Intended for healthcare professionals


The BMJ Awards 2019: Innovation in Quality Improvement Team of the Year

BMJ 2019; 365 doi: (Published 10 April 2019) Cite this as: BMJ 2019;365:l1653
  1. Jacqui Wise, freelance journalist
  1. London, UK

This year’s finalists are finding new ways to strengthen the quality of healthcare delivery and improve outcomes for patients, finds Jacqui Wise

Flow Coaching Academy

The Flow Coaching Academy grew out of the success of two pieces of work carried out at Sheffield Teaching Hospitals to redesign geriatric care and respiratory care by translating the “Big Room” methodology used by the car manufacturer Toyota.

Four years ago, the Health Foundation approached the Sheffield team to see if they could scale and replicate the approach. The team codified the intervention and produced a one year course to train up pairs of NHS staff—one clinician and one non-clinician—to become coaches.

Each pair of coaches set up a Big Room back at their own hospital to guide staff across a pathway through assessment, diagnosis, aim setting, and testing before implementation of new models of care delivery. Each one hour Big Room starts with a short patient story and the patient voice is integral to the process.

“The skill set the coaches have by the end of the year creates the conditions for true innovation by clinical teams,” says Tom Downes, consultant geriatrician and clinical lead of the Flow Coaching Academy programme.

There are currently 80 active Big Rooms around the country and the results so far are impressive. For example, at Imperial College Healthcare NHS Trust a geriatrician and a manager set up a Big Room for a vascular surgery ward, resulting in discharge rates increasing from 11 to 20 patients a week.

The Flow Coaching Academy uses a franchise model to scale up the intervention. This time next year there will be 11 Flow Coaching academies across the UK, each one training between 24 and 30 coaches per course.

Developing a sepsis strategy

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