17 March 2020

QI-Lite cherry picking techniques and tools

Using an Appreciative Enquiry with Cancer and Palliative Care Nurses.

Dr. Sara Rasool, from Macmillan Consultant Clinical Psychologist & Lead for Community Health Psychology Services. (Beds and Luton), updated the QI Department on how the use of an Appreciative Enquiry helped her and her team reflect at their team Away Day in February.


Adopting tools from QI methodology and applying them to novel situations can work very effectively.

I was asked to an away day for Cancer and Palliative Care Nurses from Luton & Dunstable Hospital, to help think about well-being. In my role as a Consultant Clinical Psychologist, I and most of my team of clinicians offer monthly supervision to cancer and palliative care specialist nurses and often among the clinical case discussion the theme of increased demands with limited resources emerge, negatively impacting stress experienced and in turn impacting up on their emotional well-being. A picture common to many areas in the NHS.

The away time was short but offered an opportunity to reflect up on their experiences of work and consider ‘what made a good’, rather than focus on a problem saturated story. An ‘Appreciative Enquiry’ technique was adapted by using a series of simple questions.

The nurses where first asked to discuss in pairs:

1.‘What matters to you when you come to work?’.

2.‘What was one memorable ‘good’ day at work for you?’

3.‘What components made it a good day?’

The nurses were asked to think individually and write these components on post-it notes. Then they were asked to sort these in small groups silently into themes, once completed, to share the emerging themes with the wider group using some examples. The final question was –

4. What one thing can you do tomorrow to improve your chances of having a ‘good’ day?

It was important to acknowledge the wider organisational and process challenges faced in the work place, but in spite of these, the nurses generated many immediate change ideas which in QI we would call ‘quick wins’. Some included, a lunchtime walking group, starting the day with a coffee, organising a daily work plan, and an end of day reflection of what went well. Capturing these possibilities demonstrated agency in the nurses to make small changes to improve their working day.

The nurses reflected on the task and shared their appreciation of taking the time to have a meaningful conversation about ‘what makes a good day’.

By Dr Sara Rassool
Macmillan Consultant Clinical Psychologist & Lead for Community Health Psychology Services. (Beds and Luton).

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