Delivering quality improvement coaching in a virtual world: the use of digital technology to empower and engage CFDigiCare clinicians to undertake quality improvement activities nationally

Carolan, C.; Dawson, S.; Cunningham, J.; Choyce, J.; Tugwell, A.; Faulkner, J.; Barnett, T.; Thomas, M.; Gledhill, H.; Anderson, A.; Tature, D.; Szczepanski, R.; Lowther, M.; Pickering, N.; Daniels, T.; Galey, P.; Wildman, M.

Background: CFDigiCare is a community of practice using digital adherence data, FEV1 and BMI to inform clinical decision-making and comprehensive digital behaviour change tools to support patient self-care. The 16 UK adult CF centres that form CFDigiCare work together using improvement science to embed digital data into routine care. The collaborative uses the Dartmouth Microsystems approach to build quality improvement (QI) capability Most CFDigiCare teams attended a one-day class-based QI training pre-COVID-19, with subsequent coaching delivered online. We discuss digital QI refresher training and coaching to the nationally dispersed improvement collaborative during the COVID crisis. Methods: 1-hour QI refresher training was delivered via MS Teams. Dartmouth improvement ramp activities were undertaken during subsequent 3 sessions. Results: Average attendance was 9. We explored two areas for improvement, teams participated in group ‘Fishbone’ exercises, silent brainstorming, discussed change ideas and planned PDSA cycles. Staff rated the meetings 9.4/10, commenting: • Useful QI demonstration and collaboration of ideas • Jamboard is a useful tool for gathering ideas • Can deliver it to the team • Good feedback for PDSAs Attendance was high with staff valuing practical interactive sessions using facilitated MS Teams calls and tools such as Google Jamboard. Virtual sessions connected clinicians from 16 centres providing a national “hive brain” perspective on system optimisation. The Dartmouth microsystems paradigm focused attention on specific aims, providing a structure to deliver iterative change. Virtual connectivity allowed QI to continue despite COVID-19. Familiarity with MS Teams increased over time with shared mastery of the technology a clear improvement outcome. Conclusion: Digital technology not only supports the delivery of QI training and coaching but can enhance it;clinical teams quickly mastered platforms such as MS Teams and Google Jamboard.