How coronavirus will change the way we do QI

The last six months has brought with it unprecedented levels of disruption, change, collaboration and learning. Whilst many aspects of healthcare will return to their previous norms it seems many aspects won’t, and in fact have been catapulted forward, evolving incredibly quickly. Our conversations with the improvement community over the last couple of months have revealed several themes that look set to change how healthcare improvement is done from this point forwards.

We believe the coronavirus pandemic will change the way we do improvement in the following ways:

Accelerate digital transformation of QI

With the initial requirement for remote work and now a realisation there are long term benefits of this way of working, QI just like many forms of work is having to adapt quickly to rely more heavily on technology.

As I have written before, staff increasingly expect to be able to work remotely and without a fixed/single location. This requires technology to connect people and allow work to be shared and facilitated. Recent events have significantly accelerated the digital transformation of many organisations. The startling rise in daily Zoom meeting participants from 10M a day in December 2019 to over 300M in April 2020 is but one example of this rapid adoption.

We now see effective use of technology as an essential part of an organisation’s improvement infrastructure. Read more about how technology can accelerate your improvement journey.

More remote teamwork

The rise in remote working and fewer staff being on-site simultaneously will require far more remote teamworking by project teams than ever before. The weekly team meeting or brainstorming session is less likely to be in the office now. We still expect to see plenty of synchronous teamwork and communication, facilitated through video calls with screen sharing calls, but also a rise in asynchronous teamwork and communication using messaging tools.

We are all used to communicating over email, but more remote working will require even more remote teamworking so will require improvements in our asynchronous communication in order to maintain effective teamwork.

More remote coaching and training

A lot of the improvement coaches and advisors we support are used to meeting with project teams face-to-face. They hold either dedicated coaching sessions with a team or often run drop-in-clinics for teams to get time with their coach. These sessions often involve papers spread on the table or people huddled around a laptop screen reviewing data. With the increase in remote working these sessions will need to shift to be carried out virtually using phone and video conferencing.

For small coaching sessions this switch to virtual rather than face-to-face can be achieved quickly and doesn’t necessitate a significant change in style. But when it comes to running large training sessions, this change presents significant challenges. We have spoken to countless improvement teams in the last few months who are grappling with how they transition their training and education offerings to be virtual, and in some cases a hybrid of virtual and face-to-face. This almost certainly requires a change in style and content.

To support teams with the shift to virtual QI training, we have provided our guidance on how to run your virtual QI training with Life QI.

More daily improvement

Daily Improvement refers to the smaller scale improvements that can be applied rapidly on a daily basis. They can be as simple as an individual’s effort to improve their own working conditions or mental wellbeing. In other cases, they may involve applying more typical QI techniques and tools by a small team on a small scale, such as a single ward or unit. Often, these types of improvement can be overlooked by focussing too much on the structured project, yet their aggregated impact can be huge. During the peak of the pandemic, many hospitals witnessed the dramatic rise in daily improvements and changes.

When presented with major challenges to the way we work, such as the COVID-19 pandemic, it has been demonstrated that people and organisations can react and adapt quickly. Much of this improvement can be attributed to the daily improvement process and the ability of frontline staff to implement rapid change. We foresee this type of improvement becoming far more commonplace as a result of the recent rapid changes implemented by countless staff. That is not to say that daily improvement will replace the larger top-down improvement initiatives, but rather we see it complementing the more planned corporate-led improvements.

More improvement, done faster

The pandemic has shown us how quickly we can work, how quickly we can adapt, and engaged staff in improvement work in a new way. With this increased engagement for QI and trend towards daily improvement, we expect to see a rise in improvement activity taking place across hospitals. Often with less red tape and more pace.

The challenge we’ll face

In the early stages of an improvement journey staff engagement is often the biggest challenge. Many organisations are already passed that, and this recent pandemic may help accelerate others through it faster than expected.

The next challenge will be more about how to harness that engagement and guide it so make the absolute most of it. Make the most of every good idea, make the most of every moment for improvement.

Could this catastrophic pandemic be a catalyst for accelerating healthcare improvement?

Almost certainly.