4. Getting started and building the project team
This initial stage involves setting up a steering group, recruiting a project facilitator, and developing a step-by-step project plan.
If you are starting a project, the first step is to set up a project steering group. This would include key members of staff from the service and their management team. They are responsible for how the project is organised, and should meet at the following critical stages:
- before the project begins
- before the first feedback event – usually the staff feedback event
- before the joint patient–staff event
- after the celebration event.
This group needs to include a key senior person, who is really enthusiastic and influential, to lead and be accountable for this piece of work. Their support may be needed when improvement ideas touch on areas outside the responsibility of the staff participating in the project.
A key task for the steering group is to recruit a project facilitator. This is a crucial role, as the facilitator is responsible for setting the timeline and making sure everything runs on track. They need to make sure clinical staff and others are involved at the right level, so that individuals do not get too bogged down in the detail.
The facilitator might be a dedicated worker on the project, or this project might form just one element of their day job. Some sites have found it useful to use a facilitator who staff already know, to build trust. Others have used external facilitators. If they are internal, it is important that they are not a colleague who they work with on a daily basis, as they need to be objective – particularly at the interviewing and observation stages. Other projects use experienced facilitators from their organisation’s quality improvement team, to reduce the amount of training needed.
Whoever is chosen, the facilitator needs protected time to manage the process. Activities such as sending out invitations can be extremely time consuming. Typically, facilitators give 40 per cent of their time to a project over a six-month period. For more information about the time needed, see our sample EBCD project timeline.
- Follow good project management principles – particularly in engaging stakeholders. For detailed advice on how to run a project, see the archived NHS Institute project management guide.
- When working out the project timescales, think about how well the patients are. If you’re working with patients who are likely to be unwell, you may need a shorter timeline. To give you an idea of a realistic timeline for a project, see the example project timeline. For more flexible approaches, and other ways of managing the project, see Section 15, Adapting the approach to your budget and accelerated EBCD.
- Make sure facilitators have the capability and capacity to carry out the role effectively. Training may not be necessary, but experience in areas such as management, team leadership, counselling and project management may all be relevant. Making contact with facilitators working on other EBCD projects may provide support. You might like to do this via the EBCD LinkedIn group.
- Keep updating everyone involved at regular intervals so they understand what has happened so far and what will happen next.
- Because EBCD is a service-improvement approach, you do not need to seek research ethics approval. However, it is advisable to notify your local research ethics committee and follow your organisation’s clinical governance and information governance procedures, particularly regarding patient confidentiality and informed consent. (For more information, see the Department of Health Confidentiality Code of Practice and the Royal College of Nursing’s informed consent in health and social care research.)
- When using EBCD with potentially vulnerable groups, the ethical issues arising from the process can be more complex – particularly when it comes to preparing them for, and supporting them through, the co-design stage. The process can be extremely rewarding, but patients, families and staff can find it challenging too, so you need extra preparation. When working with these groups, the steering group or project team should include someone with experience of dealing with the psychological and ethical issues that may arise, such as a clinical psychologist.
- If you are involving external people in undertaking some of the work with you – for example, the interviews – you may need to meet internal policies in the NHS, such as setting up honorary contracts through local R&D departments. These are likely to require Disclosure and Barring Service Checks (previously CRB checks), which can take 6-12 weeks. Make sure you have enough time for these to be processed.
- Put in place some form of social support in case anyone involved in the project is affected by the issues that arise. This could include patients, interviewers, staff, facilitators and those involved in filming and editing.