Spring is here in the Okanagan. I can’t say that our winter was hard compared to most of the country, but it is still lovely to pull out the patio furniture, see the flowers popping up and to pack away the ski gear and put on the bike rack. For me, it’s also a time to think about what worked last summer and what didn’t and how I could make my patio more of my “happy place”.
I’ve been thinking more intentionally about improvements lately because I’ve been taking the Institute for Healthcare Improvement (IHI) courses in quality improvement and evaluation. Having worked in health care engagement for over a decade, I felt it was high time to get more familiar with the process and content of quality improvement with formal training. But thinking about quality improvement specific to health care has also led me to thinking about quality improvement in engagement, both within and outside of the healthcare sector.
A consistent message from IHI is: “All improvement requires change, but not all change is improvement.” How we plan, facilitate and report on engagement changes and evolves, but the question is: does it make for better engagement, and how would we know?
IHI asks healthcare professionals across the system to ask: What are we trying to accomplish?
Taking quality improvement to engagement, we could ask the same question. What are we trying to accomplish? Maybe it’s to engage more young families, youth or people who experience barriers to participation.
The next question is: How will we know a change is an improvement? Is this about participation rates increasing, the degree to which participants describe the engagement as accessible, convenient, fun or “easy”?
The last big IHI question (though there are many) is: What change can we make that will result in an improvement? In our engagement example, this might mean trying different venues to host an engagement, trying different times of day, partnering with community groups who serve specific community members, such as youth, newcomers, or young families or directly partnering with youth to plan an engagement that looks and feels tailor-made for them, by them.
When thinking about quality improvement in engagement, I think there are a few starting points that engagement practitioners could be asking of themselves and their teams.
- What is hard or not working that could be better?
For example:
- We engage only with the very loud or the very familiar faces.
- We don’t get a broad representation of people participating who are impacted.
- Our information is consistently misunderstood.
- What would better look like?
For example:
- We engage with new faces and new perspectives.
- We learn from a more representative sample of those impacted by the initiative.
- We don’t need to myth-bust; we get questions based on factual information.
- What ideas could we test to see if a change results in improvement?
For example:
- We host the engagement at a youth drop-in centre.
- We do impact assessment, so we truly understand what people and groups are impacted by the initiative.
- We develop consistent key messages, infographics and host briefing sessions with leadership.
- How do we evaluate the change?
For example:
- Participating numbers at the new venue.
- We engaged with representative people and groups of those impacted.
- Media reporting was factual.
- How will we institute or “formalize” a new practice?
For example:
- We will develop a list of diverse community venues and integrate venue selection into our engagement planning process.
- We will consistently plan an impact assessment workshop with all internal departments before planning the engagement methods and note it as a procedure in our step-wise approach.
- We will develop a communications plan template that will be consistently developed concurrently with the engagement plan and provide staff training annually on how to complete the template.
I have increasingly noticed that there is less time, money and staff available to “do” engagement which means that we need to meet the expectations of communities and decision makers with the same or fewer resources, but with increasing expectations. This means we need to rethink the quality of our engagement and look for micro improvements along the way.
As for me, my patio micro improvements look like moving the side table to hold my morning coffee and a lovely basket to hold all my journals!
Happy Spring, Jessica