Marina Otley, a Clinical Audit Specialist at Nottingham CityCare Partnership, shares her experiences of taking part in Improvement FUNdamentals – a massive open online course (MOOC) on quality improvement, run by NHS England with the University of Jönköping and Qulturum in Sweden.
To be honest when I signed up for Improvement FUNdamentals I was only really expecting an e-learning course that would give me a refresher on quality improvement and a certificate at the end of it (and was importantly free). What I got was so much more than that.
It was clear early on that the course was going to be quite different from e-learning I had experienced previously. Not with this course would I just sit trying to remember information from slides to be tested at the end. Instead it began with an introductory video referring to the pathway through the course materials as ‘Geocaching’, an outdoor game that involves people using mapping and navigation to hide and find small boxes usually containing a log book and small items for trade.
So I got on with the course materials, particularly enjoying the videos from a variety of presenters and the live ‘improvement cafes’, which learners are encouraged to participate in whilst embracing the Swedish concept of ‘fika’ (coffee break). I then found that one requirement of the course was to connect with other people to bring the learning to life, so eventually put aside my previous reluctance and joined Twitter. At the time it was just to tick the box but a year later I now have a modest 109 followers most of whom I have never met in real life, and I am on most days sharing information and engaging in discussions about quality with more people and in a more dynamic way than the chat forums for clinical audit previously attempted by different organisations.
As someone who is not in a role directly caring for patients I found there were times on the course I had to think and apply the learning a bit differently, and this was particularly the case for the ‘workplace challenge’ to be undertaken during the course. For this, learners were asked to identify an area of work or challenge locally that we would like to improve during our time on the course using quality improvement techniques.
My initial intention for the workplace challenge was to improve the quality of action plans from clinical audit projects by increasing engagement of staff and patients/public. As I worked though the materials, I also identified a need to refocus the clinical audit projects to give an emphasis on delivering measurable improvements to the quality of care rather than the main purpose being to provide assurances. By the end of the course I had run a successful event engaging patients and carers with discussing the results and actions for one project and begun discussions on changing the clinical audit process to include other quality improvement methods.
One year on, the legacy from doing the course has been that the workplace challenge has led to changes in the way we do clinical audit projects in the organisation with an emphasis on involving patients and carers and the use of other quality improvement tools. In addition, for the regional network I jointly chair, over the past year we have invited speakers and had discussions about better integration of other quality improvement methods to support delivery of clinical audit projects. My regular use of Twitter is another legacy of the course, often whilst enjoying a ‘fika’.
Marina Otley is the Clinical Audit Specialist at Nottingham CityCare Partnership, a Social Enterprise provider of NHS Community Services. Her role is to support staff in undertaking projects to improve quality of care and support NICE guidance implementation. She is also the Joint Chair of the East Midlands Clinical Audit Support Network, one of 15 regional networks that bring together people in clinical audit, effectiveness and quality improvement roles to share learning and good practice. Marina has worked for the NHS for 15 years in roles relating to clinical audit, effectiveness, governance and quality in primary, community and acute care organisations.
Twitter handle @MarinaOtley.