Professor Jonathon Gray’s blog post on the publication of the ‘Exploring the role of communications in quality improvement’ paper in the Journal of Communication in Healthcare
2 August 2015
Profound communication for improvement
I know the difference communication for improvement can make. During my time as a director on the 1000 Lives Campaign in NHS Wales, strategic communication was integral to its success. I have no doubt that many of the lives saved by the Campaign, would not have been saved, without the effective use of communications which underpinned it.
The communications strategy was a core part of this two year national patient safety campaign and we ensured it was built into our planning right from the start. It played a central part in recognising and validating frontline staff, calling on their sense of vocation and professionalism to save even more lives in Welsh healthcare.
A framework for communications
During the campaign, we developed a framework to support colleagues through a series of steps to integrate communications into their improvement work. By using the framework methodically and consecutively, the approach was designed to enable communications to become a real ally to give improvement work the best chance of adoption and spread. The framework was published earlier this year in a paper entitled: ‘Exploring the role of communications in quality improvement’.
As Director of Ko Awatea, the Centre for Healthcare Education, Improvement and Innovation at Counties Manukau District Health Board in Auckland, I get the opportunity to work across all kinds of healthcare settings and services to reduce waste, harm and variation in the system.
I am constantly humbled by how much effort teams put into their improvement work. I continue to be fascinated by the programmes that succeed, gain wider buy-in and affect change on both a local and national scale. One of the areas I believe we need to be considering much more is the strategic role of communications to ensure that our improvement work is effective as it can be.
William Edwards Deming, founding father of quality improvement, would be disappointed to discover how many improvement projects in healthcare fail across the world.
Deming developed his approach to improvement when tasked with helping the Japanese motor industry get back on its feet after World War II. He developed a transformative approach to management, the ‘System of Profound Knowledge’ (SoPK). The system had four domains: Systems Thinking, Understanding Variation, Theory of Knowledge, and Psychology. He saw each of these domains growing and changing as our knowledge and understanding of each of these areas grew.
Deming understood the need to align people with larger organisational goals. And he objected strongly to slogans and management directives telling people what to do. He wanted people to be empowered to be motivated and improve systems themselves. I believe he would have embraced strategic communications wholeheartedly and been excited by its potential to support system level change.
Communication is included in SoPK in the psychology dimension of the system. As part of psychology in his system, communication asks questions like:
● How do we encourage adoption of change?
● How do we build will and momentum to change?
● How do we influence culture?
More than ever, we need good ideas to spread to deliver health services that are safe, efficient and the ones that people need and want. Healthcare is hungry for better ways to do things. The six step communications framework we have developed can help us all achieve greater impact and achieve our goals. If you have a great idea, or if your improvement project is showing promising results that others could replicate, I’d urge you to use it. Become as smart at sharing and spreading your work as you are at delivering improvements locally.
You can find out more about the communications in the ‘Exploring the role of communications in quality improvement’ paper – http://www.maneyonline.com/doi/pdfplus/10.1179/1753807615Y.0000000006
Professor Jonathon Gray is the Director of Ko Awatea, and Chair of Healthcare Improvement and Innovation at Victoria University, Wellington. He is also on Twitter @graymattrs.