1. Welcome Learn about culture in quality improvement
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Welcome
Learn about culture in quality improvement
William Lilley & Jo Pendray

2. Welcome What is culture? Reflects behaviours and beliefs
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What is culture?
Reflects behaviours and beliefs
Some behaviours that create value individually, for the patient and the organisation
Some behaviours that create unacceptable risk
The social ‘glue’
Safe and Reliable Healthcare
Welcome
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3. The Berwick Report
“Culture will trump rules, standards and control strategies every single time” “A safer NHS will depend far more on major cultural change than on a new regulatory regime” “The NHS in England can become the safest health care system in the world…..it will require a culture firmly rooted in continual improvement”

6. Increased reliability
Safety ……
Increased reliability
Standardise, simplify, reduce autonomy, highlight deviation from practice
Decreased variability
Institute for Healthcare Improvement • ihi.org

7. Welcome Psychological Safety Main title slide page
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Psychological Safety
“I’ve cut the corners off the questionnaire so that you won’t be able to identify me”
Consultant
“I put myself into a different job group so my answers couldn’t be identified”
Health Practitioner
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8. How culture affects QI
Why might culture affect a team’s ability to undertake improvement projects?
10 minutes in pairs!

9. How culture affects QI
Psychological safety
Value alignment
Teamwork
Communication
Burnout
Commitment
Sustaining improvement

11. Assessing culture in your team
If you were informally observing your team, what would you look for to try to gain some understanding of the culture?
10 mins in groups

12. Assessing the culture in your team- informally What are the conversations like? Are people enthusiastic? Does the team have shared goals? How do you know? What happens if an error occurs? Do you work around someone in the team? Does the team share good practice and celebrate good news?

14. Using a culture assessment tool - benefits
Confirms (or not!) informal observations / beliefs
Psychologically safe respondents will be honest
Starting point for debriefing, learning and taking action

15. Introduction to the SCORE Safety Culture tool
SCORE Survey Domain
What does it measure?
Learning Environment
The ability of a work setting to self-reflect, identify problems and solve them, learn from excellence
Local Leadership
The level of confidence that respondents have in the support they receive from their local leaders including positive feedback
Burnout & Work Life Balance
The degree of cynicism, emotional exhaustion and frustration felt by respondents
Teamwork
How effectively different disciplines coordinate their efforts and whether they work in a psychologically safe environment
Safety Climate
The degree to which mindfulness and psychological safety exist in the work setting

31. Resources https://www.kingsfund.org.uk/projects/culture

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Questions?