The power of learning: Rozi Hamilton’s perspective

How learning and development helps shape ELFT’s QI model and empowers individuals

Training and development are a huge part of the Quality Improvement model in place at East London NHS Foundation Trust (ELFT). Achieving improvement is not an easy task, so it is paramount that people involved in this process – staff, service users and carers – master tools and techniques to take them through their journey.

The QI training path at ELFT includes courses for staff, service users and carers who are looking for an introduction to QI and want to learn core QI skills (Pocket QI); flexible online courses for ELFT staff (IHI Open School); an 8-month in-depth practical course for those leading QI projects (Improvement Leaders’ Programme); and a 6-month development programme for those who want to become QI Coaches (IHI#s Improvement Coaching Programme); masterclasses and other bespoke sessions.

In this inspiring interview, Rozi Hamilton, who works as a Practice Educator in the extended primary care team in Newham and is also the Nurse advisor for the inner East London Super Hub, shares a little bit about her journey with Quality Improvement and reflects on the importance of training and peer learning. She has been involved in education for some time and is now teaching some bespoke Pocket QI modules herself.

How has your professional journey with ELFT been so far?

I came to ELFT from an acute nursing background. I came here as a practice experience facilitator in November 2010. My role initially was around supporting adult and child student nurses in their community placements, and for the last three years I have been working within the inner London Super Hub, which came about because Health Education England wanted to really work with community nursing to improve recruitment, retention, improve the quality of clinical placements and develop robust preceptorship programmes for nurses across community and primary care. The preceptorship programme we developed is now being rolled out to local practice nurses in Newham and Tower Hamlets.

How did you first get in contact with QI?

Somebody suggested that it would be something that I would enjoy and it would be a useful skill to have. I was approached by a colleague who was on the QI Forum and asked whether I would be interested in becoming a QI Coach. So that was how it happened. I did the IHI Open School courses and Pocket QI about two and a half years ago. Then I started the coaching training. At the same time I did the Improvement Leaders Programme.

How have you been involved in QI training and engagement?

I think that QI is central to healthcare and I think that ELFT is doing it in a really innovative way – something we should be proud of – so I started promoting it. I started coaching a number of projects. I like QI, I am very interested in it, and I see the benefits of it. So when I was developing education programmes within ELFT, I often signposted people towards QI. Then we were asked to provide some development for care home staff locally, so we did a Pocket QI for them. I wanted to be there because I knew that it was a new area and I wanted to be there to support staff. They don’t work for ELFT, so it is a slightly different context. So I volunteered to do some teaching and it came from there, really. So far I have taken part in four modules, teaching sections of them.

What has driven you to this area?

I have been involved with education for a very long time. Even when I was a clinical worker in the Acute trust, I spent a couple of years as a professional development nurse there. I also teach advanced life support as a Resuscitation Council Instructor. Over the years I have done lots of different types of teaching. I think what really inspired me with QI is the way it is taught – things like the Mr Potato Head game and the measuring of the banana. I think it is a really innovative way of getting a tricky subject over. And I think that there are lots of ways of learning and by introducing fun, laughter and games it is so much easier to reach the people you are teaching.

What would you say is the most valuable gain people can get from taking part in QI training?

Speaking quite personally, I think that it teaches people not to be scared about data, data gathering and presenting data in charts and things like that. For me it has certainly revolutionised tasks like report writing, because I can now create charts. And you can look at data in a far more objective way, you can look at it and work out whether it is showing you a true story. And I think to actually have people who probably haven’t had a lot to do with data being able to gain those sills I think it is good for their confidence levels.

Learning also comes from collaboration. Can you please reflect on how people can learn and develop their skills that way?

One of the beauties of ELFT is that it is a very big trust, with different services, so you can have a table with a physiotherapist who works with older adults, a mental health nurse and a community children’s nurse. People really enjoy working with people from different settings and backgrounds. We recently witnessed a big conversation with the cohort of care home nurses in which they were all saying that, although they were all care home nurses, they were all from different areas and different care homes, different organisations. And one of the things they felt was really beneficial was to have that peer discussion with people who are doing similar jobs but are not from the same organisation. That really does inspire people to speak, they find out that they have a lot in common and they can learn from each other. And it is the same really with the QI training.

You have mentioned already that the way QI is taught here is very innovative. What would you say to those people who are interested in QI but don’t know where to start or that are maybe put off by having to deal with data for instance?

I would probably say: that was me once. We’ve all been there. The first time you see a proper driver diagram you think “What on earth is that?”. And then you see Homer Simpson’s diagram [the cartoon character is used as an example to teach driver diagrams] and it all fits into place. It is also about making sure that people feel they can come along, they can learn at their own pace. There are also other options for ELFT employees to get involved in QI with so many projects going on. They can be as involved as they want. If nothing else, things like nominal group technique and multivoting can actually be very useful just in small teams, like teams of nurses, or therapists that are coming up with fairly complex problems about service delivery or particular team dynamics. So they can learn skills that they can really utilise.

What is the main lesson you’ve learned throughout your journey?

Don’t be afraid. Don’t be put off by the data bit because it is not as complicated as it looks. And realising that and being able to then use data is very empowering.