Improvement Method Olympics: Day 5

Posted by: NHS Horizons - Posted on:

  1. Five S (tool)

5S is a visual system for improvement that helps create and maintain an organised, clean, high performance workplace. It forms the basis for standards work, which enables you to measure improvement. The 5S stands for:

1. Sort: remove what is not needed

2. Set in order: agree what goes where and make easily accessible

3. Shine: keep the environment clean

4. Standardise: a consistent process agreed by all

5. Sustain: continually improve.

Read 6S (now 5s)

A picture showing four environments that are neat and tidy after doing the 5s

2. Liberating Structures (method)

Often we think that only expert facilitators or leaders can lead sessions for engaging people in change. Liberating Structures are simple rules that make it possible for a) anyone to lead a session and b) to include and engage every voice in shaping the future. Liberating Structures are  made up of 33 practical methods that are versatile enough for anyone to use for a wide array of activities and challenges. Seeing them in action once is enough for many novices to get results and adapt them for use in other settings.

Most people with a role in supporting or leading change would like to productively include and unleash everyone in the change but do not know how. Using Liberating Structures makes it relatively easy and practical to start. It also means that people not only take part in a conversation but become change agents in shaping their future. Liberating Structures are:

  • Versatile: useful in many different situations, regardless of a person’s profession, position, culture, or purpose
  • Easy to learn: no extensive training required; people can pick them up easily
  • Expert-less: require only a few minutes to introduce; everybody can use them
  • Results-focused: generate tangible results so quickly that people will sustain the effort
  • Rapid cycles: short enough to fit in the existing rhythm of work and to be repeated quickly to improve results
  • Multi-scale: useable with varied group sizes for everyday tasks, projects, or strategy/goal setting
  • Enjoyable: participants experience working together as pleasurable and satisfying rather than the drudgery they often experience

Read more: blog by Keith McCandless

The 33 Liberating Structures

A graphic showing the 33 liberating structures

3. DMAIC (method)

Define, measure, analyse, improve, and control (DMAIC) is a set of data-driven quality improvement methods. The letters DMAIC represent the five phases that make up the process, including the tools to use to complete those phases. You work through the five stages to address your quality problem. DMAIC is often used as part of an improvement methodology called Six Sigma but it can also be deployed as a standalone method.

Image describing what DMAIC stands for

Source of graphic: PCMC

DMAIC is used to improve current processes. It works best when there is a complex problem with unclear root-causes or if the risks of inaction are high. Because DMAIC brings discipline to the improvement process and discourages teams from jumping over important steps, it increases the chances of success.

4. What matters to you? (method)

Asking “what matters to you” is a simple, yet profound idea for creating deeply personal engagements with patients or service users and their family members. Because patients are the true experts on their own needs and experiences asking, listening and responding to what matters to them is a key feature of person- and family-centred care. Asking “What matters to you?” has a positive impact on quality, safety, and the wellbeing of people who work in health and care.

A global movement has grown up supporting “what matters to you?”. Whilst we should be asking these questions every single day, June 9 is marked as the annual worldwide celebration of “what matters to you?”

Table with ideas for different ways of asking the question "what matters to you"

Source of graphic: British Columbia Patient safety and Quality Council

See also:

Institute of Healthcare Improvement

What Matters to You