QA: Header - People First

Moorgate Team - MDT Improvements 

Creating an Improvement Culture

The People First Programme

Led by our Executive team and supported by the Trust’s Quality Academy is making substantial headway in implementing a new quality management system practice ( based on National NHS  Vital Signs and ‘lean’ practice) within the Trust which is changing the way that the organisation communicates a ‘Golden Thread’ and supports frontline teams with improvement. The programme also provides support to deliver improvement events and interventions to improve operational performance.

The programme is building systematically a new set of management practices based on; visual metrics; using data over time; enabling Plan-Do-Study-Act experimentation and learning; leader standard work routines combined with team-based improvement huddles. Also, bespoke events to help make rapid improvement and step change.

The support of the Board and executive practice has been significant and important to create the space and provide leadership in the programme. The derivation of the programme in 2018 was also done jointly with Livewell SW as a partner.

Although there are areas still to cover, the programme so far has enabled greater clarity on ‘Golden Thread’ through clear Executive practice, it has established practice in 2/4 Care Groups enabling clarity on focus, improvement methodology and harnessing frontline teams. It had to adapt in Covid and created much more virtual practice than physical huddles and even virtual events- all of which have contributed to teams feeling more involved, in control and impacted on better care.

The Exec team have been successful in building both improvement capacity and capability through Huddle training; use of Big Walls to tackle bigger topics; Kata, Practice Coach and Specialist Practice Coach training. This has enabled better alignment of effort, clearer impact and a fundamental better feeling in teams in support of our improvement culture ambitions.

Nick Thomas leading Exec Wall Ann James and Richard Crompton visiting CT

Building our Quality Management System Practice - The Golden Thread

The Programme has been systematically creating a new quality management system practice for the Trust that is being spread across the organisation to create a Golden Thread from strategic aspirations on the Executive Wall to delivery on the ground through front line teams - and share learning back.

strategy to deliveryGolden Thread

Key elements include strategy deployment through a cascade of visual practice across the organisation. Goals set out on the Executive Wall or Gold Command are shaping and informing our priorities at Care Group and Service Line improvement huddles. We are creating new management routines (leader standard work) which are starting to make impact on culture too. Production Control at the Service Line level supports teams to plan ahead to meet delivery, quality, and staffing and safety challenges and generate learning and teamwork to reduce ‘fire-fighting’ each day.

Finally teams are supported in running regular huddles to discuss performance, improvements and team health feedback. The ‘Team Health’ aspect of our huddles is an original practice creating open conversations about ‘how we are’ as teams. Has been well received and already practiced by approx. 500 staff. We now also measure the impact through team Reflexivity ( Ref-Professor. Martin West). The Team Health aspect of our huddles has also now been shared with several other Vital signs and Shelford group trusts.

Example of improvement huddle board lay out MAU Admin Team Improvement Huddle  

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