Dr. Damian Roland (@damian_roland) - #FOAMed supporter

An introduction to Quality (for Improvement)

In FOAMed, Medical Education on October 26, 2014 at 9:13 pm

I recently presented at the RCPCH Clinical Tutors event on the theme of Quality Improvement. I was doing an introductory talk while colleagues Jane Runnacles and Bob Klaber provided advice for those with more experience.

I was asked by the college to place the presentation on the college tutors website but I felt the collection of pictures and minimal text wouldn’t be much use to those not at the talk therefore I have quickly done a video-cast of the presentation. I have edited some of the content and wasn’t able to embed some of the videos but have supplied bit.ly links for them.

I am by no means an expert on quality improvement but have some credibility in a few projects I have been involved in. The links to the journals I have mention are below:

Paediatric Trainees and the Quality Improvement Agenda: Don’t just do another audit

Delivering Quality Improvement: The need to believe it is necessary

but I also recommend you have a look at the Archives of Disease of Childhood EQUIP series which starts with a brilliant introduction to Quality Improvement in Paediatrics and Child Health

As always feel free to comment and question!

The video cast is below

and here is the original slide-set:

and the bit.ly links



What I learnt this week: Good “Leadership” is tangibly unrewarding but ultimately fulfilling #WILTW

In #WILTW on October 24, 2014 at 5:11 pm

This is the 23rd #WILTW

I have to admit that this isn’t really new learning, more of a confirmation of something I have suspected for a long time. The trigger for this blog has been seeing a few small projects come to fruition, which I have initiated, but not really been part of the process or eventual outcome. It’s very satisfying seeing this happen despite the fact that you get no credit for it. In fact it is interesting; the things that I am probably most proud of having delivered are things in which I get virtually no recognition at all.

This is a timely observation given the Health Service Journals hunt for the next “Rising Star”. I am conflicted as I was an inaugural winner. I’ll be honest, I was quite chuffed to have been nominated and it was nice to go to an event in London. It was at the event itself that I become uneasy. I sat with a number of very impressive characters, some of whom who have had significant impact at a national level, and thought to myself “What have I really delivered to be here?” I don’t doubt I have been part of a few projects which have had a larger-than-life profile but what can I say that I’ve individually done that has really inspired others to deliver significant change? I realised then that true leadership is really about fostering others to deliver on important initiatives. The fact that you are recognised probably means that you are still required to guide the process. What you really need to happen is for you to trigger a sequence of events that becomes independent of you. Now that is something that is truly fulfilling..

What have you learnt this week? #WILTW

What I learnt this week: The frustrating advantage of being difficult #WILTW

In #WILTW on October 20, 2014 at 7:02 pm

This is the 22nd #WILTW (and a little delayed due to my attendance at #EAPS2014)

This week I took our family car into be serviced and have an MOT. I dropped it at the garage just before work and was told it would be ready later in the afternoon. However  I had an answer-phone message at about 4pm to say that the service had been done but they hadn’t got around to doing the MOT so could I please leave the car with them overnight or come back the next morning.  I was a bit frustrated by this assumption as I either

i) I couldn’t get home or

ii) would be without an appropriate car for the school run.

I suspect, in fact know, I am a bit soft in these situations and although I was frustrated I tend not to let emotions get the better of me. So surprisingly, and probably because I missed the call and didn’t get put through to the person who had initially made it, I was able to be a little more ‘robust’ in my annoyance. I felt a little uncomfortable when I put the phone down having expressed my disappointment at the service I had received. However 5 minutes later I got a phone call back saying that manager had found someone to do the MOT…

There are often times when parents, carers or relatives of children become frustrated by hospital processes. Often they are scared and emotional and outbursts can be tolerated in the context of the situation they see their children in. But sometimes it does appear the smallest thing can be blown out of all proportion and you find yourself expending energy ameliorating the parents anger at the expense of care to other patients. Conversely in my experience parents are often very humble about things they could and should be annoyed about!.

My learning last week was reflecting on whether bad behaviour gains you rewards? My small outburst with the garage sorted a problem (which probably shouldn’t have occurred in the first place). What of the families or patients we see? When is strongly challenging the care they feel their child has received appropriate? and when is it simply a method of gamesmanship?

I hope I am never in a place where I assume the latter and will always do my utmost to facilitate the former.

What did you learn this week? #WILTW


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