Organisations beginning their improvement journey may struggle, even early on, with accurately knowing what improvement work is taking place. All too often they find duplication of effort and a multitude of approaches, which lead to duplication of work, unfinished projects, and successes that were never celebrated and spread.
Thankfully effective use of technology can address these challenges …
What the improvement journey means for your organisation
When it comes to embarking on an improvement/QI journey, it’s tempting to fixate on the QI part – the method, the projects that will be run, the data that will be captured - rather than the journey part. The idea that you could just start QI and instantly begin improving patient outcomes is appealing. But fundamentally, the journey requires transformation. This brings with it new processes, new information flows, new reporting requirements, new tools and techniques, to name just a few elements.
Whilst this ‘QI transformation’ looks different in every organisation, the successful QI organisations tend to share some fundamental characteristics:
- Collaborative: Every member of the organisation is meaningfully involved in achieving a shared vision. This means working together at different levels of the organisation and across teams to build trust, promote transparency, and engage employees
- Empowered: Requires shifting away from traditional business structures and hierarchies and empowering employees to make decisions and contribute ideas
- Mobile: Staff expect to be able to work and contribute to change from without having to be pinned to the same desk or meeting room, which means they need technology to connect them and the work
- Innovative: QI organisations are always experimenting and then learning from the outcomes to inform the spread and scale of results
- Continuous: This isn’t a journey with a fixed end date. Continually improving will require regular calls for adaptations to processes, new information flows and better-informed decisions
- Data-driven: This includes not only collecting and analysing measurement data within QI projects but also measuring the progress, effectiveness and ROI of your improvement capability
- Patient-centric: Ultimately, these organisations are all focused on providing better service and a better experience for their patients
Notice that none of these characteristics are about what your organisation does; they’re about how you do things. Organisations embracing QI don’t change the core values or services. Instead, it’s about developing an improvement focused culture and establishing the infrastructure to let that culture flourish.
Why embrace QI technology now
We hope you agree that adopting technology as you scale your improvement work is inevitable and necessary, but you may not think it’s urgent. Maybe new QI projects are on the rise, staff are engaging with QI, and now doesn’t seem like the time to embark on a resource-intensive project that will shake up your approach to managing QI.
There are a few reasons to embrace the digital future sooner rather than later:
- Engaged staff. Disengaged staff cost the U.S. economy up to $605 billion each year. Digital organisations empower staff through transparency, open communication and learning opportunities. By providing staff with data (something 90% of employees want, according to a recent survey in the MIT Sloan Management Review), organisations can track and improve their performance.
- Increased productivity. Organisations can expect to increase productivity by 23% as a result of adopting digital strategies like using data to make smart decisions and training staff in emerging technologies.
- Greater resilience. New technologies will continue to shake up patient expectations and processes. A digital organisation builds resilience by replacing rigid structures and inflexible processes with a workplace culture and infrastructure that can respond and adapt to new demands.
- Avoiding the competency trap. Many organisations assume that their current success (and the methods that enable it) will continue indefinitely. Then they end up scrambling to adapt when it stops working. You’ll have to change eventually and waiting until you have to means you’ll be making decisions for short-term survival rather than long-term sustainability.
Enabling factors that contribute to a successful journey
The excellent paper by the Health Foundation on improvement journeys (Health Foundation, The Improvement Journey, Health Foundation, 2019) describes the enabling factors as:
- Leadership and governance,
- Infrastructure and resources,
- Skills and workforce,
- Culture and environment.
Of these I wish to focus on infrastructure …
The Health Foundation define infrastructure and resources as, “a management system and infrastructure capable of providing teams with the data, equipment, resources and permission needed to plan and deliver sustained improvement.”
Technology can play a massive role in encapsulating and running such a management system. So, establishing this infrastructure and resources early and then scaling them as the improvement work and culture grows is a robust way of ensuring sustainability. Leave the infrastructure until you are already at scale and you can end up with dis-engaged staff turning away from and not towards improvement activity.
Developing improvement infrastructure
"Investment in improvement skills needs to be accompanied by the development of measurement systems able to collect, analyse and feedback data on the effects of improvement activity, and the capability and capacity to make full use of these systems", (Health Foundation, The Improvement Journey, Health Foundation, 2019).
Measurement systems and analysis of improvement activity with limited use of technology (e.g. a few tracking spreadsheet) is possible at a very limited scale, but certainly doesn’t set you up for success as you progress down a journey to greater levels of activity. So again, embracing suitably specific technology early on will allow you to test and refine the measurement, analysis and feedback systems you need, and adapt and scale them as activity grows in volume and complexity.
Using technology to align and track improvement activity
As the improvement programme grows and matures, the task of aligning the different strands of improvement activity becomes ever more important and challenging. Effective use of digital technology allows real-time accurate oversight of all improvement activity. Without this the challenge of ensuring that initiatives are consistent with the organisation's strategy and mission, and that improvement teams are not pulling in different directions, becomes an incredibly time-consuming, largely manual activity for staff.
The upside of getting this right however and freeing up staff time through good use of technology, means staff can focus on identifying and unlocking operational barriers to improvement and ensuring that resources are allocated intelligently.
The improvement journey catalyst
In conclusion I would argue that technology is an essential building block of your improvement capability. It should be shaped into place as early as possible in your journey and continually refined to ensure it meets your evolving needs as your journey progresses.
Organisations that have done so, like Central and North West London NHS Foundation Trust have seen staff engagement rise rapidly, resulting in over 250 active projects in two years . Project teams have access to the tools they need, and leaders have real-time activity and impact data, allowing all work to be captured, celebrated and spread. Their journey is by no means over, but they travelled a long way in two years.
How are you using technology to accelerate your improvement journey?