Improving the use of evidence using Quality Improvement

NameJob Title / Organisation

Dominique Harvey04 November 2015Organisation

www.celcis.orgwww.celcis.org

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CELCIS Permanence and Care Team (PaCT)

• Aim – to develop and deliver a permanence improvement programme for Scotland

• Vision - to secure sustainable improvements for looked after children, achieved through systemic, strategic and practice changes

• Delivery of Permanence and Care Excellence (PACE) programme

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Aims of today’s session

1. Applying the Quality Improvement (QI) model to improving use of evidence in practice

2. What is different about QI?

3. Learning from the use of QI

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Challenges to using evidence to improve practice

1. Competing priorities2. Lack of skills, knowledge and

training3. Differentiating between good quality

and less rigorous research4. Lack of fit between research and

practice5. Need for continuous practice

development and supervisionSee Wike, Bledsoe, Manuel et al. (2014)

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Improving the use of evidence in practice in Argyll and Bute

Stage 1: Aim settingStage 2: Identifying barriers and enablersStage 3: Develop change theoryStage 4: TestingStage 5: Implementation

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Improving the use of evidence in practice in Argyll and Bute

Aim

By XXX, the number of practitioners using evidence to improve their practice will increase by XXX%

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Force field analysis

By XX, the number of

practitioners using evidence

to improve their practice

will increase by XX%

Creativity and confidence

Scope to include evidence in reports

Assessment not restrictive

People’s interest – some workers will be interested and motivated

PDR system is good for identifying areas staff want to build on and helps them to take responsibility

Good links with other agencies

Quite a lot of staff get the opportunity to develop and join strategic groups so practitioners feel

energised to take developmental opportunities

Accessibility (perhaps this should not be a barrier but is perhaps more difficult for people who are

longer out of university)

Time constraints/ competing demands

Applying relevance to a task (e.g. incorporating the research into a Hearing or CP report)

Ongoing debate re format of assessment (this has changed a number of times in one year). Format

may be a barrier to creatively incorporating evidence as some practitioners use it prescriptively

Systems do not always promote innovation

Forces for Forces against

Good team-working – having discussions and looking at topics more analytically helps to inform

assessment and creates good environment for healthy discussion

Condensing information for people

Information is easily accessible

From an organisational perspective, the service is based on a corporate business model, and therefore

some people are not always encouraged unless there is a dynamic management culture.

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Force field analysis

By XX, the number of

practitioners using evidence

to improve their practice

will increase by XX%

Ongoing debate re format of assessment (this has changed a number of times in one year). Format

may be a barrier to creatively incorporating evidence as some practitioners use it prescriptively

Forces for Forces against

Good team-working – having discussions and looking at topics more analytically helps to inform

assessment and creates good environment for healthy discussion

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Driver Diagram

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What is different about QI?

• Aim setting – creating shared understanding across whole-system

• Clear understanding of current performance

• Measurement of improvement• Building up evidence base before

moving to implementation

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:

… I wouldn’t have understood methodology, I wouldn’t have understood the need to do the PDSA’s et cetera et cetera, so

there was the education element of it

… to challenge entrenched views of how things have to be done and allows those involved the freedom to try new ways of

working and think about what will actually improve outcomes for children rather than

sticking rigidly to processes

… a new way of thinking… the most important part is that it

allows you to test changes that may seem quite radical in a

safe and informed environment

… understanding that we could do small things to effect change, that we didn’t have to, you know, go away and spend

months and months and months talking about what

we wanted to do

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:

Questions?