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Quality Improvement – Crossing Borders

13 March 2019

A Crossing Borders Quality Improvement workshop was held on 6-7 November 2018. It was funded by Co-operation & Working Together (CAWT) and developed and facilitated by the Mandy Gormley and Dr Catherine McDonnell, Western Health & Social Care Trust (WHSCT) and Lisa Toland, Health Service Executive (HSE). The workshop took place in the context of a growing collaboration between the Northern Ireland Safety Forum and HSE to strengthen a partnership across the island to support Quality Improvement (QI) work.

The focus for the collaboration was sharing experience of combining coaching and quality improvement methodology to develop frontline leadership in QI.

Steve Harrison, Head of Quality Improvement, Sheffield Teaching Hospitals NHS Foundation Trust, was invited as a guest speaker and workshop facilitator. He has led development of the Dartmouth Institute Microsystem Coaching model within the United Kingdom. He has also had a key role in the setting up of the Flow Coaching Academy (FCA). The Flow Coaching model builds on the Microsystem model but frames quality improvement work around condition-based pathways rather than on individual clinical teams or processes. It looks at the totality of the patient journey. The WHSCT is currently developing the Northern Ireland Flow Coaching Academy to provide training in this approach.

A total of 45 participants attended representing a range of staff groups from both regions. The workshop was opened by Dr Anne Kilgallen, Chief Executive, WHSCT and Dr Philip Crowley, National Director, Quality Improvement Division, HSE, who courageously shared a piece of their personal selves with the group through an informal Question and Answer session. This was followed by formal presentations of QI journeys so far from both sides of the border. The next session was the use of group work and discussion to elicit what might ensure that quality improvement work failed! This twist allowed some new and creative thinking to emerge.

The afternoon session was led by Dr Marie Ward, Quality and Patient Safety Project Manager, Childrens Hospital Group. She presented a model for sustainability of improvement work which considered the task through five different lenses, task, individual, team, organisation and system. The group worked on translating this model into possible actions across all the areas in which they worked.   The next exercise was a Dragons Den challenge where teams were challenged to “sell” QI.   Great creativity and innovation was applied to empty the pockets of the Dragons.






The second day opened with facilitators summarising material gathered from the first day and feeding back to the group. Steve Harrison shared the Sheffield Teaching Hospitals Trust’s QI journey to date. He then built on the previous day’s activities and the group continued to work on determining what helps to embed QI into teams and organisations. The diversity of the group provided rich discussion and a range of ideas. He finished by using a fishbowl conversation technique to demonstrate the value of this model in supporting productive conversations around the challenges of Quality Improvement work.

The workshop concluded with discussion about the future. Feedback was extremely positive about the value of sharing and learning together. It was agreed that a further event would be welcomed, that a report should be produced to share the learning and that relationships that had been formed should continue.

Work continues to develop opportunities for cross border sharing and learning. Dr Mark Roberts, Clinical Director, HSC Safety Forum and Dr Philip Crowley, National Director, Quality Improvement Division, HSE, will be sharing the stage to deliver a joint presentation at the International Forum on Quality and Safety in Healthcare in Glasgow in March 2019.