APPROACH
What Do We Do?
We specialise in helping healthcare teams improve and sustain performance in critical areas such as patient flow, patient safety, staff retention, and Care Quality Commission (CQC) ratings. Our distinctive approach is dedicated to fostering an environment and culture conducive to sustainable improvement, with a particular focus on cultivating psychological safety.
Our Unique Approach
What sets us apart is our commitment to creating a supportive atmosphere where teams can thrive. We understand that psychological safety, where team members feel safe to take risks, voice their opinions, and make mistakes without fear of retribution is crucial for continuous improvement and innovation.
How We Work
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Identify Pragmatic Improvements: We collaborate with teams to pinpoint small, practical changes that can have a significant impact on performance. These improvements are tailored to the specific needs and context of each team.
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Provide Quality Improvement Support: Leveraging our extensive experience in quality improvement, we guide teams through the implementation of these changes, ensuring they have the tools and knowledge necessary to succeed.
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Address Psychological Safety Concerns: We delve into the anxieties and concerns team members have regarding psychological safety. Understanding these barriers allows us to help develop targeted strategies to overcome them.
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Collaborate with Leadership: We work closely with the organisation’s leadership team to design and implement approaches that improve psychological safety, fostering a supportive and open culture.
By nurturing a culture where improvement initiatives are embraced by all, we ensure that positive outcomes are driven by the collective efforts of the organisation.
PLAN
Understanding Phase (Planning, Understanding and Consensus)
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Engagement with Leadership Teams: We start by meeting with leadership teams to gain insights into the areas earmarked for improvement.
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Data Analysis: We conduct a comprehensive review of local data relevant to the identified areas for improvement, including insights from staff satisfaction surveys. This data helps us develop clearer improvement trajectories, understand the likely pace of change, and reflect predictable seasonal pressures.
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Psychological Safety Assessment: Through a brief online questionnaire, we gauge the psychological safety levels of individuals involved in the improvement initiatives. This provides invaluable insights into organisational dynamics and opportunities for improvement.
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Stakeholder Engagement: We engage with as many stakeholders as possible to gather diverse perspectives. This includes visiting the areas for improvement, walking the patient pathway, hearing directly from team members, and assessing the difference between work as expected versus work as done.
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Executive Team Alignment: Our findings, including results from the psychological safety assessment, are shared and discussed with the executive team. The aim is to brainstorm improvement ideas and reach an initial collective agreement on the approach.
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Facilitated Conversations: We facilitate discussions with organisational leadership teams to further refine the approach and seek consensus on initial improvement strategies.
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Organisation-Wide Communication: The agreed-upon approach and improvement ideas are shared with the wider organisation through open invitations and inclusive, large-group discussions. We encourage participation and seek consensus on areas for improvement, capturing and prioritising multiple ideas through group consensus and voting. These ideas are then categorised into short, medium, and longer-term objectives.
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Communication Strategy: We assist the organisation in effectively communicating the process and approach using various communication channels to ensure transparency and buy-in across the board.
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On Site Observations: On site observations of clinical pathways in real time to understand the gap between work as imagined and work as delivered.
DO
Action Phase (Initial Implementation)
We support local managers & clinicians to develop their own plan & do not impose a series of recommendations on the organisation.
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Supporting Local Leaders: We provide support to leaders in developing a local structure and process for improvement that aligns with the organisation’s needs. Weekly check-ins are conducted initially to maintain momentum and energy.
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Initial Implementation: Implement the initial plan in a controlled environment to test its effectiveness. We support data collection to understand the impact of the change and document any problems or unexpected observations that arise. Quick-win actions are agreed upon within four weeks to demonstrate tangible results and foster belief in the improvement process.
STUDY
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Data Collection and Accessibility: Confirm the data collection process and ensure all improvement measures are accessible to everyone involved.
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Data Analysis: Analyse the data collected during the "Do" phase to determine if the initial plan worked as intended. Compare the results against expected outcomes to identify any differences. This step involves a thorough review of the data and results to understand the effects of the interventions and to learn from any deviations from the expected results.
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Review of Progress: Conduct a qualitative and quantitative review of progress using a ‘big room’ approach.
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Sustainability Assessment: Facilitate the completion of a sustainability questionnaire to underscore the importance of maintaining improvement momentum.
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On site observation to assess the reality.
ACT
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Informed Decision-Making: Leveraging insights from the "Study" phase, we facilitate, coach, and encourage teams to make timely and effective decisions regarding the adoption, adaptation, or abandonment of plans. Successful plans can be standardized and scaled up, while unsuccessful ones can be modified and re-evaluated in a new cycle.
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Support for Implementation: We assist in the implementation of agreed-upon actions to ensure smooth execution.
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Coaching: We offer supportive coaching, particularly for leaders, focusing on creating and sustaining the right culture and developing psychological safety, which is linked to improved performance (see our blog)
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Ongoing Support and Accountability: We help leadership teams set timelines for progress check-ins to ensure continuous support and accountability.
The process is iterative, meaning it is repeated multiple times to ensure continuous improvement. We provide support to a point agreeable to the organisation’s leadership team, then hand over with a sustainability assessment and an ongoing improvement plan, with the option for progress reviews if required or requested.
