Welcome
to the first of the series
of web-ex
Continuous Improvement
th
8
May
Start time 9 am
Whilst you wait please ensure you put your phone
on mute thank you
Todays discussion points
• Continuous Improvement – models and
approaches.
• Culture of Continuous Improvement and
Different dimensions of change.
We know having an improvement method
or model can make a difference but does
it matter which approach it is ?
Regardless of which approach all have
similar philosophy
• Management commitment and staff awareness
to adopting continuous improvement is essential
• Actions need to planned and prioritised
• Team working is a vital component
• Tools are needed
• Management tools and approach's are also
needed
• Patient/end user/customer focus is paramount
Don’t forget the distinction between an
approach and tools:
• Approach: the way of working which usually
involves a variety of different tools to be used
at different points in the approach . Usually
applied at organisational level or a whole
system.
• Tools: used stand alone or in combination for
making improvements.
Plan – do - Study - Act
What are we trying to accomplish?
How will we know that change is an improvement?
What change can we make that will result in improvement?
Deming 1986
PDSA Cycles
Traditional Approach to Activities
D
P

S
A
Time
Suggested
Approach
P
D
S A
Time saved
Which is typical of your experience?
PDSA Cycles
How can we achieve this?
SOMETHING
BIG!
AP
SD
The problem with PDSA?
•
So…PDSA, been around for 60 years
• Experience shows many are familiar with the concept
• Experience in academia, industry and progressive
healthcare organisations has shown – time and again –
that it works
• It’s simple to remember
So what’s the problem?
Culture of Continuous Improvement and
Different dimensions of change.
But Continuous Improvement is more than a specific
method or an approach, when efforts fail to deliver, it
rarely a method, approach or a tool that was the
problem. Rather, its is the culture or the human
dynamics.
Leading change
Why changes fails: think about your personal experiences
Of these what are the
main factors
• Other objectives
• Resources / time
• Not sure it was making a
difference
30%
• Leadership not supportive 35%
• Staff resistant to change 35%
70%
of improvement
programmes fail
People and culture
There are lots of reasons why people are
resistant to change:
• Having poor appreciation of the need.
• Having poor understanding of the proposed
solutions or consider to be inappropriate.
• Disagree on the implementation.
• Lack of trust in person or organisation – failed
previously.
Thinking about context – ensuring you give
yourself the best chance of this improvement
work being a success:
Intervention + Context = Outcome
Deming (Improvement / Quality Guru)
Strong Intervention + Poor Context = Poor Outcome (limited improvement)
Weak Intervention + Good Context = Poor Outcome (limited improvement)
Strong Intervention + Good Context = Good Outcome (good improvements)
Definition of context: the environment the intervention happens in (in this case – your
organsation, internally, and the external environment your organsation operates in).
Context
Internal context
Can have a powerful effect on the output of innovations
and continuous improvement.
Think about and be aware of: culture, leadership, size
and scope of the activities, nature and ownership,
stability, standards of care and staff satisfaction,
professional training ad identity - these are just some
of the factors which can effect success and spread of
change and improvements.
Context
External Context
Lack of insight into external context often leads to
unrealistic expectations so the output of innovations
and continuous improvement is seen as limited.
Think about and be aware of: the extent of which the
activities are centrally driven, the regulatory
environment, the power of the workforce in which the
activities are taken place – the social and ideological
movements, the health rated movement (example
external campaigning by patient groups).
The implications for people/culture
Considerations and tools to support:
• The process of change
• Tools and frameworks to support people
– WIFM
– Helping people into their discomfort zone
– Building Trust and relationships
– Managing conflict
– Engaging others
– Understanding diffusion of innovations
End of Session
Next session: 18th May 9am
A learning organisation that
mobilises the full capability of
people by creating, capturing,
incorporating and sharing
experience.