Continuous Service Improvement

Developing Quality
Improvement Skills
Improving Quality Together

Building capacity across Cardiff & Vale University

Health Board to improve the quality of services that we
deliver.
This document describes the training and support
available in the UHB.

Improving Quality

Continuous Service
Improvement
Monmouth House
UHW

Phone: 029 20758581

E-mail:
nick.tyson@wales.nhs.uk
Continuous Service
Improvement
 Delivering Quality Improvement Skills

―You have two jobs: your job and the job of improving your job‖ (Don Berwick, 2013)

Providing all staff with an appropriate level of improvement skills is vital to help them to
successfully engage in their second job. The
national Improving Quality Together (IQT)
programme aims to provide 25% of the Welsh
NHS workforce with skills in this area by 2014.
This document sets out how we, in Cardiff & Vale
University Health Board, aim to support the
development of these skills across the
organisation..

The Improvement Skills development programme

is delivered through a number of vehicles, ranging from e-learning to bespoke skills training for
individuals and teams. The following pages set out the courses that are delivered in-house, by
the Continuous Service Improvement team, and the support provided to other programmes to
ensure continuity of the quality improvement skills approach.

The IQT programme provides improvement skills to all staff irrespective of job role or grade with
a focus of delivering improved outcomes for patients and citizens, and as such the ambition fits
neatly with the UHB‘s Organising for Excellence Strategy.

Improvement Skills Development programmes available

Improving Quality Together—Bronze 2

Developing Quality Improvement Skills—Bronze 2

Developing Quality Improvement Skills—Silver Foundation 2

Developing Quality Improvement Skills—Silver Practitioner 3

Developing Quality Improvement Skills—Champion 4

Managing Change Successfully 5

Building towards Gold

Other development programmes with a QI component 6

 What skills are we looking to develop?

Managing •Managing change skills are about understanding both the extrinsic and
intrinsic approaches to change. It is about developing an understanding of
Change how you approach change and how it affects others and yourself

Leadership •Leadership links closely to managing change but is more about improving
your own leadership

Communication •There is a link here to leadership and managing change, but the focus here is
on how you would communicate change to facilitate engagement.

•This area is concerned with providing skills around the rigour needed to
Implementation successfully implement new ways of working and include s project
management, documentation, training etc.

•Problem solving skills are focused on improving peoples skills in properly

Problem Solving solving adaptive problems in the work place as opposed to technical problems
that often have a known solution. It includes problem solving techniques and
tools.

•Process analysis skills are about being able to understand and change
Process Analysis processes, it includes a range of approaches such as process mapping and
process observation

•This area is concerned with the use of data, its collection analysis and

Data Analysis presentation. It includes giving people I.T. skills in the use of spreadsheets
and other specialist software. It aligns closely to measurement for
Improvement.

•Human Factors raises individual skills in understanding that human factors

Human Factors have a large part in how reliable our systems are. It looks at factors that affect
human behaviour and the subsequent impact that may have, as well as
introducing approaches to mitigating the risks.

Capacity, •Understanding the purpose, demand and capacity of the service you provide
is key to effectively and efficiently managing it . This area develops the skills
Demand & Flow needed to understand these and how to make the work flow.

•Patient safety raises awareness and provides approaches to improving patient

Patient Safety safety. Individuals would be better aware of the impact of harm and some
tools to reduce variation.

Measurement for •Measurement for Improvement is about giving individuals the skills to better
think about what they need to measure to better understand their service and

Improvement
provide focus on where improvements are required. It also touches on the
impact measures have on behaviour and action.
 Improving Quality Together

Bronze

Quality Improvement Bronze—e-learning

The Bronze level will help you to take a new look at the work you do and find ways to make it
even better. It is suitable for staff across every discipline, including non-clinical functions, and at
every level.

So whatever you do in the UHB, and however much responsibility you have, you will gain
knowledge of quality improvement through the Bronze level e-learning modules.

Quality Improvement Bronze level includes four e-learning modules (each about 30 minutes in
duration) which cover;

1. Introduction to the Model for Improvement;

2. A focus on a person-centred approach;

Each module concludes with a multiple choice assessment

The Bronze level IQT eLearning is hosted on Learning@NHSWales. Please follow these steps to
undertake the Bronze level learning.

Using your internet browser go to http://www.mle.wales.nhs.uk/

1. Log into the site if you are already registered, otherwise register with the site by clicking on
―Create new account‖ towards the top right of the screen. Once you receive your site password, log
into the site.

2. Scroll down the page, under ―Course Categories‖ you will see an option ―Quality Improvement‖.
Click here.

3. You should now see an option for the ―Improving Quality Together – Bronze Level‖ course. Click
here.

Using the CVIQT enrolment key for join the course. Instructions on how to progress through the
course are given on the course homepage.
 Developing Quality Improvement Skills

Bronze—Taught Sessions

Quality Improvement Bronze

This is a half day taught course with a paper based multi-choice assessment at the end that
covers all the principles in the IQT bronze e-learning. It is an interactive session in which you
get to take part in improving a process and get plenty of opportunity to discuss your
experiences of being involved in improvement work. It is delivered as part of the Skills2Manage,
Transforming Care and the RCN Clinical Leadership Programme. There is scope to deliver this
on a demand led basis e.g. when you are about to embark on an improvement journey.

Developing Quality Im provem ent Skills

Silver Foundation

Quality Improvement Silver Foundation

The Silver Foundation level will help you apply quality improvement principles to make your
workplace function more smoothly.

Silver Foundation level includes:

A two day taught course offering a complete package of training.

Understanding and applying the Model for Improvement

The 2 days provide a more in depth overview of quality improvement and how you might
apply it.

Participants will be required to complete a short reflection on their learning and its
application after completion of the training.

This program is aimed at being delivered to teams on demand led basis, e.g. a department is
looking to develop its team in quality improvement skills, a programme delivered to them by CSI
supported by a Silver Practitioner from that team.

Also there could be up to 80 delegates per year participate in scheduled programmes (4 cohorts
of 20 delegates), this will be demand led. In addition, staff participating in the Leading
Improvement in Patient Safety (LIPS) programme will achieve the Silver Foundation Level.
 Developing Quality Improvement Skills

Silver Practitioner

Quality Improvement Silver Practitioner

This is a more advanced continuous improvement programme, an intensive 6 day course which
goes into more detail on continuous improvement approaches, tools and techniques. As part of
the course the Practitioner programme equips participants with the skills to deliver an
improvement project in their workplace. The project must be agreed and championed by an
Executive or Senior Manager who will need to state how they will intend to use the delegates
new skills after completion of the programme. In this way both the individual, the service and
ultimately patients and citizens benefit.

You will be able to:

Apply skills that will help you to complete an improvement project in the workplace .

Be able to apply the DMAIC approach to problem solving.

Understand and be able to apply the Model for Improvement.

Learn to recognise the processes you work within and how you can improve them – thereby
collectively improving the services provided by the public sector in Wales.

Increase your confidence in using continuous improvement tools & techniques.

Demonstrate ability to make service improvements.

Demonstrate improvement to the wider organisation.

Target Audience:

Individuals who are being asked to lead the delivery of sustainable improvement or those
who are interested and motivated by delivering improvement.

Duration:

5 ½ days – 3 workshops over 17 weeks ( ½ day introduction workshop, 3 day workshop, 2

day workshop).

The aim is that up to 80 delegates participate per year (4 cohorts of 20 delegates)

If you want to apply to undertake this course please complete the application form at the back of
this prospectus.
 Developing Quality Improvement Skills

Improvement Champion

Quality Improvement Champion

This 1 day interactive workshop is designed to give senior influencers/decision makers an
overview of continuous improvement approaches, tools and techniques. There is a focus on
how the expectations, roles and responsibilities of senior decision makers influence the success
of continuous improvement work. The delivery of successful improvement work is dependant on
the ownership, support and challenge of the senior leaders. Quality improvement efforts can fail
because they are seen as additional to the ‗day job‘ and the issues being looked at are not seen
as important or owned by those senior individuals. Participants will:

Undertake a continuous improvement self assessment

See quality improvement tools in action

Have a whistle-stop tour of IQT training

Have an opportunity to discuss and plan how they take quality improvement forward

Target Audience:

Senior influencers/decision makers within departments who are responsible for the delivery
of sustainable improvement and development. If you intend to send staff on quality
improvement training, this workshop is essential to the success of that training.

Developing Quality Im provem ent Skills

Managing Change Successfully

This 2.5 day programme provides practical insight into the skills and knowledge to manage
change successfully combined with an organisational development perspective to focus upon
people, structures, cultures and systems. The aim of the programme will be to build expertise in
managing change to support new models of service delivery and the transformation of service.
Managers and leaders will be inducted into the latest thinking and change management practice
to build a kit of high impact tools and technologies supporting the drive for greater efficiency and
innovation. The programme will focus upon intrinsic and extrinsic ways to deliver change and
incorporate a new impact methodology to ensure that learning is translated into practical
outcomes. Participants will be required to complete a number of diagnostic assessments to build
personal awareness and develop a personal action plan for improvement.
 Developing Quality Improvement Skills

Building towards Gold

Building towards Gold

Gold improvement leaders are not necessarily defined by their role or what course they
have been on, rather it is more about those within an organisation that have significant skills
and enthusiasm for quality improvement.

To help facilitate the development of these individuals there is an opportunity to shadow a

member of the improvement team in delivery of training, mentoring/coaching delegates and
facilitating workshops around particular areas of work. During this shadowing arrangement
the delegate will get the opportunity to observe, practice and when ready lead on some
aspects of the work they are shadowing and to begin to take on a mentoring/coaching role
with their colleagues who are undertaking quality improvement training/work.

Target Audience:

Individuals working across the organisation who have a significant improvement agenda and
have undertaken the Silver Practitioner programme or equivalent. The delegate will show
enthusiasm for improvement work and will be self motivated to free up their time and play an
active role in their own personal development in this area of their skills

If you want to apply to undertake this programme please complete the application form at the
back of this prospectus.

Cardiff & Vale UHB

Other Programmes with QI

Other Development Programmes with a supported QI component

There are a number of programmes available within the organisation which cover a
wider area of development for delegates but have a QI component, and all delivered by
the Continuous Service Improvement team. These include the RCN Clinical Leadership
Programme, Skills2Manage, Senior Clinical Leaders Programme and Leading Quality
Improvement.
 FOUNDATION
Developing Quality Improvement Skills - Silver Foundation Course Application Form

Name
Email address

Contact Number

Dept/Dir/Clinical Board

Date of Course
I wish to undertake the Silver Foundation-
Course starting on

Below put your reasons to attend

If accepted I will commit to attend all training sessions and after the course take time to complete a reflection document that shares
my learning and what I am/will do differently in the future.

Signed

Date

Sponsors Name

Sponsors Email address

Sponsors Contact Number

Dept/Dir/Clinical Board
I fully endorse this application to undertake Silver Foundation Training and will commit to releasing them to attend all training ses-
sions and encourage and provide the resource for the delegate to complete the IQT Bronze eLearning prior to attendance.

The Bronze level IQT eLearning is hosted on Learning@NHSWales. Please follow these steps to undertake the
Bronze level learning.

Using your internet browser go to http://www.mle.wales.nhs.uk/

1. Log into the site if you are already registered, otherwise register with the site by clicking on ―Create new ac-
count‖ towards the top right of the screen. Once you receive your site password, log into the site.

2. Scroll down the page, under ―Course Categories‖ you will see an option ―Quality Improvement‖. Click here.

3. You should now see an option for the ―Improving Quality Together – Bronze Level‖ course. Click here.
Using the CVIQT enrolment key for join the course. Instructions on how to progress through the course are given on

Signed
 PRACTITIONER
Developing Quality Improvement Skills - Silver Practitioner Course Application Form

Name
Email address

Contact Number

Dept/Dir/Clinical Board

Date of Course
I wish to undertake the Silver Practitioner
Course starting on

Below put your reasons to attend

If accepted I will commit to attend all training sessions and the time that I need to properly apply my learning to an improvement
project that has to be delivered to successfully complete this programme. I have also read and understood the information overleaf.

Signed

Date

Sponsors Name

Sponsors Email address

Sponsors Contact Number

Dept/Dir/Clinical Board
I fully endorse this application to undertake Silver Practitioner Training and will commit to releasing them to attend all training ses-
sions and to give them time and resource needed to complete their improvement project. Also on completion of the programme I
intend to utilise the skills that have been demonstrated by the delegate on an ongoing basis to deliver further improvements for the
organisation. The following statement summarises my intentions

Signed
 Developing Quality Improvement Skills - Silver Practitioner Course Application Form
Programme information
Duration of the programme – 6 months

Programme Duration of Details

Workshop

Acceptance Joining instructions will be approximately 30 days prior to start of workshop. You will be
notified who your mentor is and you will need to arrange to meet them prior to the first work-
shop. They will explain the process and what is expected of you and what you can expect
from them throughout the programme.
Workshop 1 4 hours The first workshop introduces you to the process and helps to scope your project. Following
this workshop you will have approx 30 days to complete your project charter prior to the
next workshop. Your mentor is available for support.

Workshop 2 3 consecutive Workshop 2 covers the Define, Measure and Analyse part of the process. You will need to
days verbally present your project charter to the group. If you have access to a laptop it would be
beneficial to bring it on the second day. Following this workshop you will have approx 60
days to work on your project prior to the next workshop, your mentor is available for support.
Workshop 3 2 consecutive Workshop 3 cover the remainder of the DMAIC process Improve & Control. For the work-
days shop you will need to prepare a short presentation for feedback to the group on your pro-
gress and during this workshop you will undertake an open book assessment. Following this
workshop you will have approx 60 days to complete your project prior to the Presentation,
your mentor is available for support. You will also need to complete a short reflection on
your learning and the application of that learning.

Presentation 4 hours You will present your project to your peers, mentors, sponsors and champions. During
which you will be assessed on application of learning and the outcome of your project.
(Formal End
of Pro- (See assessment criteria below)
gramme)

Assessment Criteria

Define Measure Analyse Improve Control

The project has a A data collection plan Charts have been used Appropriate tools have Appropriate controls
clear problem state- was developed prior to appropriately been used to select the have been introduced to
ment that identifies collecting data improvement action ensure sustainability
Data / Charts Inter-
the problem
An appropriate amount preted appropriately PDSA pilot has been Post improvement data
A project charter has of data has been col- undertaken and results has been collected and
Data has been used to
been completed and lected recorded illustrated in appropriate
inform decision making
submitted charts
Data has been collected Stakeholder/s have
Processes have been
A high level process in a consistent manner been kept appropriately New process has been
observed, analysed to
map has been de- both before and after identify waste in the engaged throughout the documented where ap-
veloped changes system project propriate
Stakeholder analysis Ideas have been experi- Outcomes are clearly Sustainability has been
was carried out at mented with evidenced evidenced
the beginning of the
Further improvements /
project
next steps have been
considered and re-
corded
 Building towards Gold
Developing Quality Improvement Skills - Building towards Gold Application Form

Name
Email address

Contact Number

Dept/Dir/Clinical Board

I wish to shadow a member of the Continuous Service Improvement team because

If accepted I will commit to attend all planned shadowing opportunities and take time to complete a reflection log that shares my
learning and what I am/will do differently in the future and I will be taking an active role in quality improvement in my department

Signed

Date

Sponsors Name

Sponsors Email address

Sponsors Contact Number

Dept/Dir/Clinical Board
I fully endorse this application to shadow CSI team members and will commit to releasing them to attend all planned shadowing
opportunities and support and challenge this individual to take a significant role in Quality improvement in the department which
should include mentoring/coaching other staff when they are undertaking training. Below summarises how I will facilitate this.

Signed
Silver Foundation Course Schedule - 20 places per course - venues tbc

2013/14 Foundation C5 12th and 13th March 2014

2014/15 Foundation C1 Demand Led

2014/15 Foundation C2 Demand Led

2014/15 Foundation C3 Demand Led

2014/15 Foundation C4 Demand Led

Silver Practitioner Course Schedule - 20 places per course - venues tbc

First Workshop - 11th

2013/14 Practitioner C3 October 2013

First Workshop - 23rd

2014/15 Practitioner C1 January 2014

First Workshop - 9th April

2014/15 Practitioner C2 2014

First Workshop - 18th June

2014/15 Practitioner C3 2014

First Workshop - 4th

2014/15 Practitioner C4 September 2014

First Workshop - 10th

2014/15 Practitioner C5 December 2014

All other development is available on a need, demand and capacity led basis. If your
department is looking to have bespoke Quality improvement skills training then complete
the CSI Support Request Form
http://nww.cardiffandvale.wales.nhs.uk/pls/portal/url/ITEM/DB06031579D126D0E0400489923C490D

For further information contact

Nick Tyson
Knowledge Management & Improvement Skills Development Manager
Continuous Service Improvement

  02920 748581

WHTN 01872 8581

Email Nick.Tyson@Wales.NHS.uk