QI Essentials: Thinking of holding a meeting for QI? Read this first…

Sometimes a 15-minutes huddle is more efficient than a 1-hour meeting… Have a read of Amar’s latest QI Essentials blog for tips on how to run effective Quality Improvement meetings.

For most of us, when we think about how to bring people together to work on something, our first thought is often to hold a meeting. So when we’re working on a quality improvement project, we might naturally default to organising our work by holding meetings. I’m hoping this blog might change the way we think about how to bring people together to work on quality improvement…

Over the 15 years that I’ve been working in the NHS, for a variety of organisations, I can’t even fathom how many hours of my life have been spent in meetings. And this just seems to keep increasing, the more senior one’s role. However, I’m fairly confident that the vast majority of meetings that I’ve sat in, or chaired, haven’t been as effective as they could be. I’m sometimes left wondering why I’ve actually been in the room, what value I’ve added, or what we’ve achieved in the time together. Leaving a meeting more energised than when I entered hasn’t usually been the norm.

With quality improvement, our task is to bring together a diverse group of people representing different aspects of the system we want to influence, in order to generate and test out new ideas aimed at achieving a shared purpose. Is the best way to do this through a series of meetings? Perhaps, but maybe not in the way we traditionally run meetings…

Quality improvement is an almost completely practical activity. The value comes from applying ideas in practice, with a little bit of planning and thinking around how we might learn and adapt. Once you’ve got going with a project, the only real reason for coming together as a team is to ask three simple questions:

• What is the data telling us?
• What did we learn from our last test of change (the study part of the PDSA cycle)?
• How should we plan our next test – what’s our theory and prediction, how might we design a test to see if this holds true, and what data would we need in order to evaluate this?

I’d suggest that a 15 minute huddle might easily be enough to work through these three questions together, as long as we’ve planned how we want to use the time. A meeting is a process, and so needs careful design. Turning up to a meeting with just an agenda and list of attendees is really only scratching the surface of how to run an effective meeting.

As with any process, we need to be clear about what objective we want to achieve, and how we’ll design the process to involve everyone in achieving this. So having a project lead or meeting facilitator is critical, in order to make sure we make most efficient use of the time we have. Whoever takes on this role will need to put in a little time before each catch-up to design how best to use the time. This might involve thinking about the room layout or seating arrangements, the equipment available, any exercises that will be needed, and other roles within the meeting (such as recording actions, or time-keeper) which will help the team be as effective as it can be.

If our tests of change are long, the pace at which we are able to learn and bring about change will be slow. So our ambition is to run tests at a quicker pace, enabling us to be more agile and nimble. It makes sense then to try to meet more frequently, but for less time. Coming together for 15 minutes a week, which helps us run a test that lasts no longer than a week, is much more effective than a one hour meeting once a month. My only caveat to this would be that in the early days of a project, when we’re trying to bring the project team together around a shared purpose, and then attempting to understand the system, we might need slightly longer sessions which allow deeper connection and more involved exercises. An hour spent as a group creating a really detailed cause-and-effect diagram or generating ideas and developing a driver diagram might be hugely valuable time well-spent.

We have an opportunity in the way that we go about quality improvement to model a better way of working that involves people more deeply, connects people to shared purpose and makes more efficient use of our most scarce resource: our time. We want to pull people towards quality improvement work, to feel energised by it, and so the way in which we go about the work needs to generate energy and excitement. A well-designed, short huddle that helps us build a rhythm around frequent tests of change is more likely to help us learn faster, solve our quality issue quicker and generate more energy within the team around the work.

Our focus and energy needs to be spent on changing the system, not administering the process – so I’d encourage us to think about how we can remove waste in the way we go about the work. Do we really need minutes for quality improvement meetings? Can we capture and distribute actions in the meeting itself, rather than leave this as a task after the meeting? Could we use a whiteboard or flipchart to capture actions as we go, take a photo and circulate, so we’re all set to work on our actions and test of change from the minute we go our separate ways? What could we do instead to create energy, involve people more deeply, tell stories to connect back to the shared purpose…?

You can read all past QI Essentials posts here.