How do we EQUIP our future GPs to be leaders in improvement? “Awake their curiosity”

14 February 2020

Dr Nigel Hart, Associate Director, GP Training, Northern Ireland Medical and Dental Training Agency & Associate Director for General Practice, Queen’s University Belfast

“Everyone in healthcare really has two jobs when they come to work every day: to do their work and to improve it”; say Paul Batalden and Frank Davidoff, in their paper, ‘What is “quality improvement” and how can it transform healthcare?’.

Because 90% of all NHS patient contacts take place in primary care, that second ‘job’ can make a real difference at scale. So, finding what empowers and activates our future GPs to be leaders in improvement is the great prize with potential to transform healthcare.

The goal is to move from “Know-how” to “Do-how”

The EQUIP (Education & Experience in QUality ImProvement) programme was developed to support geographically dispersed GP trainees to acquire the language, the skills, the tools, and to gain experience to equip them to lead improvement. Using the age-old approach of case-based learning and using video conferencing on the ECHO platform, EQUIP engages GP ST3 trainees into a community of practice where the ethos is “All Teach, All Learn, All Improve” and the goal is to move from “Know-how” to “Do-how”.

The EQUIP logo encapsulates the Q and the I of quality improvement and the PDSA (Plan, Do, Study, Act) iterative cycle of change for improvement that characterises a QI approach. At the centre of the programme (and the logo) is the nurturing of a community of improvers working with and supporting one another to develop and refine their ideas for improvement.

The initial endeavour to formulate a QI training programme for GP trainees in 2016 received affirmation at the end-of-programme “Day of Celebration” in June 2017 (and has done each year since). Trainees stood up with confidence in front of their poster, one by one, took centre stage and said, “Well in my practice we tackled missed appointments...”, “In my practice, we realised that those with gestational diabetes were not adequately followed up”, “ In my practice...”,“In my practice,...”, “In my practice...” This was the point we knew that we had achieved what we set out to do.

Each year the standard of the QI work through EQUIP has improved and the GP trainers are increasingly speaking the language of QI, a fluency gained vicariously from their trainees.

If you would like to know more about EQUIP you can watch our video case study on, the RCGP's quality improvement tool, QI Ready, which is free to access. You can also view a selection of our EQUIP posters.

“Awake their curiosity. It is enough to open the minds, do not overload them. Put there just a spark. If there is some good inflammable stuff it will catch fire.” Anatole France from “Le Jardin d’Épicure” 1894



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