Billy Boland: QI forum

billy_bolandIt’s been really rewarding discussing quality improvement (QI) with colleagues at my trust. We’ve set up a few different resources for people to make use of. My favourite of these so far is something we’re calling a QI forum. Essentially it’s an unstructured meeting where we discuss QI in general with whoever turns up. We’re finding people have varying needs, understandings, and interests, so it’s been useful to get a sense of where we are as an organisation. We also take the opportunity to give a short presentation of our evolving QI approach. Our vision is to come up with a common QI language that we can all unite around, one that facilitates collaboration.

We’ve found lots of QI work going on that we’ve not been sighted on as an organisation. Some really, really excellent stuff. Looking back, I think I had arrogantly imagined myself as a sort of modern day quality improvement prophet, ministering the good news to the good people and welcoming them on board. But none of the fora so far have been like that. Each time we have heard examples of staff working on issues methodically in innovative ways to resolve problems in the system or create opportunities. Typically it takes a little while for these stories to come out. Each one has been a delight that I’ve been keen to celebrate. But these examples have also made me think about why the work hasn’t reached me already. Why have I only learnt about it through the forum? Why hasn’t the learning been shared more widely in the trust in other ways?

It has often come down to modesty. I was heartened to find hard working motivated clinicians see quality improvement as a core part of their role. A must do. Something that is intrinsic to their work. And as such, many do not see it as something to shout about – they’re just doing their job. Some don’t want to put themselves out there as if to suggest they are better than others – they see their colleagues driving quality improvement too.

Therein lies a wonderful dilemma. How not to disrupt people’s private passion for QI, yet find a way to foster co-operation and shared learning across an organisation. We’ve not got that totally figured out yet, but it is a joy trying.

Billy Boland is a consultant psychiatrist and associate medical director for quality and safety at Hertfordshire Partnership University NHS Foundation Trust. You can follow him on Twitter @originalbboland

Competing interests: I declare that I have read and understood BMJ policy on declaration of interests and I have no relevant interests to declare.