Community Space: exploring fresh approaches to recovery

To open the session, everyone was invited into a collective silent pause to centre ourselves on a theme emerging in our current work. Members then shared reflections ranging from the difficulty of their ongoing workload and managing the pressures of COVID-19, to the crucial need for an open and psychologically safe space at work.

Picking up on the theme of ​‘psychological safety’, Hilda Campbell introduced a set of practical guiding principles for building this kind of environment:

Sharing impressions on ​‘toxic positivity’, Hilda made an observation that positivity, if used as camouflage for how we are really feeling, can discourage us from acknowledging that we are in difficulty and need help. This phrase triggered a discussion about how important it is to create an empowering and emotionally authentic environment for improvement to take place.

During the session, we heard from two members who carried out Q Exchange projects during the pandemic that have now reached implementation stage.

In October 2019 a multi-disciplinary team co-ordinated by Northern Ireland’s Health and Social Care Trust started a project to apply gaming principles and concepts to human factor learning in health and social care. 

The aim of the project was to offer the training to the maximum number of staff possible and increase learners’ motivation by making it fun. A gaming app, Human Factors in Healthcare that staff could download on their phones seemed an ideal way to achieve both these goals.

Having a Trust-led team in place meant that the project team was able to quickly pull together their gaming strategy, missions and characters. They faced many challenges along the way, including a key member having to leave the project team following the onset of COVID-19. Members heard practical insights about the key elements involved in developing a digital learning tool. 

These included the importance of having multi-disciplinary input into the content and design of the learning journey; formal ownership over intellectual property; a tight, clear specification for the app before procuring a supplier; and contingency budget for quality testing the product to ensure that it is accepted into the marketplace.

Members reflected on their need to have the space to talk about quality improvement, to share, collaborate, connect and support each other.

Improvers Without Borders is a collaborative approach to facilitating ​‘wicked’ system wide problems from diagnosis through to improvement, while building QI capacity and capability through ​‘learning by doing’. A partnership project co-ordinated by Gloucestershire Hospitals NHS Foundation Trust, the project team chose palliative and end of life care strategy development as their ​‘wicked problem’ just as the pandemic hit. 

They used funding from Q Exchange to hire a project manager to pull together around 130 staff from the Gloucestershire Integrated Care System. The team studied performance and system data to develop an overview of this area of care. Through a series of three online workshops, they used value mapping to identify shared areas of concern and co-design a new strategy for end of life care.

Because of the impact of COVID on the workspace, the project was forced to move its workshops online. While there were challenges with moving to a virtual working system, the online workshops allowed for more individuals to attend. 

The team chose not to use the term ​‘quality improvement’ to describe the work, and people involved in the project were able to use their skills and knowledge without needing to take formal QI training or join a QI collaborative. This meant that, while everyone on the project was doing QI, some may not have recognised it as such.

The project team is now writing up the approach and outcomes of their work to share with the wider Q community.

During the session, we heard a strong desire in the community to keep connecting with people in improvement. Members are being expected to lead teams through the new improvement world post-COVID and, because of this, having a space to connect and learn from the experiences of others was recognised as valuable, motivating and helpful in thinking creatively. 

Members reflected on their need to have the space to talk about quality improvement, to share, collaborate, connect and support each other. To be less alone in navigating complex systems. 

As one member put it: ​‘Space and time together nurtures us. We’re all facing similar challenges – we can share, and know we’re going in the right direction.’