Top tips for success

Key drivers in achieving results

• Executive sponsorship and organisational attention.
• The engagement of doctors.
• Support for and encouragement of the team (including the focus on staff experience) and team-working within the organisation.
• Focus on driver diagrams, aims and measures.
• Significant and unwavering emphasis on the importance of shadowing patients and understanding patients’ lived experiences
• Strong focus on data and its usefulness for the team.
• Having a sense of where you would like PFCC to sit in your organisation in the longer term.

The aim should be for PFCC to become the way of doing business, rather than a one-off project whose impact will not be sustained. Different PFCC teams have approached this in different ways: by changing their approach to improvement overall; by building the approach into new care experiences; or by ensuring the work they have already done fits within the existing governance processes, so that its momentum is not lost. This video shows how some of the PFCC teams see the work continuing in the future.

Barriers to success

• Scope that was too wide or unrealistic.
• A lack of skill in measuring or poor attention to data.
• A sense among the teams that data was being used for performance management, rather than to support them in achieving their own aims.
• Measures chosen not relating closely enough to the interventions being trialled.
• Leaders paying insufficiently active attention to the work.
• Boards not acting on the results of the work.
• Team members lacking time to do the work.
• Teams not acting as a team, with common goals and commitment.
• Participants believing they already knew what patients were experiencing and therefore did not need to do further work on this.
• Shadowing not being undertaken by senior people involved in the programme, or not being taken seriously.

Advice to others embarking on PFCC

• Seeing things from patients’ perspectives was transformative for staff.
• Senior leadership and medical leadership were essential components of success.
• Good management of improvement work was integral to its success. This meant that teams must work as teams, with a commitment to a common goal, and with an infrastructure to support the work.
• Participants in improvement work must be allowed adequate time if it is to be successful. It will not be successful if it is merely added on to their current jobs without any additional support. Often this support takes the form of improvement expertise or project management support.
• The best chance of making this happen is when an improvement technique is adopted as an organisation’s ‘way of doing business’.
• The demands on individual staff to take forward improvement work can be lessened by having a broad inclusive approach, which actively encourages involvement from a wide variety of staff.
• Teams that already exist as teams tend to be more successful than teams that come together only for the purpose of a service improvement project. New teams may need to spend some time on building the team.
• For the benefits of this work to endure, it needs to become integral to the business of the organisation – not a separate project – and it needs to become the expected way of working, on an ongoing basis.