Following the first wave of Covid, I was involved in a trust project to capture key learning to assist with planning for the second wave and inform organisational culture in the longer term. This piece discusses my involvement in the work and reviews the tools that we used to capture learning.

The Task and Finish Group
A multidisciplinary group was established in May 2020 to capture learning from Covid. The group was led by the Director of Continuous Improvement and included membership from Strategy and Planning, Continuous Improvement, Governance, Organisational Development, Business Improvement, Advancing Quality Alliance, the Integrated Care Partnership (ICP) and yours truly. The intention was to complete the learning capture quickly and share approaches across the ICP; weekly meetings were established to facilitate this.

Our Approach

There were four stages to capturing the learning and I was involved in the first two and will have a role in the fourth.

Initially we conducted interviews and focus groups with all departments including both clinical and non-clinical staff. I was aligned to the Corporate Division and conducted nine interviews with a range of teams and individuals. There were many common themes arising from the interviews, such as the importance of communication from the senior leadership team and the ability to introduce innovation at pace. A member of the Continuous Improvement team thematically analysed the data obtained from 50 interviews in total. I was part of the small group who pulled together a report for the Executive Management Group, which I presented together with my colleague from Continuous Improvement.

The Interview tool
We used a free open access learning framework (Collaborate CIC, 2020) to capture the learning. The tool itself is divided into two sections. Part one includes eight questions which consider core changes and their impact at individual, organisational and system levels. The second section provides a framework to reflection on five key themes such as leadership, behaviours and collaboration. Each interview took approximately 45-60 minutes and the tool provided a useful guide to the discussion. As the tool was so comprehensive, it did generate some repetition across responses, so to help reduce the length of the interviews we didn’t use many of the prompts.

The Pre-Mortem Approach
Another approach that was used for information capture was the pre-mortem. Unfortunately, I wasn’t able to attend on the day, but it was used across the ICP to capture learning. The pre-mortem is essentially an opportunity for people to come together and to think about the worst case scenario. In this instance, the question would be if we have a second wave of Covid what are the many things that could go wrong? Once a range of problems are identified, these are assessed against the real world scenario to see if any improvements need to be introduced. It was quite time consuming with a large group, but would work well with a small team about to embark on a new project.

Next Steps
Now that we are in the second wave, much of the learning has been embedded within existing processes and has informed organisational change. Findings from the learning are also being aligned to the trust programme review and will be embedded within our strategy. It has been great being involved in this type of project, working quickly to capture knowledge and using that to make tangible organisational changes. The challenge will be to ensure that momentum continues and that the learning makes a difference and we close the learning loop. I will continue to be involved in the project and our next steps will be to help disseminate the learning more widely across the organisation and to co-author an article about the experience.

Collaborate CIC (2020) Learning from COVID-19: A tool for capturing insights now to shape the future.
Klein (2007) Performing a Project Premortem. HBR

Tracey Pratchett
Knowledge and Library Service Manager
Lancashire Teaching Hospitals NHS Foundation Trust