ECNI-2.6 – The Model for Improvement: Ideas for Change and Improvement

Change Ideas

When you are starting an improvement project remember that it is important not to jump to solutions too quickly. This is why we take time to really understand what the problem is, what our aim might be and how we will know things have improved, rather than just changed.

Then we can start to think about ideas for change. But how do we come up with good ideas or know which ideas to try?

Improvement tool: 5 Whys

This is a technique originally developed at the Toyota Motor company to help teams get to the root cause of problems and prevent them recurring, rather than just tackling the symptoms. It is simple to use and helps uncover things we might otherwise miss.

Improvement Tool: Fresh Eyes

  1. Define the problem or issue.
  2. Each member of the team takes on a random alternative perspective (see list) and views the problem from their new perspective. Actually go and observe what happens in practice from this viewpoint, if you can. Ask the following questions of yourself from this new perspective:
    • What would be important to me here?
    • What would I focus on or notice?
    • What questions would I ask?
    • What ideas and approaches do I have that could be helpful?
  3. Reflect on the observations and ideas that are generated and think about how they might be adapted for your situation. If there is a particularly useful concept, you might want to carry out a brainstorming session focusing on that concept to explore it further.

Adapted from
Thinking Differently, NHS Institute for Innovation & Improvement, 2017
Further resource Improvement Hub » Through the Eyes of…Observation DVD and Card Pack (england.nhs.uk)

 

the third step in the model for improvement.

Elizabeth’s change ideas

Elizabeth noticed that there were two patients on the ward with similar names. This meant that there was an increased risk of misadministration medication. Click the boxes below to see some of Elizabeth’s first ideas.

  1. Staff should follow the 6 rights of medicines management when undertaking medication rounds.
  2. Staff should have the correct number of working devices on the ward to support medicines management.
  3. Staff should be able to complete their medication rounds without being disturbed to ensure they can concentrate completely on ensuring accurate and safe administration.

 

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