What I learnt this week: How to get people to alter their typical ‘change’ vintage #WILTW

This is the 30th #WILTW

I was at a development meeting for LIIPS (pronounced leaps) today. LIIPS is a collaboration between academia and the NHS with the aim to connect and share expertise, knowledge and support in service improvement across Leicestershire. Unfortunately the need to re-inforce a culture of patient safety and quality improvement persists in health care. This is in part due to some concepts being ‘relatively’ new so that there isn’t the infrastructure of knowledge out there in individuals to embed good practice in trainees, students and juniors. LIIPS hopes to assist in resolving some of these issues. There was a lot of expertise in the room, and therefore a variety of different approaches and suggestions on how LIIPS should evolve and deliver. One commonality shared by virtually everyone was the desire to move from traditional mechanisms of improvement, a reliance on audit alone, to more focused interventions which rapidly audit, review, revise and re-audit using measurements focused on patient outcomes.

Wine Bottles

There is nothing new about why ‘change’ is difficult but I have hit upon maybe something new to try. On the way home from work I stopped to buy some drinks from a local supermarket. As well as some bits and pieces I also picked up a bottle of wine. Try as I might I find it very difficult to move away from tried and tested regions and varietals. In fact that’s a lie: one particular region and one particular varietal.

This compulsion to stick with the familiar has been present since about 2005¹ and only really gets challenged when a new wine I try is unexpectedly pleasant on the palate (while there is no editor for my blogs I self-reflect the middle-class nature this train of thought is taking). It would have to be by an almost accidental wine tasting to prompt a change in tradition.

Moving improvement science from a new-fangled ‘thing’ into the ethos of healthcare culture is going to be long and arduous task. I wonder then if accidental “change tasting” is a realistic possibility within current system dynamics. While this seems implausible, with a generation of medical students and trainees hopefully being exposed to improvement principles at a much earlier stage, perhaps weaning a generation of professionals off their current vintage isn’t an impossible task.

What have you learnt this week? #WILTW

1. Following a year in Perth, Western Australia, Chardonnay’s from Margaret River have become a firm favourite

4 thoughts on “What I learnt this week: How to get people to alter their typical ‘change’ vintage #WILTW”

  1. Hi
    Can you say more about the two forms of audit? When I first really learned about an audit back in GP training 15 years ago it involved measuring, figuring out how to improve, changing things and remeasuring. Is that your first or second description of audit? Many thanks

  2. Thanks Anne-Marie. I suspect you know the answer to your own question…

    Clearly the ideal is that audit is part of an improvement process. What you learnt 15 years ago has been lost to many though and audit becomes just a ‘thing’ to do. “Quality Improvement” is just re-identifying this lost use of audit as a real tool to improve care.

    So it is the first description really – and its a shame in some ways it has been in-corporated into the second!

  3. We really need to improve your wine repertoire… There is MUCH better wine than Chardonnay from Margaret River 😉

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