Scaling improvement: from local, to national, to international joy in work
The ImproveWell solution has been designed with scalability in mind – whether supporting small teams or larger multi-disciplinary functions. This helps each individual partnership to develop a rollout strategy to meet its specific needs, ensuring that the programme is performing at each stage. Flexibility has been key to the uptake of the ImproveWell solution. So, too, has the power of advocacy. Here we share the journey of scaling improvement with East London NHS Foundation Trust, Royal College of Psychiatrists and the Institute for Healthcare Improvement.
East London NHS Foundation Trust
East London NHS Foundation Trust (ELFT) provides mental health, community health, primary care and specialist services to 1.8 million people. In 2017, ELFT started using a quality improvement approach to help achieve the strategic objective of improving staff experience, using the Institute for Healthcare Improvement (IHI) Framework for Improving Joy in Work. ELFT’s Enjoying Work programme brings together teams to develop their own ideas and apply quality improvement to enhance joy in work. Following a variety of manual data collection techniques, ELFT partnered with ImproveWell to develop our digital solution into a tool that supports IHI’s Framework for Improving Joy in Work. The goal was to create a single digital platform that would enable ELFT to improve workforce wellbeing by giving staff a voice, providing a tool for staff to identify challenges and solutions, and using improvement science in a systems approach.
“We’ve now had over 50 teams take part in this programme and we’ve got stories from all those teams about the richness of coming together as a team, talking about enjoying work and looking at the things that really contribute to us having a great day at work – and the things that get in the way. Focusing on what matters to our staff and giving them the power; the tools to be able to make changes to the way they work is very powerful. ImproveWell really is a great enabler for us to capture people’s experience in real time. A single simple place for people to share ideas…to be able to have the autonomy and control to be able to make a difference.” Dr Amar Shah, Chief Quality Officer, East London NHS Foundation Trust. National Improvement Lead, RCPsych.
In 2021, results from the initiative were published in a peer-reviewed article in the British Journal of Healthcare Management. In the first two cohorts of ELFT’s Enjoying Work programme, 14 of the 21 teams demonstrated sustained improvement in the percentage of staff who felt they had a good day at work.
Royal College of Psychiatrists
Building on the successes and learnings from ELFT’s Enjoying Work programme, in summer 2021 the National Collaborating Centre for Mental Health (NCCMH) at the Royal College of Psychiatrists (RCPsych) launched a national Enjoying Work collaborative to achieve improved workforce wellbeing. The largest of its kind on the topic, the programme enables a range of healthcare teams across the UK to use quality improvement techniques to help their staff connect to what brings them joy in their work and find ways to enhance their wellbeing.
Since launching the ImproveWell solution in July 2021, RCPsych has received over 5,200 survey responses from 40+ teams across 20 NHS organisations; a significant opportunity for shared learning.
Institute for Healthcare Improvement
In September 2021, the Institute for Healthcare Improvement (IHI) launched its latest Joy in Work collaborative and made the ImproveWell solution available to participating organisations. A fantastic example of international collaboration, the collaborative has enrolled 18 teams from 15 organisations across the NHS, US, Canada and Kenya, using the ImproveWell solution to capture real-time data.
Giving all staff a voice 24/7, ImproveWell has a ripple effect and encourages participation in a way that change shaped purely from the top never could. A multidisciplinary approach to improvement enables all areas and levels of workforce (as well as wider stakeholder groups) to drive lasting and powerful change together. Plus, the ability to spread ideas across the whole community – as and when the teams are ready – means the opportunity to draw on collective intelligence is truly there for the taking.
“With the magnitude of the challenges facing healthcare systems in the wake of COVID-19, including the impact on the wellbeing of healthcare workers worldwide, this approach offers a scalable way to improve psychological safety, wellbeing and experience at work. The quality improvement approach brings an intentional focus on the team leading the change, through understanding and improving the system they work in, towards a shared goal which is developed by the team itself. Enabling teams to lead the process of recovery, renewal and rebuilding, with support and permission from their organisations, encourages a shift away from big initiatives across large, complex organisations, which often fail to resonate with those at the point of care, towards giving teams more autonomy and power to determine how they wish to function, and to develop their own ideas to support wellbeing and enhance joy in work.”
Dr Amar Shah, Joy Harken, Zoe Nelson, Quality improvement in practice—part two: applying the joy in work framework to healthcare
