Corporate

Project

Qi Garden: making quality visible

Lead: Debbie Roberts, Quality Improvement Manager

 

What was the problem?

Not everyone can see the improvements being made at BCHC and the Qi Garden was a way of making improvements visible to everyone, overall, showcasing quality improvement projects is crucial for improving patient outcomes, and fostering a culture of excellence and continuous learning.

 

Aim

To establish a Qi Garden at 3 BCHC Trust premises which will promote and embed QI concepts and methodology and share good practice across the organisation by July 2025.

 

What did we do?

• Establish illustrative Qi Gardens at multiple high traffic sites across the Trust, which depict completed projects as flowers to help promote and embed Qi concepts and methodology, and share good practice across the organisation.
• When teams successfully complete a project, new flowers are awarded and added to the garden to celebrate and showcase the learning. Each division has been assigned a colour to enable an immediate visual of Qi projects completed.
• The Qi Gardens feature a QR code that, when scanned, direct individuals to the detail of completed Qi projects.
• An internal and external website page was developed to promote the Qi Garden and all completed projects. Project poster templates were developed for use on both the internal and external websites/pages, which divisions could then use to submit further projects.

 

What are the benefits for patients and staff?

As well as being underpinned by the Trust's strategic objectives, providing safe, high quality care for our patients and service users, becoming a great place to work for colleagues and delivering integrated care, the Qi Garden will promote equity, a key golden thread that is supported by the Trust Strategy, as all members of staff will have an opportunity to contribute or to take part and embed quality improvements using Qi tools and methodologies and making changes to their teams and services.

 

The Qi Garden will help develop our improvement culture. This will benefit colleagues by:

• Feeling valued and have access to information they can act on.
• Giving them a stronger voice.
• Allow colleagues across BCHC to access information which will lead to an empowered workforce.
• Having a positive impact on morale and health and wellbeing of staff.

 

Service users will be able to see that changes are happening and will be able to read about the quality improvements in more details.

 

Measures used

• To monitor any increases in the number of projects being registered via S&P portal as a result of viewing Qi Garden.
• Capturing number of times QR code has been scanned/accessed.
• Feedback.

 

Qi Tools used

• Plan, Do, Study, Act (PDSA) Cycle.
• Feedback.

Project

Improving engagement for the Improving2Gether Forum

Lead: Quality Improvement Team

 

What was the problem?

Engagement from BCHC staff in the Improving2Gether forum has been limited, particularly in presenting their improvement projects. Several factors may be contributing to this, including:

• An unclear registration process.
• Inconsistent communication about forum dates.
• Accessibility challenges (for example, location, digital access).
• Few opportunities to celebrate and share successes.
• Limited involvement from clinical divisions.
• Addressing these issues could help increase participation and foster a more collaborative and celebratory environment.

 

Aim

To improve BCHC staff engagement of the Improving2Gether forum by 80% by 31st December 2023.

 

What did we do?

• Simplified the Quality Improvement registration process via the project management portal.
• Devised a consistent approach for colleagues to submit completed projects.
• Strengthened links with Governance teams.
• Promoted the forum using internal communications, such as leadership brief reminders.
• Used internal communication and Twitter (X) after every forum to promote.
• Consistent day and time each month for the forum.
• Raised Divisional awareness of the forum at Quality Improvement Steering Group meetings.
• Introduced and included improving2Gether forums to Qi Huddle training programme.
• Recorded all sessions so lessons can be shared widely and viewed any time.

 

What are the benefits for patients and staff?

• Increased engagement allowing colleagues to reflect on and share learnings across the organisation.
• Celebration of successes of completed improvements.
• Encouraged other colleagues to make improvements.
• Improved processes and services which may benefit both staff and patients.

An attendee of the Improving2Gether forum said:

It is such an inspiration to see colleagues showcase and celebrate their quality improvements and see what a difference it has made to them and their service. Sharing the learning and knowledge is really important as it encourages others to make their own quality improvements and in turn, share them at the Improving2Gether forum for others to see.

 

Measures used

• Baseline data collected from attendees at previous forum.
• Continuous data collected to monitor any shifts, trends, improvements and so on.
• Statistical process control (SPC) chart completed with data to show changes and improvements.

 

Qi Tools used

• Driver Diagram.
• Plan, Do, Study, Act (PDSA) Cycle.

Project

Onboarding.

Leads: Sally Anne Poyser, People Promise Manager; Amy Jowicz, Service Improvement and Development Officer

 

What was the problem?

New Staff were not receiving elements crucial to starting their role on day one. This included:

• A laptop with internet access,
• User accounts,
• A Smartcard and access to Rio,
• ID badge,
• Mobile phone,
• Access to mandatory training.

This issue impacts the first impressions of new starters joining the Trust, potentially affecting their confidence and integration. Clinically, it poses a risk to staff who require essential equipment to perform their roles safely and effectively.

 

Aim

To ensure all new BCHC staff receive 100% of their onboarding components by day 1 of their start date. This is to be achieved by September 2025.

 

What did we do?

• We explored the process of porting mandatory training records from previous employers. A deep dive with the Mandatory Training Team revealed opportunities to streamline this task. As a result, we collaborated with NHSE to complete the necessary paperwork and initiate the process, aiming to reduce duplication and improve the onboarding experience for new staff.
• To assess feasibility, we conducted a deep dive with all relevant functions and consulted divisional representatives. This collaborative approach led to the creation of a “plan on a page” outlining the onboarding process.
• We also worked closely with the Mandatory Training Team to design an afternoon session that combines corporate induction with onboarding activities. A Plan, Do, Study, Act (PDSA) cycle was completed to evaluate and refine the session, ensuring it met the needs of both staff and the organisation.
• To improve communication around onboarding for both new starters and managers, we identified key areas where clarity and consistency were lacking.
• We engaged with divisional leads through regular monthly onboarding feedback groups and conducted process mapping sessions with onboarding functions. These collaborative efforts led to the development of a Standard Operating Procedure (SOP) and the creation of a dedicated onboarding area on the BCHC intranet.

 

To reduce delays in the onboarding process, we focused on improving the TRAC form based on insights from process mapping, monthly onboarding feedback from divisional leads, and a deep dive into manager-reported issues.

This work led to the identification and integration of essential elements into the TRAC form to streamline information flow to onboarding functions:

• New starter location field added to ensure Clinical Illustration can produce ID badges and dispatch them to the correct location, reducing delays in access and readiness.
• Mandatory training requirements form developed to minimise manual tasks for  the Recruitment Team and prevent delays caused by incomplete information being sent to the Mandatory Training Team.

 

What are the benefits for patients and staff?

• Smoother onboarding process: staff experience a more streamlined onboarding journey, with resources clearly signposted and easily accessible, enabling quick resolution of any issues that arise.
• Faster role readiness: staff receive all onboarding components essential to their role from day one. For clinical staff, this means they can begin delivering patient care sooner, directly benefiting service delivery.
• Enhanced first day experience: a more structured and welcoming first day supports the Trust’s strategic aim of being a better place to work. This may lead to improved staff engagement, more positive feedback, and higher long-term retention.
• More efficient onboarding functions: onboarding teams benefit from a review of current processes, potentially reducing unnecessary workload. This efficiency helps teams manage onboarding demands more effectively and sustainably.

 

An observer of the PDSA onboarding hub day said:

I think this initiative is what the Trust needs and simply makes you ask the question, why wasn't this done before? I think it is excellent having new starters leave with almost everything they require on their first day including access and any other information they may require.

 

Feedback received from 5 new starters on their onboarding hub experience:

Great to meet other teams and also great to meet people in the same division.

 

Learning and Development was really informative and gave me a great understanding of what training I needed to complete.

 

Market place went really well.

 

Booklet given by learning and development was really great for training.

 

Measures used

• Staff feedback survey: percentage that received all components for their role.
• Staff feedback survey: percentage breakdown of staff that received laptop, network access, phone, smartcard, ID badge.
• Staff feedback survey: percentage of new starters who were detractors, neutral and promoters in response to question: How satisfied are you with the overall experience from the point of receiving your unconditional offer to starting on your first day?
• Staff feedback survey: percentage of new starters who were detractors, neutral and promoters in response to question : Were you given sufficient information about what to expect in your first few weeks at the organisation?

 

Qi tools used

• Fishbone Diagram.
• Process Mapping.
• Driver Diagram.
• Plan, Do, Study, Act (PDSA) cycle.