A2: Enabling change across a whole system


Thursday 11 April 2024 | 11:00-12:15


Format: Workshop
Stream: Change
Content filters: Recommended for those working at system level in QI


To quote David Fleming, “Large scale problems do not require large scale solutions: they require small-scale solutions within a large scale framework”. This session brings together three case studies where practitioners address the relationship and tension between large scale and small scale change. Our first presentation from Canada explores how to deal with emergence in large scale change. The second, from Scotland, looks at how to prepare students to be future of change linked to their improvement portfolios. Building on the principle that real change happens in real work, our final case study looks at the redesign of the interface between primary care and specialist practitioners to create a consistent approach across the English NHS.


As a result of this session, participants will be able to:



  • Gain insight into the critical relationship and tension between large scale and small scale change

  • Identify key factors that contribute to successful large scale change from different perspectives and in different contexts

  • Develop your own strategies for enabling large scale change


Sasha Karakusevic NHS Horizons, England (chair)



PART 1: Moving from concept to reality – learning how to support emergence


Leaving the prescribed solutions and detailed plans behind, the Saskatchewan Health Quality Council (HQC) is embracing the opportunity to work in new ways by supporting emergence to drive change across health, social and community sectors. We will share the good, pull-back the curtain on the messiness, and highlight our learnings in bringing complex system change to life.


Tanya Verrall Saskatchewan Health Quality Council, Canada


Tracey Sherin Saskatchewan Health Quality Council, Canada



PART 2: Adapting improvement education to context: small-scale projects or diverse and reflective portfolios?


Lecturers from a UK university will share their learning, research and experience within a degree level health professionals’ curriculum of transitioning educational efforts from small scale improvement projects in practice to longitudinal improvement portfolios. They will share lessons learned using the small-scale project approach to teach QI, and report upon findings from an extensive ethnographic multiple-case study of thirty undergraduate health professionals doing small-scale change projects across nine clinical settings in Scotland.


Lorraine Armstrong University of Stirling, Scotland


 


PART 3: Local is global: advancing healthcare quality on the international stage


The session will present tools to understand the local healthcare culture and delivery system, methods to assess the local quality and safety system, and best practices in conducting process improvement and change management in an international arena. It is important for international participants of the healthcare quality forum to gain exposure to healthcare delivery and quality improvement on the global stage, and apply the principles learned from this session in their own professional and work context.


Tao Xu Mount Sinai (US)


Jonathan Wetzel Mount Sinai (US)