Development of a transferable package of capacity and\ud demand training to empower front-line staff to use change\ud tools and techniques, informed by data, to improve their\ud patient flows.

Doctoral thesis English OPEN
Bird, Dominique

The purpose of this project was to develop an approach to training for the National Leadership and Innovation Agency for Healthcare (NLIAH) that could be applied across the NHS in Wales to increase understanding at a local level of capacity and demand interactions. Through an action\ud research approach a transferable package of capacity and demand training was developed. This aimed to empower front-line staff to employ change tools and techniques informed by data when undertaking improvement projects. This constituted part of the NLIAH Skills4Change programme: an improvement course for front-line staff which combines\ud blended learning with practical action for improvement.\ud An analysis of questionnaire responses by former NLIAH capacity and demand training delegates identified the potential barriers to its application and its current wide-ranging use. These barriers were perceived as ‘access to information’; ‘no time to complete this project’ and ‘extra work on my current role’. Application of the tools was largely evidenced in outpatient and inpatient departments. The action research project built upon these findings, testing the barriers in a therapeutic setting. This highlighted the differences in applying these tools in a more complex service provision area.\ud From the two threads of this research: questionnaire analysis and action research project, there are key elements which can be utilised to form recommendations for future employment of the package of training by NLIAH.\ud The presence of an external facilitator during the action research project, alongside management support was identified as crucial to the momentum of this work. The ‘empowerment with support’ model this provided ensured sustainability of the improvements implemented.\ud However, it was evident throughout the project and from the questionnaire responses, that organisational and service specific delivery of these tools is essential.\ud Tools, methods and strategies for implementation are where the Skills4Change training programme traditionally focuses, with a mixed service delivery. The findings from this research suggest that to ensure maximum benefit and sustainability the tools and techniques need to be made real and relevant to the training participants. They need to see improvement in action and experience the benefits of the changes they are making. Linking the training with an understanding of the organisational culture will enhance this. Staff will be empowered to continue to change their services for improvement, as they witness the\ud support from the organisation in which they operate.
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