Improvement Method Olympics Day 3

Posted by: NHS Horizons - Posted on:

  1. Appreciative Inquiry (methodology)

Appreciative Inquiry (AI) is a way of looking at organisational or system change that focuses on doing more of what is already working. So instead of starting with ‘what’s the problem’ and looking for fixes it starts with ‘what’s already working’ and how can we build on that?

That doesn’t mean we ignore problems; we just look at them in a different way. AI is based on the principle that a group, organisation or system will grow in the direction of whatever its people focus their attention on. By creating a space for people to share experiences of when they worked at their best, not only does it stimulate energy for change; it also builds relationships and a shared understanding of everyone’s contribution.

Appreciative inquiry - the 5D model Definition, Discovery, Delivery, Design, Dream

View the Appreciative Inquiry Resource pack from the Scottish Social Services Council and NHS Education for Scotland.

​2. Model for Improvement (Method)

The Model for Improvement is a simple yet powerful tool for accelerating improvement. The model is not meant to replace change models that organisations may already be using, but rather to accelerate improvement.

The Model for improvement has two parts:

  • Three fundamental questions, which can be addressed in any order to help us define what we want to achieve, what ideas we think might make a difference, and what we’ll measure to help us understand if change is an improvement
  • The Plan-Do-Study-Act (PDSA) cycle – outlining the steps for the actual testing of the change ideas. The cyclical nature allows the change to be refined and improved through repeated cycles of testing and learning. This provides a vehicle for continuous improvement.
Model for improvement. Rectangles with text "what are we trying to accomplish" "How will we know that a change is an improvment" "What change can we make that will result in improvement?" Underneath is a circle with the text Plan, do, study, act

Source: IHI and East London Foundation Trust

3. Design Sprints (method)

A Design Sprint is an intensive process, typically of five days duration,  which seeks to tackle complex problems throughout co-creation, rapid prototyping, and qualitative testing with a small group of people who play key roles in a process or service, including users. The Design Sprint is a process invented at Google to accelerate decision-making  and reduce risk in strategic projects and it has spread to other sectors across the world. It condenses months of work into just a few days.

Graphic showing a timeline - 1 understand, 2 diverge, 3 decide, 4 prototype, 5 validate

Source of graphic

See also: what is a design sprint and why is it important?

4. Failure Mode and Effects Analysis (tool)

Failure Mode and Effects Analysis (FMEA) is a tool for conducting a systematic, proactive analysis of a process in which harm may occur. In an FMEA, a team representing all areas of the process under review convenes to predict and record where, how, and to what extent the system might fail. Then, team members with appropriate expertise work together to devise improvements to prevent those failures. The FMEA tool prompts teams to review, evaluate, and record:

  • Steps in the process
  • Failure mode (What could go wrong?)
  • Failure causes (Why would the failure happen?)
  • Failure effects (What would be the consequences of each failure?)

Teams use FMEA to evaluate processes for possible failures and to prevent them by correcting the processes proactively rather than reacting to adverse events after failures have occurred

FMEA example chart - spreadsheet

From the Institute for Healthcare Improvement