Please introduce yourself, your job title, how long you've been in your current role, and how long you've worked at HHFT?
I’m Sarah Noble, a Consultant in Emergency Medicine and Associate Medical Director for QI at HHFT. Also, I’m the South-East Regional Clinical Advisor for NHS England and run the deanery Patient Safety Programme for junior frontline staff - an introduction to patient safety, human factors, and quality improvement.
How do you explain your role in the QI team to those that may be unfamiliar with Quality Improvement?
I’m a bit of a nomad – but still very much involved in the QI team and passionate about making sure EVERYONE in the organisation is equipped to make improvements to patient care. I bring our QI Bronze training content to the shopfloor (offering me a chance to plug the videos and scrub sized booklet on the QI Intranet page!), and lead/advocate for organisational projects in a way that demonstrates robust improvement methodology, underpinned by data analysis.
How did you end up where you are now? What has your career journey looked like up to this point?
Alongside my clinical training I have always been interested in delivering improvements not just for individual patients but through developments in the system. This should link to governance which identifies opportunity and need along with a human factors system approach that informs meaningful improvements rather than just telling people to do it better. This has manifested itself in carrying out and mentoring many clinical projects, and more recently leading on multisystem change to improvement pathways for patients in urgent care.
What have been a highlight for you at work recently?
Talking data with NHSE has been super fun. Clinical input to data enables conversations around whether the data answers the questions we are asking - E.g., Bed occupancy showing as 89% (because the denominator includes labour ward and paeds beds) when there are no beds for the 30 patients in ED isn’t helpful - that’s something we’re looking at trying to fix… ideally before winter 
!
Coupled with that bigger picture stuff, I am always energised by projects which are delivered by dedicated teams (often in their ‘spare’ time), just thinking about what they can improve for their patients and then getting on with it – Tim the porter making sure we all know how much oxygen we have for transfer, or the genius who, inspired by gym equipment, put QR codes on our equipment to remind us how to use it when we need it… #EveryoneIsAnImprover!
What would you say to someone who was curious about Quality Improvement and how the tools/methodology could help them in their roles, but were unsure of where to start?
It’s easy to be overwhelmed by tools but it’s not rocket science. I have seen incredible projects succeed with just my favourite approach – the model for improvement. Essentially, answer the questions:
- What are you trying to achieve? (This could be for the patient or the system… what does it look like? This is NOT a solution… yet)
- How are you going to know when you have got there? (i.e., what will you measure?)
- When you have your team together, what can you try to make it happen?
- Get on with it (that does not mean rolling something out, it means testing it for an hour/day/week and seeing what happens – nothing works first time!)
…and the QI academy is there to support you!
