Background: Improvement science provides a framework for transformational change, focused on healthcare improvement that is geared towards improved patient safety, outcomes and user experience. It includes techniques, strategies and theories that can then be used by teams in different settings to undertake quality improvement and provide consistently good experience of care.[i]
Framework: Our framework (image to be provided in May) assumes that:
The starting point is always what do the users of our services want/need from us - this requires a fundamental rethink of how services are designed around the needs of the service user;
Organisations already have lots of transformational ideas and capability in-house and could harness it more effectively than they currently do;
The kind of accountability that is more meaningful to us all is not up and down but works peer to peer. Our colleagues and service users are the people who matter to us, their feedback is real-time; and
Openness to learning from mistakes is critical - this is the only way to improve quality sustainably and requires trust and honesty.
The framework draws on Kotter’s eight-step approach[iii] to develop the co-creation journey, starting with volunteers who are supported to model a new way of acting collaboratively across organisational and functional boundaries, harnessing the talent already in the system. A critical enabler of the framework is agile collaborative leadership; leaders need to unlock the collective intelligence of their organisations to work as powerful collaborative transformational networks to enable the co-creation of integrated care.
Case Study: The framework was applied to co-create the model for Connecting Care for Children (CC4C)[iv], a programme which represents a new way of working across organisational boundaries.
Three co-creation workshops with professionals (n=101) and citizens (n=43) and two collaborative sessions with the board took place. Workshops established a shared vision for CC4C, facilitated reflective practice from lessons learnt and co-created a framework, core components and roadmap for greater integration. The professional’s workshops involved group activities, informed by data from the pilot sites and experiences of clinicians and users. Citizens were recruited through community champions and workshops included individual and group activities, adopting art and media to co-create and communicate ideas. Together, sessions worked to refine the outputs to inform the CC4C case for change.
Conclusion: The case for change informed proposals to scale CC4C across a wider geography and has been included within the Commissioning Intentions of five of the eight CCGs[v] in North West London.