Assemblies, Onions and Tips for QI Meetings

The ED Assembly

Last week’s video message from our Chief Executive, Suzanne Rankin (@SuzRankin ) was all about quality improvement and a new type of improvement meeting in the Emergency Department.


Dr Asim Nayeem (@asim_nayeem ) has set up an ‘ED Assembly’ in the department to bring people together and work collectively to solve problems and make improvements.

You can see the whole video here.

Asim was inspired to set up the ED Assembly having seen a similar approach taken in another hospital, but also because of the belief that he shares that if everyone is given the opportunity to contribute to QI in supportive team setting, lots of small changes can lead to big improvements.

Operation Onion

In a similar example, someone brought this blog to my attention by Samantha Jones, then Chief Executive at West Hertfordshire Hospitals NHS Trust and now Director for the New Care Models National Programme at NHS England ( @SamanthaJNHS ).

The blog is about a daily improvement meeting implemented at West Herts a few years ago, which Samantha describes as “about listening to our clinical and non-clinical staff and looking at immediate changes we can make to ensure our patients are treated quickly, efficiently and correctly, first time.”

The daily frequency of an onion-type meeting may not be suitable for all teams, but there are a number of elements that are common with other good examples of improvement meetings, such as inclusivity and teams working together to rapidly identify and make changes.

Some tips

Clearly the format of a focussed improvement meeting is transferable, but we thought it would be useful to describe, based on our experience, what are the characteristics that make this approach more likely to be successful:

  • Being inclusive and without hierarchy – clinical or non-clinical staff at all levels should be invited and positively encouraged to contribute
  • Simple and focussed – by keeping an agenda simple it is possible to achieve a lot in a short time (the ED Assembly is a standing-up meeting!)
  • Stick to a simple routine – by keeping a routine of the same day, time, room for every meeting it is easier for people to plan for and you are more likely to get good (punctual) attendance
  • Be persistent – from all the examples we have seen (including the ED Assembly) it is clear that success requires the persistence and energy of an inspired and inspiring person to lead the team and ensure that we keep going; even when it is hard to do so

There a few more tips on getting the most from improvement meetings in a previous blog here.

If you are interested in taking this approach with your own team please get in touch and just let us know your thoughts in the comments section below.


Mark – @MarkH_Work

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