Professor Andy Hardy, Deputy Chair of the National Improvement Board, discusses the quality improvement journey at University Hospitals Coventry and Warwickshire (UHCW).
Our quality improvement journey at University Hospitals Coventry and Warwickshire (UHCW) started in 2014 when we launched the ‘Together Towards World Class’ programme. We formed a new vision to be a national and international leader in healthcare and an opportunity to work with the Virginia Mason Institute. We applied to the Trust Development Authority and in 2015 became one of five NHS Trusts to partner with the Virginia Mason Institute.
Our journey so far
Firstly, there is a leadership challenge associated with bringing quality improvement and quality management systems into an organisation. It challenges leaders at every level of the organisation to think about how we lead differently.
And where that thinking really starts is about the patient. We have to challenge ourselves to think: “Do we absolutely put the patient first and foremost in everything we do and how we plan things?” In every decision we make, every process that we design, and redesign – are we putting the patient at the centre?
Secondly, many of us, as we go through our careers, are promoted because we’ve been able to solve problems. Because we are ‘solution finders’.
Where this approach has really challenged us, and certainly challenged me, is that we’re not here to solve problems – we’re here to help frame problems. This comes back to one of the fundamental premises which is a strong belief that those who do the work, know the work. And those who know the work, can improve the work. We need to create an environment and a culture which enables people, in whatever job they do, to feel that they can attempt to solve the problems they see in front of them.
A leader’s role is to help them frame those problems and let them make the solutions. And to give them the tools to be able to embed those solutions when they come along.
Another reflection I have around what could we have done differently, is embedding standard work earlier. We all do standard work. I do standard work as a Chief Executive. Every week if I’m on site on a Monday morning at 9am, you’ll find me giving inductions to new colleagues who are joining UHCW. On a Tuesday morning at 8am, you’ll find me in the main reception doing a stand up – short, sharp presentations with colleagues from across the organisation, talking about the improvement methodology. And of course, that standard work includes trust boards.
I’m a rugby fan and if you look at the New Zealand All Blacks, they are the most successful international sporting team. They talk about the fact that they’re successful because they do the basics better than everybody else.
And that is fundamental to this. It’s giving people tools to do their basic work, their ‘standard work’, better.
Visit the NHS IMPACT website to access improvement resources and events: https://www.england.nhs.uk/nhsimpact/
About Professor Andy Hardy
Professor Andy Hardy is Deputy Chair of the National Improvement Board. He was appointed Chief Executive Officer of University Hospitals Coventry and Warwickshire (UHCW) NHS Trust in 2010. For the six years prior to that he was Chief Finance Officer of UHCW, as well as Deputy Chief Executive Officer from 2008 to 2010.