Many of us have accepted challenges to improve a service in which we have worked. Sometimes we were successful. But often when were not, we just moved on to a different place and project. Sometimes lessons have been learned, but often we repeat the same mistake or optimise similar lucky breaks! The burgeoning science of how to do this in healthcare is variously called implementation or improvement science.
A recent research report summarised the active evaluation of 4 improvement projects which were set up as learning communities, across 2 different sites in the UK. The authors summarised that key individuals were required to be trained in 3 sets of skills that they considered essential for successful implementation of improvement projects;
- Technical skills – critical appraisal of research, project and process analysis and management
- Soft skills – leadership, communication, negotiation
- Learning skills – individual and group learning, sharing knowledge, critical reflection
They used an analogy of a pyramid, where each side represented these sets of skills, and proposed that to sustain improvement (the apex of the pyramid), the organisational base (environment, culture, structures and resources) should be broad and solid enough to support the construction of the three ‘walls’ (‘technical’, ‘soft’ and ‘learning’ skills) to the maximum height.
In addition, they emphasised key strategies that discriminated the successful projects, such as;
- Aligning the improvement project with external and internal environments
- Recognising and shaping the internal organisational culture for improvement and learning
- Developing appropriate structures and processes to sustain organisational cultures
- Developing the knowledge and expertise of leaders to manage the improvement projects
- Using project and process management principles to manage tasks
- Promoting opportunities for new and regular communication to build trust
- Supporting learning and knowledge sharing
This all sounds very promising, but is there an art to developing and using these skills to implement the key strategies to actually achieve the desired improvement??