Training People to Advocate QI Excellence - The SQS Fellowship

Organisational snapshot

'NHS Education for Scotland (NES) is an educational and training body, and a special health board within NHS Scotland - with responsibility for developing and delivering education and training for the healthcare workforce in Scotland. NES has a Scotland-wide role in undergraduate, postgraduate, and continuing professional development.

NES also cooperates and collaborates with regulatory bodies and other organisations that are concerned with the development of the health and care workforce, for example the General Medical Council, universities, and other professional bodies.'

NES Vision & Mission

NES have a clear vision and mission with quality education at the heart of the organisation. Their aim is to improve health and care through education. A significant proportion of their work focuses on the clinical workforce, with a large part of their funding used to pay for doctors and dentists in training and the training of those who train them. NES also support public service reform and current policy priorities such as improving quality, service re-design, leadership and management, mental health, dementia, reshaping care for the elderly, young adults, and children, with a particular emphasis on enabling sustainable quality through the 2020 vision. 

The Training Programme

One of the courses developed by NES, Healthcare Improvement Scotland, and NHS Scotland Boards is The Scottish Quality & Safety Fellowship (SQSF) programme which is a leadership level quality improvement course. The Fellowship is aimed at clinicians to strengthen their leadership skills, understanding of drivers of patient safety and ability to apply improvement methodology. Previous Fellows have used these skills in their own organisations to transform care with some taking on influential national roles. 

The programme is run over a 10-month period which includes residential workshops, project surgeries, virtual meetings, mentoring, a group field-trip to the IHI/BMJ International Quality & Safety Forum, a national networking event and funding for individual study trips to facilitate learning from global experts both inside and outside of healthcare. 

The Fellowship is built and delivered using principles of both adult-learning and action learning, and is delivered using a blended learning style. All Fellows are expected to undertake an improvement project throughout their participation on the programme, and are expected to work on this as part of their day job. Fellows are expected to network with colleagues undertaking similar activities in the UK and abroad. 

The programme consists of a combination of:

• Self-directed distance learning supported by webinars and an online learning platform
• Mentoring delivered by previous Fellows, or others working in patient safety or QI roles
• Formal education delivered through a series of 3-day residential courses
• Workshops, networking events and project surgeries
• Fellows present reports of their learning and achievements to their sponsoring organisations
• A selection of reports of Fellows work are submitted for presentation at national and international conferences and peer-reviewed publications.

Nearly 300 Fellows have taken part in this tailored programme so far, enhancing their individual capacity for leadership in improvement and strengthening clinical leadership Scotland, as well as globally. Below outlines the current reach of the Scottish Quality & Safety Fellowship programme, going into cohort 12:

The positive impact of the programme

People that have undertaken the SQSF programme, have not only successfully completed an improvement project and seen the outcome, some have submitted their projects for international recognition and a good percentage of people have gone on to progress their career based on the knowledge they now have. The career progression results from completing the SQS Fellowship is shown below:

Career progression results from completing the SQS Fellowship - SQSF 10th Anniversary Networking Event Exec Summary

The Challenge

NES are now into their 12th year of running the SQSF programme, which has doubled in size over the past few years.

As the programme grew facilitating peer-to-peer sharing between Fellows and streamlined administration became more of a challenge. So, in 2017 NES sought a platform with a strong QI focus to complement their learning management system. They wanted something that offered peer-to-peer sharing, a mechanism for Fellows and Faculty to record progress and report as well as a system that had integrated QI tools allowing all the Fellows' QI projects to be run and shared in one single place. This system also had to assist distance learning, encourage collaboration and have a clear improvement project structure, that wasn't disjointed to ensure both the fellows were learning quality improvement methodology in a consistent way. 

The Solution: Adopting Life QI

NES were introduced to Life QI as a robust solution that made it easier for the faculty to monitor progress of Fellows projects. It provided a consistent way for Fellows to run projects, easily share them with the others and made it simple for Fellows to regularly report on project progress.

The change was significant, overnight they went from a number of different systems, to Life QI, a system that offered the ability to house all of the fellowship projects, a structured way to record, report and analyse course work, all in one place. 

Running SQSF in Life QI

NES used a range of Life QI functionality to facilitate the Fellowship programme. Let's take a look at the key aspects that have made a big difference: 

• Ability to run a real QI project in Life QI. Allow participants to experiment with QI tools in Life QI, provides experience of chartering a project and allows them to use the embedded QI tools to solve a real improvement issue.
• Bring everyone together in a cohort group. All the fellows and their projects are linked to a SQSF cohort group, allowing for easy peer-to-peer sharing and discussions.
• Share ideas, feedback and files in discussions. Through the use of discussion threads the Fellows and the Faculty can collaborate and share useful information, all in one place.
• Making it easier for the Faculty to track project progress. The Faculty have access to an Analytics Dashboard which gives real-time progress and content information from every project. 
• Coaching Fellows through discussions. The Faculty, Fellows and Fellows' mentors use discussion threads on individual projects to coach and debate issues within the project, allowing them all to come together around the same information.
• Routine reporting. The Fellowship has a well-established report structure which has now been embedded in Life QI, allowing Fellows to routinely run the report and add their learning reflections, direct from Life QI.

Benefits of Life QI 

So, what difference has Life QI made to the delivery of the SQS Fellowship?

• Ease of peer-to-peer sharing - all project information is shared across all Fellows, allowing the peer-to-peer support and discussions.
• Streamline reporting for Fellows - project information is collated into reports with a few quick clicks, leaving Fellows to concentrate on learning reflections, not report writing.
• Real-time access to all information for Faculty - monitor real-time progress metrics and deep dive into the projects that need extra support.

The best thing about Life QI is ...

“Life QI has improved the governance and administration of the Fellowship for the Faculty, and opened up the opportunities for peer-to-peer sharing amongst the Fellows”.

Shobhan Thakore, SQSF Clinical Lead