Step 4: Develop working groups to carry out the improvement work

Once you have identified the state of the current experience, it is time to develop effective working groups, to involve staff from across the organisation in creating change.

The first step is to agree on the breadth of functions within the organisation that should be included in the working groups. For example, they might include housekeeping staff, porters, ICT and human resources. The administrative champion sends out a letter inviting the selected candidates to be on the working group. (See PFCC invitation for working group - letter template)

Key roles in each working group are listed below.

  • One or more clinical leads or team leaders – to give direction, set objectives, lead the team towards clear goals and empower members to bring new ideas, speak up, resolve conflict and promote good teamwork. Ideally, this role should be carried out by medical staff, to ensure medical engagement.
  • Ward or clinic champion – a sister or staff nurse to lead the ward team in a new pathway approach and organise training and support for staff.
  • Key contact – a general manager to organise the team, bring them together, and ensure that action notes, plans and reports are completed.
  • Scribe – someone to take notes and circulate action points.
  • Team members – a range of staff whose contributions depend on their skills and knowledge so they can work together in the team towards the team’s aims. It is useful to include people with experience of improvement methods and project management skills.

At the first meeting, you need to introduce the PFCC method. You then share any intelligence about the current state of the care experience (gathered during Step 3). Also establish whether there are any resources available to make changes. You can prepare this information as a pack, which members can take away. The group then commits to returning with a detailed view of the current experience of patients. For examples of how members might go about this, see the PFCC Go Guide.

Key points

  • Who you recruit to the working group will depend on what patient experience you are working on. For example, a surgical experience might include a consultant surgeon, consultant or senior anaesthetist, general manager or matron, specialist nurse, ward nurse, physiotherapist and/or occupational therapist, pre-op assessment nurse, theatre or recovery staff, trainee doctor, and ideally a patient.
  • It is critical that you involve medical staff, in order to encourage medical engagement. This will make a huge difference to the success of the work.
  • Involve a consultant in the leadership role, or at least as a member of the working group. This is because they are involved at multiple stages of the patient journey and often in a clinical decision-making role.
  • For the first four meetings, the group should meet weekly, at the same place and same time, to build momentum. After this time, meetings should be held at least every fortnight, but they don’t need to be long – 30 minutes should be sufficient. This is because the meetings are action-focused, rather than a forum for discussion.
  • At the first meeting, book in dates for meetings for the coming year. This demonstrates commitment to see the project through to completion.
  • Keep meetings short and sharp and make it clear that members are expected to attend every time.
  • Make a note of action points from every meeting, and circulate them. This helps maintain momentum, creates a record of the work as it progresses, and keeps members focused on their tasks.
  • Set up a team email group to circulate information and tasks and make sure all members are kept in the loop, as well as a shared drive facility for sharing documents.
  • It is a good idea to arrange for the guiding council meetings to take place directly after each working group, so members can debrief and plan next steps.

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