How are we improving our Improvement Coaching programme?

ELFT has one of the largest single-organisation internal Quality Improvement (QI) coaching groups in the world, with more than 100 QI coaches trained so far.

Coaches are at the heart of supporting individuals, teams and directorates wanting to make improvements. They add value to the teams they support and fulfilling this role also benefits their own development. Three service users have completed their training as QI Coaches alongside ELFT staff and external participants. This has given them the opportunity to learn more advanced quality improvement skills and enabled them to build their experience and confidence coaching QI projects. Another benefit is that this has given ELFT the opportunity to learn from the ways directorates have been testing out how to make the best of this experience for the coaches and the teams being coached and how to adequately reward the coaches’ participation.

With this backdrop, we spent the summer of 2019 engaging in conversations with QI coaches to get a sense of what is working well and areas for improvement. What came out from those conversations is that there is much to be proud of but also some areas that need to be tweaked and some rethought. At present only 63% of trained coaches who are still in the organisation are coaching projects [Measure 1]. There are some practical and systemic factors that need to be addressed to improve the experience of coaches and impact on the teams being coached. Our theory is that once QI projects have progressed beyond planning and have some activity, that is scoring 2.5 on our learning and QI project management platform LifeQI, they should be able to see some modest anecdotal evidence of improvements within 3 months. At present, almost 30% of projects are not seeing this progress within 3 months [Measure 2]. Though project progress can be affected by a multitude of factors and there is no direct causality with coaching support, we believe this is an important indicator to pay attention to as we think about enhancing the role of QI coaches. There is also an opportunity to activate an aspiration to apply the lessons we have built so far to accelerate the role of service users in coaching improvement work.

Several change ideas have been generated by coaches to improve their impact and experience. You can read below, one such change idea being tested by corporate QI coaches.  As with the other objectives, this story also represents the broadening of where and how quality improvement work happens. Historically our approach to QI has been solely project based, but we are starting to move more towards ‘daily improvement’ where people are given permission and support to do improvement in their everyday interaction and delivery of services in addition to formal QI projects. Over the next 2 years, the role of coaches will transform to support this additional approach to quality improvement. You can read some of the current thinking around this extended approach in this blog by Amar Shah, the ELFT Chief Quality Officer. As the thinking develops, more will be shared in future newsletters and other opportunities.

Measure 1: % Active Coaches

Measure 2: Percentage of active projects on LifeQI with a score of ≤2.5 and that have not progressed in the last 3 months

By Auzewell Chitewe and Shuhayb Mohammad Ramjany