A Practical Guide to Quality Improvement for Burn Care


Change is not easy Implementing change is not easy and might not go to plan for a number of reasons. Here are some of the reasons why change doesn’t happen: • More of the same – if people are not used to change, they will suggest more of the same, more people, money, equipment, as the solution. But until you really understand the root of the problem you cannot know if this is the right solution – sometimes it doesn’t need more resources, it needs a new way of working. • Adding more inspection or auditing – this might be another first response that colleagues will suggest, but is not always the solution as it is likely that this does not tackle the root of the problem. This might unnecessarily increase workload or decrease motivation. • Adding more procedures – it is easier to add to an existing system than to change it, but you need to be careful not to end up with an unnecessarily increased workload. Try to think of the whole system and of the long-term sustainability. • Focus on individuals rather than the system – for change to be sustainable, often it is the system that needs to change. Individuals might need training to change with it, but do not focus your change on them. • Searching for the perfect change can stop people implementing any change – however, there will always be unintended consequences and side effects, so while anticipating barriers, testing concrete changes is most important way to make progress. Start by making small incremental changes and scale up once you know these work. How do you get your team on board? Once you have designed your strategy for change, you will also need to consider how you will communicate your intended changes. It is crucial to any QI project that stakeholders are motivated to listen and be part of the changes you are suggesting.

Example : Richard gave presentations in his hospital to a wide range of stakeholders to communicate his project, as you can see in this photo. He also practiced an ‘elevator pitch’, which is a short message to sell your project (i.e., if you ever find yourself in the elevator with the Director of the hospital and you have two minutes to convince him or her to support your project, what would you say?) Find Richard’s elevator pitch here.

You can see some other examples in Olive & Ziphilly’s project strategy above. They created a motto for their project and they kept track of the best documenter of the month. Such ideas keep interest going and motivate people to stay involved.


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