Building a QI Infrastructure Critical Friend Visit
NHS X
Date
Sample Agenda with commentary
Time: / From 13:30- 16:30 (Sandwich lunch for all at 12:30 – critical friend team pre meet from 12 noon)Venue: / x- at discrimination of the host
Item / Agenda Item / Lead / Time / Mins
1 / Welcome and introductions / Team Chair / 13:30 / 5 min
2 / Background to the programme* and context – see Chair’s notes / 13:35 / 10 min
3 / Brief welcome / Board Chair ** / 5 mins
4 / Critical friend team lead discussion on the completed QI diagnostic tool and additional material – usually starts ‘how did you complete the tool?’ / Team Chair / 13:50 / 20 min
5 / Discussion with the critical friends on specified topic
Eg Leading QI This uses an appreciative inquiry approach, with discussion and provocations / Team Chair / 14:10
6 / ‘Floating’ Break This is designed to happen at a natural break in the exchange / 20 min
7 / Discussion with the critical friends on specified topic
Eg Building QI capacity (and subsequent teaching skills)
This session often returns to the themes identified in the earlier exchange as the conversation deepens– it is important to allow space and time for reflection / Team Chair
8 / Teams separate for debrief On most occasions the key themes identified by both the critical friend team and the host team are identical / 16:00 / 15 min
9 / Reflections together on the visit
It is not within the ethos of the visits to have a challenge to action unless the Board volunteers this / Team Chair / 16:15 / 10 min
10 / Close of visit / 16:30
Contact: Support to Critical Friend team email and telephone no
Appendix (other materials supplied to all attendees)
1. Critical Friend Team biographies
2. List of attendees from NHS board
3. Completed QI diagnostic tool
4. Supporting material eg latest NHS board report (this is not ‘evidence’ and is minimal – 2 or 3 key documents)
Comments
1. This is a draft agenda for a small critical friend visit with only two broad areas of discussion. Visits with more topics and a slightly bigger team may last up to 3.5 hours.
2. The agenda should have no more than three topics unless subgroups are used to ensure critical friend expertise is properly accessed.
3. Some host boards may wish to design their agenda around three or four topics and if this is the case we suggest subgroups for different conversations with specific critical friends allocated to each topic. This presupposes sharing of intelligence after the visit.
4. Lunch or coffee beforehand and breaks for everyone together are a good way of supporting networking and positive exchange.
5. The roving break allows the chair to suggest a break at a natural point in the exchange. Some visits with more topics and more critical friends had two short breaks but the rule of thumb is that the design of the visit should allow space and time. A cluttered agenda with strict times inhibits this.
6. A premeeting for half an hour before the lunch for the visiting team gives the team the opportunity to firm up their thinking around questions, roles and who will lead on what area. They will already have spoken together on the premeeting telephone call.
7. If critical friends from outside the NHS or outside Scotland are used the team leader may incorporate a short question and answer session or give the critical friend the opportunity to speak for a short period during one of the discussion sessions to ensure this voice is heard and expertise shared.
8. The host board needs to be reminded that this is not a ‘show and tell’ exercise and that the point is to convene busy people who often do not have time to exchange and to allow space and time for reflection.
9. The visit usually starts with a description of how the QI diagnostic tool was completed and how the exercise had contributed to the thinking.
Venue and practical considerations
· Ideally the critical friend visit is not undertaken with a board room style seating. Dispersed tables where everyone can see everyone speak allows for more movement and informality mirroring the ethos of confidentiality and openness.
· The visiting team are dispersed through the host board attendees to facilitate discussion and a supportive ethos.
· Natural light, flexible seating, and access to refreshments through the visit have all been appreciated elements of the critical friend visits.
* Programme – the critical friend visits in NHSScotland (2014-2016) were part of a programme which had a wider series of activities including a national event to launch the programme, QI Executive leads meetings and masterclasses for the QI Executive Leads.
It is anticipated that a self assessment followed by a critical friend visit could be an activity which any organisation could use to assess its position in relation to Quality Improvement, independently of being part of a programme.
**Board chair- usually the Chief Executive or the QI Executive Lead
Team chair – requested by the host team.
File Name: Sample agenda with comments / Version: 1.0 / Date: XXX