous_resources/policy_and_strategy/quality_management_system.aspx
Leadership development tailored around your needs
Underpinned by the six leadership capabilities
Extending
Pathways
Developing
Managing
Leadership People and
and Leading
for Health Resource
Quality
and Care Management
Improvement
Beginning

Three levels to explore Choose your pathway

 What is Quality Improvement?

Quality Improvement is defined as the

application of a systematic approach that
uses specific techniques to improve quality.

Health Foundation 2014

 The Typical Approach To Change…
Conference Room

DESIGN DESIGN DESIGN DESIGN APPROVE

Real World
IMPLEMENT
 The Quality Improvement Approach
Conference Room

DESIGN APPROVE
IF NECESSARY

Real World
TEST & TEST & TEST & START TO
MODIFY MODIFY MODIFY IMPLEMENT
 Roots of Improvement Science

W. Edwards Deming Walter Shewhart Joseph Juran

1900 - 1993 1891 - 1967 1904 - 2008
Image by FELDSPATH (CC BY-SA 4.0)
Photo courtesy of The W. Edwards Deming Institute®
Walter Shewart 1891 - 1967
 W. Edwards Deming 1900 - 1993

Lens Of Profound
Knowledge Appreciation of
a system

Building Human side

knowledge
of change
Photo courtesy of The W. Edwards Deming Institute®

Understanding
variation
 Joseph Juran 1904 - 2008

Quality
Control/
Assurance

Quality
Management
Juran
Image by FELDSPATH (CC BY-SA 4.0)

Trilogy
Quality Quality
Improvement Planning
 Business as Usual?

Ignore

New Way Circumvent Old Way

Sabotage
 The greatest waste...is failure to use
the abilities of people...to learn about
their frustrations and about the
contributions they are eager to make

W. Edwards Deming - Out of the Crisis

Dr. Deming’s 7 Deadly Diseases that kill QI Culture
(5 relevant to our context)

1. Lack of constancy of purpose

2. Emphasis on short-term profits
(public sector = short-term savings)
3. Performance management &
annual reviews
4. Mobility of top management
5. Running a company on visible
figures alone (failing to recognise
importance of culture & relationships)

6. Excessive medical costs

7. Excessive legal costs
Dr. Deming’s 14 Points for leaders to create a QI Culture
Improve quality of Replace management Eliminate inspection.
supplies with leadership Focus on quality

Create joy in work Transformation is

everybody’s job
Institute training on
the job Drive out fear
Create constancy of
Institute vigorous
purpose
programme of
education and self-
Eliminate quotas
improvement
(targets) - Substitute
leadership
Break down barriers
Eliminate slogans. Fix & silos. Work as a
the system team
Focus on continuous Supervision should
improvement be to help people
 Four Steps for Leaders

1. Ask staff “What matters to you?”

2. Identify unique impediments to joy in work

in the local context

3. Commit to a systems approach to making

joy in work a shared responsibility at all
levels of the organisation

4. Use improvement science to test

approaches to improving joy in work in your
organisation

http://www.ihi.org/resources/Pages/IHIWhitePapers/Framework-Improving-Joy-in-Work.aspx
 Session Objectives

Understand key points in the history of

improvement science

Acknowledge key influencers and their

contribution to development of improvement
science

Explain how we are applying this approach across

Scotland’s Public Service
 First Steps..

Think about which team to

support.

Explore improvement ideas.

Think about a stone in your shoe

for coaching practice.
Opportunities

Learn by doing
Plan for…
e-learning modules
completion

Modules 2 : 12th Jan

Module 3 : 19th + 20th Jan

Module 4: 2nd Feb

Coaching - consolidation of
learning and sharing key
What questions do
you have?