30 March 2023

Taking over an existing pursuing equity project to improve LGBTQI+ patient experience of safety

By Nic Makomva, Life Skills Recovery Worker

“I’m also having a lot more fun than I expected, especially when I see glimpses of improvement!”

Our quality improvement (QI) project started back in spring 2022. At the time, the project was led by the modern matron, I was an active project member together with colleagues and three service users. The project aims to “Improve LGBTQI+ patient experience of safety on the ward by 95% and increase staff confidence when addressing LGBTQ+ matters, by December 2023”. I took over as project lead in late summer, after having been persuaded to sign up to the Improvement Leaders Programme (ILP) which was due to start just a few weeks later. The project has generated a lot of learning, and ILP has supported me as I’ve developed both my QI and leadership skills. Taking over the project was daunting. I had limited experience and I kept finding myself in rooms with senior members of staff. Luckily, I had great support and encouragement from people like my manager, my QI coach, and Improvement Advisor. I managed to use my influencing skills (a lot is to be said about smiling at people!) to get more staff and service users involved and see the project progress. It became clear that it isn’t necessarily seniority, but instead it’s the will and passion to make a positive difference that is important.  

How did ILP help? 

ILP has supported me to become more comfortable and confident with leading, to trust that I know what I’m doing and talking about. The training has provided structure and an understanding of what the natural progression of QI projects looks like. Before ILP, I felt a bit like Bambi in the headlights.  It can be quite difficult asking the right questions or asking for support when you don’t know what you don’t know. Since ILP, I’m no longer afraid to use my voice in unfamiliar spaces. I’m also having a lot more fun than I expected, especially when I see glimpses of improvement! 

Learning from the Plan Do Study Act cycle 

Something I really like about QI is that it feels a bit like a design sprint where you’re able to test an idea, learn and adapt, and then test again. It beautifully highlights the difference between what’s a great idea, theoretically, and what’s feasible given your specific environment, available tools and resources.  See our poster at the end of this article for an example of the ideas we’re testing. 

Figure 1. Picture of visual display board on Ruth Seifert ward, promoting Equality and Diversity

What we learnt

The project itself has provided many lessons learnt. The most important one has been patience! Patience with ourselves and with those around us. There’s a lot of passion to create equitable spaces centred around community and kindness. The passion from all those involved has helped drive a lot of momentum for change, and it has also highlighted the breadth of the challenge we’re facing.

Since the project started, we have witnessed many moments of kindness and compassion between our service users. We’ve seen the ward community come together to help a young man brush his wig, apply his eyelashes, and give him the ‘ok’ before he headed out.

In many ways it’s been a rocky journey and tricky learning to balance my regular duties with QI work, but I’m slowly finding a rhythm. My ambition is for the work from our project to be spread to other wards, other directorates, and eventually other trusts. One thing is certain, I will continue to use the skills and tools I have learnt, work with colleagues and our service users, and keep pursuing equity in our services.

To learn more about Nic’s QI project, see the poster below.

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