In this article we’re going to be looking at the importance of quality improvement (QI) meetings and how they can be a vital tool in supporting your improvement efforts. It’s worth bearing in mind that – for the best results - a successful QI project team meeting might take a bit of time to prepare, so we’ll be drilling down into detail and looking at hints and tips on how to run great improvement meetings.
Meetings as a tool for fostering an improvement culture
QI project team meetings can really help support and transform your improvement culture. It is therefore worth bearing in mind that: ‘The structure, aliveness, deadness, whisper or shout of a meeting teaches and persuades us more about the culture of our workplace than all the speeches about core values and the new culture we are striving for ... What we call meetings are critical cultural passages that create an opportunity for engagement or disengagement.’ 
When you are planning your QI project team meetings, it is worth considering the structure and length to ensure it is really beneficial for all involved. In his blog, 'QI Essentials: Thinking of holding a meeting for QI? Read this first’, Amar Shah, Chief Quality Officer at the East London NHS Foundation Trust Hospital (ELFT) talks about meetings – and the amount of time he’s spent in them over the years!
He goes on to say: ‘With quality improvement, our task is to bring together a diverse group of people representing different aspects of the system we want to influence, in order to generate and test out new ideas aimed at achieving a shared purpose. Is the best way to do this through a series of meetings? Perhaps, but maybe not in the way we traditionally run meetings…’ This is thought provoking and advocates a different way of thinking about running QI meetings.
The U.S. AHRQ (Agency for Healthcare Research and Quality) Primary Care Practice Facilitation Curriculum Module advocates thinking carefully who you invite to your QI project team meeting. It states: ‘A meeting leader can set the stage for teamwork beginning with the invitation list—such as, by engaging diverse members of the practice, including office staff, medical assistants, clinicians, and practice staff in discussions about the practice—and by introducing the habit of repeatedly.’
How to plan a QI project team meeting
Planning is key when you are preparing for your QI project team meeting. One of the first things to do before the meeting is to establish the purpose and objectives of the meeting.
As we’ve learned from Amar Shah’s QI blog, keeping your meeting short can be a very good move! In QI, the ‘huddle’ – a short meeting of around 15 minutes – is a popular and efficient way to review progress and keep up to speed with what’s going on in your QI project. It’s amazing what you can do in such a short time if you keep to a strict structure and focus.
Amar describes that QI work ‘needs to generate energy and excitement. A well-designed, short huddle that helps us build a rhythm around frequent tests of change is more likely to help us learn faster, solve our quality issue quicker and generate more energy within the team around the work.’
Amar Shah goes on to say: ‘Once you’ve got going with a [QI] project, the only real reason for coming together as a team is to ask three simple questions:
- What is the data telling us?
- What did we learn from our last test of change (the study part of the PDSA cycle)?
- How should we plan our next test? What’s our theory and prediction, how might we design a test to see if this holds true? And what data would we need in order to evaluate this?’
This is worth bearing in mind when planning your meeting – and a helpful structure to adhere to.
The rules and steps of running an effective QI project team meeting: tips for best practice
If you want to plan for an effective project meeting, there are certain steps you should follow. In his blog, Amar Shah says: ‘A meeting is a process, and so needs careful design’. He also encourages you to ask the question: ‘What could we do instead to create energy, involve people more deeply, tell stories to connect back to the shared purpose…?’
So, preparation is key for your meeting and you need to ‘design’ it to make the best use of time. You also need to ensure that the right people are there, while enabling and encouraging people to talk and contribute.
Before the meeting, you should set out and share objectives and also put in place a meeting facilitator. Someone who will help guide the meeting and ensure that it provides the best use of time for all attendees.
It’s really important that you have someone who will facilitate the meeting. That could be you, or you could ask someone else to do this. He will ensure that your project team meeting runs to time and makes the most efficient use of your time. If you choose someone else as a meeting facilitator, it's worth talking to them before the meeting to agree arrangements.
It’s also a good idea to assign roles to people before the meeting – can you ask someone to record actions? (preferably to share them before the meeting ends) Can someone make sure you are following the timeline? Amar Shah suggests to record actions while you are in the meeting. Then, you should capture them in a photo to share before leaving the meeting room.
If you are in the position to hold face-to-face meetings, rather than virtual meeting, it’s worth putting some time aside to ensure that the meeting space works for you and the team. Is there a flipchart / whiteboard you can use? Do you need any other equipment?
We’ve talked about shorter meetings on a weekly basis being a suitable way to cover off PDSAs. However, Amar Shah recommends in the early stages of a project, a one-off longer meeting to design your project.
If you want to look in more detail at different types of QI project team meeting, you might want to look at our article: ‘How to plan your PDSA cycle as a team,’ which drills down into planning for your PDSA meetings.
Make sure you and your team dedicate time for project work and reviews
When you start out on your QI journey, it’s really important to prepare your team and organise meetings in advance. In this way people get prepared to dedicate a certain amount of time and energy going forward. Although you want your team to spend time and focus on QI work, you don’t want them to feel overwhelmed. Therefore it’s better to start out managing expectations about this and ensuring that time is allocated in advance.
The NHS Improvement guide ‘Building capacity and capability for improvement: embedding quality improvement skills in NHS providers,’ recommends the Institute for Healthcare Improvement’s (IHI) ‘dosing’ method which identifies the type and ‘dose’ (level) of improvement skills which are required. This approach can also help support mapping out time and planning for QI capacity and workload. It has also worked well for the East London NHS Foundation Trust who have implemented a successful ‘dosing’ approach. This might also work for your teams and help them map out timings.
You could also think about using software solutions such as Life QI which can be really helpful in supporting the management of QI projects, as well as managing planning, as you keep all your QI projects in one place, which makes it easy to manage and monitor them.
How to empower participants to actively participate in the discussion
You may think it will be tricky to engage attendees in your QI project team meeting. But if you have planned your meeting carefully, this will not be the case. You want to create an atmosphere where everyone feels free to actively participate in discussion – and with a few subtle changes and tweaks, you can make people feel comfortable, engaged and willing to participate.
It is really important to make sure that every team member at your meeting feels they can contribute - and you can do this by asking for contributions directly to individuals. In the blog ‘16 secrets of engaging remote meetings’ Rick Lepsinger, President of OnPoint Consulting says: ‘Clarify expectation that participation is expected and call on people who you haven’t heard from. Mention them by name and repeat the questions – you don’t want to “catch” them, you want to engage them’. You absolutely want to empower your participants to participate in the discussion, not put them on the spot! There’s a subtle and important difference!
Fun ‘icebreakers’ can work for engagement, if they are designed well – as they can make people feel more relaxed. If you don’t already all know each other it might also be a good idea to have quick introductions at the beginning of the meeting.
You should design your QI meetings to empower and energise everyone in the meeting.
When you are running your meeting, you need to be watching your team – are they engaged? Do they feel able to join the discussion? Or are they holding back? If you feel someone is holding back, you can ask set questions to engage them.
If you plan and prepare for your QI project team meetings, with good objectives and communications, you will have no trouble running an engaging meeting. To finish with Amar Shah’s words: ‘We have an opportunity in the way that we go about quality improvement to model a better way of working that involves people more deeply, connects people to shared purpose and makes more efficient use of our most scarce resource: our time.’
 Terms of Engagement: New Ways of Leading and Changing Organizations Richard Axelrod, 2010