Using quality improvement methods to design a weekly ward-based teaching programme.

Introduction: A weekly ward-based teaching programme was designed and implemented using quality improvement methodology. 10 topics were identified to be covered during each 4-month rotation. 1) Topic of the week introduced via a presentation in the weekly teaching session; 2) Daily topic discussions at ward level.

Method: 7 wards. PDSA 1 (weeks 1 and 2): Weekly poster with the topic and a daily fact / question PDSA 2 (week 3 onwards): a) Software introduced to enable interaction in the teaching session b) Departmental WhatsApp used to send out daily questions. PDSA 3: a) New topics selected b) More staff groups added to WhatsApp group c) Questions weekly for each ward to ‘answer’ in the WhatsApp group

Results: Cycle 1 – little daily ward level discussion. Generating discussion in weekly teaching difficult. Cycle 2 - more engagement with both discussions. Variation in (MDT)staff group awareness. Daily teaching not habitual everywhere. Nursing staff more engaged with prompt cards than via Whatsapp. It was clear that each ward should be supported to have a different approach to delivering the teaching. Not all staff could access to weekly teaching sessions. Cycle 3 – more ward level ownership and interaction in the virtual space. The wards that have gained the most benefit from the teaching have made the questions a fixed part within their morning routine and include the entire MDT in five-minute discussion around the questions.

Conclusion: Staff working in these wards were generally positive about the weekly topic style. Having clinical leaders who are invested in teaching can support daily - cooperation and “buy-in” from those in senior roles is crucial for the development of this learning culture. This work has demonstrated some of the challenges of teaching a diverse multidisciplinary team to make information and learning accessible and useful for all.