Reflecting back to move forward – Institutional Memory

By Miles Tringham, Improvement Advisor 

The sun was out over Springfield Park in Hackney, as teams came together to celebrate and reflect on 10 years of Quality Improvement. We were grateful to be joined by Pedro Delgado and Goran Henriks of the Institute of Healthcare Improvement (IHI), to lend some perspective and insight on our achievements and learnings.

We then set our sights to the future. “Our goal is to further embed and strengthen an improvement culture, sustain the positive changes, while ensuring we capture the voices of our service users and carers.” – Jed Francique, Borough Director for City & Hackney.

We spent time reflecting on what we’ve learnt from past projects. Around the room were posters of improvement work going back to 2015. Some of this great work produced by people that have since moved on. Many of these projects covered wide topics of work such as patient/ carer experience, record keeping, and violence reduction. Topics that are still areas of focus today. Prior to these reflections some staff had thoughts of starting projects from the ground up, with aims akin to what was on display. They questioned the value of this approach. They were not aware of these past projects, so had not seen the learning; what worked, what didn’t. Why re-invent the wheel?

How can we ensure the project gains are sustained, and the learning is passed on to future improvers? Discussions flowed into how we can create an institutional memory. It’s the little things. We all have a part to play. There was agreement that we can do this better. Starting with how we advertise our projects, during, and post completion. All project posters are being put up around their relevant teams, throughout the offices. In some cases they are being reprinted to be even bigger, grander. The vision is to make the lessons part of the building, weave improvement into the fabric of the environment. City & Hackney wants to showcase what has been done, to prove what can be done.

The second part is culture, and how we define it. “We need to move away from thinking culture is something in the air, that sits around us. It’s not. Culture is a doing word. It’s what you do, what you don’t do. What you say, or don’t say. Culture is action.” – Pedro Delgado, Vice President at IHI.

In building a common language and framework of improvement, City & Hackney are working to make QI training and involvement more accessible than it ever has been before. All staff should have the opportunity to train to become an improver. We owe it to ourselves, and all those we serve, to be better… and stay better.