I’ve been obsessed with the concept of sharing proven good practice and experience in the NHS for more than four years. This was originally sparked at a Healthcare Communications Association meeting where a commissioner from Manchester talked about innovation uptake. His presentation focused on the practical nuts and bolts of how a system makes this happen. He explained that people start a project with a blank sheet of paper to create the solution to their locality.
As he spoke a question came to mind: surely people must learn from someone that has done something similar before and not reinvent the wheel? As the Q&A session opened my hand shot up and I asked my (diplomatically rephrased) burning question. The response was that people try, mainly unsuccessfully, to find and learn from others but it’s a difficult challenge and most do start from scratch.
“That’s mad,” I thought and being a curious type I wanted to understand more. So, I bounded up to the speaker to ask for a meeting. He accepted my request and a few weeks later over a mug of tea and a round of fish and chips in Salford’s Tesco superstore cafe, this inspiring chap and I talked about his experiences on the topic of spreading innovation.
In one part of the country, out of view, an ‘improver’ and their colleagues can spread an innovation locally like wildfire – benefits are seen, often measured. That innovation, which is enhancing quality and safety, can receive a chilly reception elsewhere. As a result, little or no traction occurs, despite the potential to confer a host of benefits which might include:
- delivering better patient outcomes, improving and saving lives
- saving time for both patients and NHS employees, making for a better experience
- creating efficiencies and potential savings to the system.
Interesting anecdotes were shared, beyond the obviously important human and cultural factors involved in the uptake of innovation and improver projects. What fuelled my obsession was that for more than 20 years I had certainly seen this happen with medicines. Innovative drugs, assessed to be cost-effective with the potential to transform patients’ lives, can sit on the pharmacy shelf or often never get on the shelf in the first place.
However, I was intrigued as we talked about how a service delivery or procedural changes, big or small, can equally fly or flounder when there isn’t a high-value medicine in the mix to be the ‘reason’ for lack of spread.
Now don’t think me too naive, I do get folk. We all know that people find it hard to change what they are doing, but surely if you can get it to work in one place, you have to be able to learn from that. I pondered, “the system must be capable of making this happen?”. My obsession was set.
So, I’ve been on a quest to understand the sharing of ideas and practice. It became a key focus of Aurora’s Access All Areas initiative. We did qualitative research, hosted a meeting at the Royal College of General Practitioners in 2015, and produced a report with a systems thinking lens to assess how we can create opportunities for patients to get access to innovation. Next an intern (the smart Freda Katunda) was hired to dig into the topic. We travelled all over the UK to meet people searching for the golden nugget of insight, that could then be spun across the system to fix the sharing conundrum.
You know what? That golden nugget was elusive. I met people, went to conferences, joined webinars, scoured the literature and finally, yes finally, the truth revealed itself. The truth is that there was no nugget to be found, not even a silver or bronze one.
All was not lost. Even though the system appeared more heterogeneous and complex with each expert I met, there was something that everyone agreed on: that the sharing of experience and practice works. That it is a good thing. It saves people time and money, brings quality and makes things more efficient. I remember writing that on the whiteboard in my office with Freda – we wrote it up as a hypothesis – it was our Eureka moment… just make it happen because it works.
That is why it is so important that when the wildfire has caught in a specific location, that the ‘how?’ is shared and widely disseminated to help that innovation scale across the country. Rather than getting bogged down in why it’s hard to get sharing to work, we need to roll up our sleeves when we have great examples and crack on.
Here are four tips, beyond having a positive, cup-half-full mindset, that I’ve learnt to help the sharing of proven good practice and ideas that everyone can bring to their work…
- Acknowledge the importance of collaboration… every hard-fought change has a great improver leading it. Just remember that a change takes a huge collection of people to create, implement, adopt and feedback – call them out, give them recognition.
- Minimise the time impact on your ‘improver’ change leader… people that make change happen are highly motivated, the chances are they are busying themselves with another project already. Develop sharing and dissemination ideas that don’t burden them and take up too many of their precious working hours.
- Uncover the more intangible elements of a change or improvement project… ask your improver to share when the tipping point occurred on a project. What did they say or do that turned people from pushing back on a change to positively engaging with it?
- Share the failure or the waste of time elements… not all change projects are successes and even a successful project will have, with hindsight and reflection, elements that someone doing a similar project could skip or avoid. These insights are likely the real gems.
Sharing proven good practice and experience is important, there is loads of evidence and literature to immerse yourself in. The bottom line is that we all need to look at the positive opportunity of sharing and liberate ourselves from being caught up in the reasons why it is so difficult.
Sharing is caring. We should give kudos to the people, these improvers, these leaders, who go out of their way to share their proven good practice and experience with their peers. It’s worth being obsessive about and to fan the flames of sharing and dissemination.
If you need to share your proven experience and practice associated with your innovation then give us a call – we can help you think through the challenge and create an approach that will work.