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Leading Change in Health Services

Module description

In this module, you will develop a critical awareness of the different ways of working with multiple stakeholders to change practice, implement innovation, and improve health care. You will develop skills in Quality Improvement and critically consider how routine data, the communication of knowledge, and reflective practice can contribute to achieving evidence-based change in health services

Module aims - intentions of the module

You will develop the skills to use Quality Improvement tools and techniques as well as identifying and appraising the leadership skills and personal qualities required to do so. The module will enable you to develop a detailed strategy for achieving change in an area of health care practice. You will critically consider how research evidence, learning from reflection, and locally-generated data can be integrated to achieve evidence-based change in practice.

Intended Learning Outcomes (ILOs)

ILO: Module-specific skills

On successfully completing the module you will be able to...

• 1. Understand how iterative testing can be applied in health care and other settings to achieve evidence-based change
• 2. Engage actively with data sources and informatics for surveillance and monitoring to identify challenges and solutions

ILO: Discipline-specific skills

On successfully completing the module you will be able to...

• 3. Develop reflective practice skills that facilitate collaborative working with diverse stakeholders to achieve improvements in practice
• 4. Develop a detailed strategy for the application of quality improvement and leadership in an area of professional practice

ILO: Personal and key skills

On successfully completing the module you will be able to...

• 5. Critically apply Quality Improvement approaches to achieve change in complex organisations
• 6. Reflectively and strategically plan own role as a leader and team member to deliver improvement within an organisation or area of professional practice

Syllabus plan

Whilst the module’s precise content may vary from year to year, an example of an overall structure is as follows:

Quality Improvement: Tools, techniques, and measures

Making critical use of routine and ‘big’ data

Communicating knowledge and reflective practice

Bringing it all together: Leadership, improvement and team working

Student presentations

To accommodate current teaching restrictions:

Face-to-face scheduled lectures may be replaced by short pre-recorded videos for each topic and/or brief overview lectures delivered via MS Teams/Zoom, with learning consolidated by self-directed learning resources and ELE activities. 

Small-group discussion in tutorials and seminars may be replaced by synchronous group discussion on Teams/ Zoom; or asynchronous online discussion. 

Workshops involving face-to-face classroom teaching may be replaced by synchronous sessions on Teams/Zoom; or Asynchronous workshop activities supported with discussion forum.

Learning activities and teaching methods (given in hours of study time)

Details of learning activities and teaching methods

Formative assessment

Summative assessment (% of credit)

Details of summative assessment

Details of re-assessment (where required by referral or deferral)

Re-assessment notes

Same as for the original summative assessment, to include response to the written feedback and undertaken during the University’s agreed referral/deferral period.

Indicative learning resources - Basic reading

Aarons, G. A., M. G. Ehrhart, L. R. Farahnak and M. Sklar (2014). "Aligning leadership across systems and organizations to develop a strategic climate for evidence-based practice implementation." Annu Rev Public Health35: 255-274.

Braspenning, J., Hermens, R., Calsbeek, H. et al. (2013) Quality and safety of care: the role of indicators. In: R. Grol, M. Wensing, M. Eccles & D. Davis, eds., Improving patient care: The implementation of change in health care. pp.3-135, Oxford: Wiley Blackwell/ BMJ Books

Jeffcott, S.A., Ibrahim, J.E. and Cameron. (2009) Resilience in healthcare and clinical handover. Quality and Safety in Health Care 18:256-260

Langley, G.J, Moen, R.D, Nolan, K.M et al (2009) The Improvement Guide. San Francisco, CA: Jossey-Bass (Parts 1 and 2 and Appendix A and B)

Manojlovich, M., J. E. Squires, B. Davies and I. D. Graham (2015). "Hiding in plain sight: communication theory in implementation science." Implement Sci10: 58

Marshall, M., C. Pagel, C. French, M. Utley, D. Allwood, N. Fulop, C. Pope, V. Banks and A. Goldmann (2014). "Moving improvement research closer to practice: the Researcher-in-Residence model." BMJ Quality & Safety23(10): 801-805.

Morgan, L., S. New, E. Robertson, G. Collins, O. Rivero-Arias, K. Catchpole, S. P. Pickering, M. Hadi, D. Griffin and P. McCulloch (2015). "Effectiveness of facilitated introduction of a standard operating procedure into routine processes in the operating theatre: a controlled interrupted time series." BMJ Qual Saf 24: 120-127

Ovretveit, J. (2010). "Improvement leaders: what do they and should they do? A summary of a review of research." Qual Saf Health Care19(6): 490-492.

Provost, L.P & Murray, S.K (2011) The Health Care Data Guide: Learning from data for improvement. San Francisco, CA: Jossey-Bass

Power, M., Wigglesworth, N. et al. (2010) Reducing Clostridum difficile infection in acute care by using an improvement collaborative. BMJ 341:c3359

Sumner, P., S. Vivian-Griffiths, J. Boivin, A. Williams, C. A. Venetis, A. Davies, J. Ogden, L. Whelan, B. Hughes, B. Dalton, F. Boy and C. D. Chambers (2014). "The association between exaggeration in health related science news and academic press releases: retrospective observational study." BMJ349: g7015

Taylor, M. J., C. McNicholas, C. Nicolay, A. Darzi, D. Bell and J. E. Reed (2014). "Systematic review of the application of the plan-do-study-act method to improve quality in healthcare." BMJ Qual Saf 23(4): 290-298.

Yau, N. (2011) Visualise this: the flowing data guide to design, visualisation, and statistics. London: John Wiley & Sons

Indicative learning resources - Web based and electronic resources

ELE – https://vle.exeter.ac.uk/course/view.php?id=6667

Key words search

Leading change, Health services, Quality Improvement