1. Quality Education for a Healthier Scotland Scottish Improvement Skills Influencing colleagues and other stakeholders

2. System of Profound Knowledge Deming 2000

3. Quality Education for a Healthier Scotland Influencing colleagues and other stakeholders By the end of this session you will be able to: Apply frameworks to identify key stakeholders and gain understanding of their needs Plan for positive influencing using reflection, advocacy and inquiry.

4. Stakeholder analysis: RACI matrix Responsible Accountable Consulted Informed

5. RACI matrix: template Title of project, or change idea, or test of change Name Task 1 Task 2 Task 3 Task 4 Task 5 Task 6

6. RACI matrix: example Pulmonary Rehabilitation Programme: Patient Education Materials JohnSueKiranAlexLynAnna Write material ARCCCI Arrange design and print AR Distribution to GP practices ACR Data collection AAR Data analysis AAR Reporting ARCIII

7. Quality Education for a Healthier Scotland Planning communications Stakeholders Purpose of communication Key messages to be communicated Timing of communication How to communicate Who is responsible for communication.

8. Influencing: Ladder of Inference

9. Quality Education for a Healthier Scotland Your Story Something similar has happened to all of us. What’s your story?

10. Example Hand hygiene

11. Quality Education for a Healthier Scotland Example: Hand Hygiene In a corridor near the door to a clinic. A handwash gel dispenser is on the wall by the door. Liz approaches the door. Chris is just beyond the door, along the corridor, holding a clipboard. Liz uses the gel dispenser and rubs a dose of gel into her hands. She steps towards the door. Chris says ‘Excuse me, can I …’. Liz says ‘Sorry, I’ve been bleeped,’ and goes t through the door.

12. Quality Education for a Healthier Scotland Observable Data Data I select Meanings Assumptions Conclusions Beliefs Actions

13. Quality Education for a Healthier Scotland Observable Data Data I select Meanings Assumptions Conclusions Beliefs Actions Chris is standing in the corridor holding a clipboard. The gel dispenser is on the wall by the door.

14. Quality Education for a Healthier Scotland Observable Data Data I select Meanings Assumptions Conclusions Beliefs Actions A clipboard means collecting data. We’re supposed to use the hand gel before going through the door. Chris is standing in the corridor holding a clipboard. The gel dispenser is on the wall by the door.

15. Quality Education for a Healthier Scotland Observable Data Data I select Meanings Assumptions Conclusions Beliefs Actions It’s an audit on use of handgel. A clipboard means collecting data. We’re supposed to use the hand gel before going through the door. Chris is standing in the corridor holding a clipboard. The gel dispenser is on the wall by the door.

16. Quality Education for a Healthier Scotland Observable Data Data I select Meanings Assumptions Conclusions Beliefs Actions There’ll be trouble if people don’t use the gel. It’s an audit on use of handgel. A clipboard means collecting data. We’re supposed to use the hand gel before going through the door. Chris is standing in the corridor holding a clipboard. The gel dispenser is on the wall by the door.

17. Quality Education for a Healthier Scotland Observable Data Data I select Meanings Assumptions Conclusions Beliefs Actions They treat us like children. They don’t trust us to do the right thing. There’ll be trouble if people don’t use the gel. It’s an audit on use of handgel. A clipboard means collecting data. We’re supposed to use the hand gel before going through the door. Chris is standing in the corridor holding a clipboard. The gel dispenser is on the wall by the door.

18. Quality Education for a Healthier Scotland Observable Data Data I select Meanings Assumptions Conclusions Beliefs Actions I’ll show them. I won’t give anyone a reason to find fault. I’ll use the gel – as usual. I won’t talk to her about it. They treat us like children. They don’t trust us to do the right thing. There’ll be trouble if people don’t use the gel. It’s an audit on use of handgel. A clipboard means collecting data. We’re supposed to use the hand gel before going through the door. Chris is standing in the corridor holding a clipboard. The gel dispenser is on the wall by the door.

19. Quality Education for a Healthier Scotland Example: Hand Hygiene In a corridor near the door to a clinic. A handwash gel dispenser is on the wall by the door. Liz approaches the door. Chris is just beyond the door, along the corridor, holding a clipboard. Liz uses the gel dispenser and rubs a dose of gel into her hands. She steps towards the door. Chris says ‘Excuse me, can I …’. Liz says ‘Sorry, I’ve been bleeped,’ and goes t through the door.

20. Quality Education for a Healthier Scotland Observable Data Data I select Meanings Assumptions Conclusions Beliefs Actions

21. Quality Education for a Healthier Scotland Observable Data Data I select Meanings Assumptions Conclusions Beliefs Actions Liz is approaching the door. She’s using the hand gel.

22. Quality Education for a Healthier Scotland Observable Data Data I select Meanings Assumptions Conclusions Beliefs Actions Using the hand gel is good practice. Liz is approaching the door. She’s using the hand gel.

23. Quality Education for a Healthier Scotland Observable Data Data I select Meanings Assumptions Conclusions Beliefs Actions She knows why she uses it. Using the hand gel is good practice. Liz is approaching the door. She’s using the hand gel.

24. Quality Education for a Healthier Scotland Observable Data Data I select Meanings Assumptions Conclusions Beliefs Actions She can tell me why she uses it. She knows why she uses it. Using the hand gel is good practice. Liz is approaching the door. She’s using the hand gel.

25. Quality Education for a Healthier Scotland Observable Data Data I select Meanings Assumptions Conclusions Beliefs Actions She won’t mind me asking her about it to help develop ideas for my improvement project. She can tell me why she uses it. She knows why she uses it. Using the hand gel is good practice. Liz is approaching the door. She’s using the hand gel.

26. Quality Education for a Healthier Scotland Observable Data Data I select Meanings Assumptions Conclusions Beliefs Actions I’ll stop her and go through the survey questions with her. She won’t mind me asking her about it to help develop ideas for my improvement project. She can tell me why she uses it. She knows why she uses it. Using the hand gel is good practice. Liz is approaching the door. She’s using the hand gel.

27. Quality Education for a Healthier Scotland Observable Data Data I select Meanings Assumptions Conclusions Beliefs Actions

28. Quality Education for a Healthier Scotland Observable Data Data I select Meanings Assumptions Conclusions Beliefs Actions

29. Quality Education for a Healthier Scotland Observable Data Data I select Meanings Assumptions Conclusions Beliefs Actions

30. Quality Education for a Healthier Scotland Observable Data Data I select Meanings Assumptions Conclusions Beliefs Actions

31. Quality Education for a Healthier Scotland Observable Data Data I select Meanings Assumptions Conclusions Beliefs Actions

32. Quality Education for a Healthier Scotland Observable Data Data I select Meanings Assumptions Conclusions Beliefs Actions

33. Quality Education for a Healthier Scotland Observable Data Data I select Meanings Assumptions Conclusions Beliefs Actions

34. Quality Education for a Healthier Scotland Observable Data Data I select Meanings Assumptions Conclusions Beliefs Actions Reflexive Loop

35. Quality Education for a Healthier Scotland Your Own Example 1.What action did you take, or what did you say? 2.What beliefs was that action based on? 3.What conclusions led you to those beliefs? 4.What assumptions did you make? 5.What meanings did you add? 6.What data might have been available that you selected out?

36. Quality Education for a Healthier Scotland Observable Data Data I select Meanings Assumptions Conclusions Beliefs Actions Reflexive Loop Reflection Advocacy Inquiry

37. Influencing colleagues and other stakeholders: summary RACI matrix Communications plan Ladder of Inference: Reflection Advocacy Inquiry

38. Quality Education for a Healthier Scotland References and further resources Senge, Peter M, 1994 The Fifth Discipline Fieldbook: Strategies for Building a Learning Organisation Nicholas Brealey Publishing