Step 4

Process Steps Tools What is it? When should I use it? Document

Step 4 – Understand what is happening now


Observations of practice or care

Quality Peer Review handbook

Observations is a powerful way of understanding the culture of the workplace and identifying the pervading priorities considered important in that workplace. Looking at a particular context through different eyes and using the senses is a very different experience to working in a context. The aspects that are taken for granted are often accentuated. You can gain experience of this by participating in one of the Quality peer reviews that take place on a Friday on each site (Link to handbook)

Obseravtions of practice or care

Matrons Summary Feedback July 2015 (3)

Matrons Summary Feedback July 2015

Peer Review Resource Pack

Emotional Touchpoints

Starter kit

Touch points staff Students, patients, relatives, Opd

Learning about compassionate caring through the use of Emotional Touchpoints. Emotional touchpoints focus on what matters to people, be that patients and service users, staff or students.

The following benefits have been identified in using this method to learn about experiences of care:

  • Helps patients and families focus on what matters to them

  • Challenges assumptions about what staff feel is important to patients and their families;

  • Enables development of relationships with patients, families and staff;

  • Helps people to see in a balanced way both positive and negative aspects of experiences;

  • Helps patients and families to be involved in shaping and improving quality;

  • Helps to redress the power imbalance between staff and service users

Emotional Touch Points - Starter Kit

Emotional Touch Points to Learn About the Experience of Receiving Care

Emotional Touch Points - Outpatients

Emotional Touch Points - Patients

Emotional Touch Points - Relatives

Emotional Touch Points - Staff

Emotional Touch Points - Students


Appreciative Inquiry

Appreciative Inquiry is a purposeful solution focused approach that builds in visioning and ways of working where the emphasis is on building on what works well already

Appreciative Inquiry Paper

Statistical Process Control

Activity Analysis

Obtaining data about what is already happening is useful to provide insights to trends and comparisons and seasonal fluctuations. Dash boards are also valuable sources of data than can support pre and post evaluation strategies

Statistical Process control (SPC) is a type of charting that tells us about the variation that exists in the systems that we are looking to improve and is a practical approach to resolving problems

Activity Analysis helps with understanding the processes within a pathway to identify both issues and waste

Activity Analysis

Statistical Process Control


Waste is all the activities that we do that do not add value. There are nine types of waste. 

Use this checklist when reviewing the current pathway and when developing a future pathway. Try to eliminate all waste whilst taking care not to produce new waste.

Key Wastes