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Case study: Using Quality Improvement (QI) to get London to zero HIV

In October 2019 the Fast-Track Cities Leadership Group launched an improvement fund of £1 million per year for three years. The aim of the fund was to build on, and complement, all the excellent existing work in London.

The fund offered grants to tackle HIV testing, ensure more people with HIV stay on treatment and support people with HIV to live well.

12 projects were chosen from 40 bids. The projects are all led by voluntary organisations working together in creative ways with other community and voluntary groups, the NHS and Local Authority services.

The 12 projects aim to support many of the more complex, vulnerable or marginalised groups; immigrants, homeless people, people with substance misuse issues, people from Black and minority ethnic populations, women, younger people, people who are socially isolated and various faith groups.

You can read more about the 12 projects here.

You can read about the improvement fund process here.

The projects all agreed to form an improvement community to share learning and support each other. They are also being trained in Quality Improvement science to deliver effective, adaptable, results driven projects.

Quality Improvement (QI)

Fast-Track Cities want to help release the creativity, knowledge and innovation within London’s HIV sector.

To facilitate this, the projects are using a Quality Improvement methodology to manage and deliver their projects.

The Quality Improvement way of doing things goes beyond traditional project management and target setting. It helps teams to experiment and work flexibly to adapt ideas, so the project is getting the best possible results. The Quality Improvement method looks to achieve improvements in quality, user experience, outcomes and costs.

QI enables teams to:

  • undertake root cause analysis of issues
  • identify clear aims and outcomes
  • use a systematic data based approach to tacking complex problems
  • gives everyone a voice by bringing staff and service users together to improve and redesign the way care is provided

This model for improvement requires teams to ask themselves three questions:

  1. What are we trying to accomplish? (Aim) The project team asks which specific outcomes they are trying to change through their work.
  2. How will we know that a change is an improvement? (Measures) The project team identifies appropriate measures to track their success.
  3. What changes can we make that will result in improvement? (Changes) The project team identifies key change ideas that they will actually test, reflect on and iterate further.

Fast-Track Cities London is working with East London Foundation Trust QI Team to deliver the Quality Improvement training and coaching sessions for the project teams.

Collaborative working

As well as formal QI training and coaching, Fast-Track Cities London has also created an improvement community, which provides a network around the projects for learning and support.

This complements the formal training and project work, and aims to enhance creativity, problem solving, learning and networking.

All 12 projects meet virtually every two months for half day coaching and learning sessions. This community has enabled the projects to share progress, data, problems and issues, share learning around their specific projects, as well as listen to and contribute to others.

If you would like to find out more about the approach we are using to achieve the best results for your projects, then please get in touch with David Groom, Quality Improvement Advisor, Healthy London Partnerships at david.groom1@nhs.net.


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