Jul 112018

Kate Mackenzie leading a team trust exercise!

We all know someone who always seems to have boundless energy, a drive that puts Audi to shame. Someone who seems to stuff more into a week than most can in a month – you know the type…the ones with a massively busy job, hectic family with at least 2 dogs and a rescue cat, a baking habit and a highly successful allotment (or amateur dramatics club).

Simply put they are a tour de force (that’s force not France…I won’t stray into cycling analogies). It is precisely these Tours de Force that generally won’t stand for max effort for substandard outcomes and embark upon “sorting things out” or what we like to call “improvement projects”. These are the magicians that yank their metaphorical boots up, declare very loudly that it’s time to change and generally cajole their peers, teams, colleagues to follow suit.

And if that doesn’t work they beg and plead with detractors or pull some supernanny tricks to get them to fall in line (naughty step anyone?). It can be quite a thing to witness.

Problem is that it can quickly become their pet project, their thing, their baby to drive – it is quickly evident in language used “I have to go to a meeting for Chris’ thing” or I need to record some info in Avril’s tool”.

And so for all their success, the Tour de Force worries that it hinges on them being there.

All. The. Time.

And it can. But it needn’t.

Good communication in the early days to make others believe (arghh…the data girl is banging on AGAIN about talking) or identifying another TdF in the midst is a great way of doing a double flanking manoeuvre on the less enthusiastic. It certainly shares the load.

I think great leadership for improvement is about never wavering from your core message, never swaying away from the non-negotiables. Key to the last bit is actually knowing what these are, so that the other stuff, well – let others achieve those in whichever way they choose. Your colleagues are free thinking adults, treat them as such and remember just because you have the drive doesn’t mean you have all the good ideas.

Most importantly drip feed….drip…drip…drip. Same language. Same concepts. If it’s good, it will stick – with or without your presence.

We in 1000 Lives Improvement are always on our own improvement journey, we want to make sure we are using our skills and talents to their best. We had a substantial reboot, 3 years ago heralded by the arrival of an uncompromising English man, very tall, quietly spoken and rather stubborn. He was absolutely insistent about aligning with IHI’s model for improvement and frankly OTT about measurement.

His homeland has come calling and he has answered, leaving our fair and sunny shores. I can’t tell you how many people have asked what will become of 1000 lives improvement without Aidan. Truth is, we know which bits are ingrained in us, which bits still need working on and, of course, there maybe a thing or two that we might revise/quietly let slip.






It’s an entirely backhanded compliment (but meant in the best possible way) to say “Boss, it’s okay, we don’t need your presence to carry on the great work you started, we got this”

That’s leadership.

Nov 172017

Kate Mackenzie, Senior Measurement Improvement Manager

So my last blog was about hard-nosed numbers…facts, figures and full of great (!) advice like “Know your baseline” (please follow that one). Perhaps I came over a bit too ‘Wall street’ and you have visions of being stuck to a calculator or spreadsheet? If I did, then I hope you shouted at your screen that chasing numbers can often lead to trouble. And it can…I am with you on that one…IF it’s the only thing that is considered.

So what else is there? What can you do to ensure that your improvement project is not boiled down to one dry number?

Time to go jackanory.

What are you telling your patients, your colleagues, your bosses? How are you communicating? How often?

My answer to these questions is generally lost in an arm-waving fluff and bluster. What’s your response?

For anyone who has undertaken improvement training*, you can be under no illusion that time spent on developing a clear measurement plan is time well spent. But how many of us expend the same energy or time on planning our communications? Isn’t it just talking?

I wonder if you are pondering the questions posed above or rather querying why a data bod is talking about talking.

The thing is comms and measurement aren’t such different beasts when it comes to planning.

Take, for instance, the 6 questions that my wonderful communication colleague, Andrew Cooper has developed for “communications for improvement”

And now if you were to talk to me about your measurement plan:

Okay – there is some different terminology, but the key elements aren’t so different.

So just like Astaire and Rogers made a match whilst Ella Fitzgerald mused whether to just call the whole thing off, comms and measurement are happy bedfellows… perhaps even a new tweetably attractive combination of “commeasurement”.

By planning your communications strategy in tandem with measurement plan, it can actually save you time as you are explore the same questions from two aspects rather than undertaking separate tasks. And there is likely to be crossover – for instance, you may need to track twitter activity if you are raising awareness. And you definitely will need to present your data to someone, somewhere. To be effective, you need to think of the full picture in order to position yourself in that sweet spot of “Change” – where people understand and are engaged to do something differently and want to improve.

With thanks to the Scottish Improvement Leaders Course for introducing me to Brent Dykes: https://www.forbes.com/sites/brentdykes/2016/03/31/data-storytelling-the-essential-data-science-skill-everyone-needs/#39bc0e1a52ad

In this seemingly fear-mongering age, some might immediately declare that you are doomed if you neglect one of these but I prefer to say you are a stronger force for improvement when you appeal to the hearts AND minds of your team, patients, bosses.

If you are despairing of now needing to factor in yet another thing into your planning, here is a handy video to help remind you of those key steps…

Happy commeasuring!

*Big up for Improving Quality Together colleagues (if you haven’t already then please check out the website: Bronze training is an online cracker)

Nov 172017

Kate Mackenzie

Roedd fy mlog diweddaraf yn trin a thrafod rhifau oer a chaled…ffeithiau, ffigurau a chyngor gwych (!) megis “Byddwch yn ymwybodol o’ch llinell sylfaen” (mae’n werth dilyn y cyngor hwn). Efallai fy mod wedi swnio ychydig fel rhywun ar ‘Wall Street’, a’ch bod yn dychmygu eich hun yn gaeth i gyfrifiannell neu daenlen? Os felly, yna rwy’n gobeithio eich bod wedi gweiddi at y sgrin bod rhedeg ar ôl rhifau yn gallu arwain at bob math o drafferthion. Ac yn wir fe all…rwy’n cytuno’n llwyr â chi…OS mai dyna’r unig beth a gaiff ei ystyried.

Felly beth arall sydd yna? Beth allwch chi ei wneud i sicrhau nad un rhif sych yw hanfod eich prosiect gwella?

Mae’n amser stori.

Beth ydych chi’n ei ddweud wrth eich cleifion, eich cydweithwyr, eich penaethiaid? Sut ydych chi’n cyfathrebu? A pha mor aml?

Yn gyffredinol, mae fy ateb i’r cwestiynau hyn yn cael ei golli mewn pwl o chwifio breichiau a rhefru di-sail. Beth yw eich ymateb chi?

I unrhyw un sydd wedi cymryd rhan mewn hyfforddiant gwella*, fe wyddoch fod treulio amser yn datblygu cynllun mesur clir yn ddefnydd da o amser. Ond sawl un ohonom sy’n buddsoddi’r un faint o egni neu amser yn cynllunio’r hyn rydym yn ei gyfathrebu? Onid siarad yn unig yw hynny?

Tybed ydych chi wrthi’n ystyried y cwestiynau a ofynnwyd uchod neu’n cwestiynu pam mae person data yn sôn am siarad.

Yn y bôn, nid yw cyfathrebu a mesur mor wahanol i’w gilydd pan mae’n fater o gynllunio.

Ysytyriwch, er enghraifft, y 6 chwestiwn mae fy nghydweithiwr cyfathrebu gwych, Andrew Cooper,  wedi’u datblygu ar gyfer  “cyfathrebu er mwyn gwella ansawdd”

  1. Beth ydych chi eisiau ei gyflawni?
  2. Beth sydd ei angen arnoch i ennyn diddordeb?
  3. Beth mae angen i chi ei ddweud?
  4. Sut byddwch chi’n cyrraedd eich cynulleidfa?
  5. Sut byddwch chi’n ennyn diddordeb eich cynulleidfa?
  6. Beth fyddwch chi’n ei ddysgu ar gyfer y tro nesaf?

A phe byddech yn siarad â mi am eich cynllun mesur:

  1. Beth ydych chi eisiau ei gyflawni?
  2. Beth yw’r sefyllfa bresennol?
  3. Beth sydd angen i chi gadw llygaid arno?
  4. Sut byddwch chi’n cadw llygaid arno?
  5. Sut byddwch chi’n ennyn diddordeb eich cynulleidfa?
  6. Beth fyddwch chi’n ei ddysgu ar gyfer y tro nesaf?

Iawn – mae’r derminoleg ychydig yn wahanol, ond nid yw’r prif elfennau mor wahanol â hynny.

Felly yn union fel yr oedd Astaire a Rogers yn cydweddu’n berffaith tra bod Ella Fitzgerald yn pendroni a ddylai roi’r gorau iddi, mae cyfathrebu a mesur gyfuniad da… efallai hyd yn oed yn gyfuniad newydd atyniadol gwerth ei drydar, sef “cyfesur”.

Drwy gynllunio eich strategaeth gyfathrebu ar y cyd â’ch cynllun mesur, gall arbed amser i chi mewn gwirionedd wrth i chi archwilio’r un cwestiynau o ddwy agwedd wahanol yn hytrach nag ymgymryd â thasgau gwahanol. Ac mae’n debygol y bydd meysydd yn gorgyffwrdd – er enghraifft, efallai y bydd angen i chi ddilyn gweithgaredd ar twitter os ydych chi’n codi ymwybyddiaeth. Ac yn ddi-os bydd angen i chi gyflwyno eich data i rywun yn rhywle. Er mwyn bod yn effeithiol, mae angen i chi feddwl am y darlun cyflawn er mwyn rhoi eich hun yn y lle perffaith i gyflawni “Newid” – lle mae pobl yn deall, ac yn ymroddedig i wneud rhywbeth yn wahanol, ac yn awyddus i wella.

Yn yr oes hon lle mae pawb fel pe baent yn codi bwganod, efallai y bydd rhai yn datgan ar unwaith eich bod yn wynebu eich tranc os byddwch yn esgeuluso un o’r rhain, ond mae’n well gen i ddweud eich bod yn fwy grymus o ran sicrhau gwelliannau os byddwch yn apelio at galonnau YN OGYSTAL Â meddyliau eich tîm, eich cleifion a’ch penaethiaid.

Os ydych yn anobeithio oherwydd bod angen cynnwys rhywbeth arall eto yn eich gwaith cynllunio, dyma <https://www.youtube.com/watch?v=tU2i2Qzv1-4> fideo defnyddiol i’ch atgoffa o’r camau allweddol hynny…

Pob hwyl wrth gyfesur!

*Llongyfarchiadau i gydweithwyr Gwella Ansawdd Gyda’n Gilydd – os nad ydych wedi gwneud eisoes, cymrwch gip ar eu gwefan: mae Hyfforddiant Efydd yn wych.

Jul 262017

Kate Mackenzie (back), Senior Measurement Improvement Manager

So I went running on the weekend (“So what?!”).

I took part in a running event (“Oh you’re are one of those types!”).

I ran 104 miles.

Now I have your attention. I ran 28 miles on day 1, 39 miles on day 2 and 37 miles on the final day.

I should add for the millennials amongst you, that’s 167 km. Or Milford Haven to Cardigan for visualisers and geographers. Some of you are likely wondering why on earth I would do such a thing. You may even be thinking – I’d love to try something like this. And the compassionate ones might be concerned for the state of my feet (a bit weary, puffy ankles and medically taped up. My ice bath is calling!).

It is the same with improvement projects.

Rarely can you capture interest or support merely by saying “I am doing some improvement”. The only people whose heads will turn are other improvers. “I am doing an improvement project” might capture a few more as it sounds like something out of the ordinary. The third gets everyone’s attention. It’s the data.

Done right, the data is your common language. It immediately gives a frame of reference for your journey. And it explains the magnitude of your achievement. It provokes a response. It shouldn’t be complicated or onerous to collect or explain.

The words “data” or “measures” often raises groans of not being mathematically minded or it’s all too hard. It can feel that it is something extra to do on top of all the lovely improving that you are doing.

Measuring your improvement is inextricably linked to the change you are making. Your data is sitting all around you. You just need to look around with your project aim clearly in mind and think how do I check whether this has improved?

If you don’t know your numbers at the start (your baseline), how can you truly know that you are putting your effort into the right thing?

By monitoring your progress (regular measurement), you are aware of positive results which can be a massive morale boost to keep going. Or you know that blips are just blips or if there is something more determinedly awry.

And then when it comes broadcasting your success to your colleagues, your peers, your directorate manager or the finance director. You want them to recognise and celebrate your achievements but you need to tell them in a way that is meaningful to them as well as you.

You could think about another example – many people undertake a personal improvement project at some stage of their lives,  to lose some weight. In this instance, decisions are taken about what time of day to weigh, how often or whether to enlist the support of a local club. The key point is that no-one starts without knowing their weight to begin with and without recording their regular weigh-ins. Measurement is how you keep yourself on track, how you keep pushing forward with your project.


It is how you prove to the detractors that your efforts are making a tangible difference. It will be how you convince your upper echelons to give you the support and investment.  And when you look back, it will be the thing that crystallises your success.

Happy measuring!

Jul 262017

Kate Mackenzie

Es i i redeg ar y penwythnos (“Beth am hynny?!”).

Cymerais ran mewn digwyddiad rhedeg (“O un o’r rhieni wyt ti!”).

Rhedais 104 o filltiroedd.

Nawr rwyf wedi llwyddo i ddal eich sylw. Rhedais 28 milltir ar ddiwrnod 1, 39 milltir ar ddiwrnod 2 a 37 milltir ar y diwrnod olaf.

Dylwn ychwanegu ar gyfer y mileniaid yn eich plith mai 167 km yw hynny. Neu o Aberdaugleddau i Aberteifi i ddelweddwyr a daearyddwyr.

Bydd rhai ohonoch siŵr o fod yn meddwl pam ar y ddaear y byddwn yn gwneud y fath beth. Efallai y byddwch hyd yn oed yn meddwl – Byddwn wrth fy modd yn rhoi cynnig ar rywbeth fel hyn. Ac efallai y bydd y rhai trugarog yn eich plith yn pryderu am gyflwr fy nhraed (braidd yn flinedig, wedi’u lapio mewn tâp meddygol gyda fferau chwyddedig. Mae’r bath iâ yn galw!) Mae’r un peth yn wir am brosiectau gwella.

Anaml y gallwch ddal diddordeb neu ennyn cefnogaeth rywun drwy ddweud “rwy’n gwneud ychydig o waith gwella”. Yr unig bobl y bydd eu pennau’n troi yw pobl eraill sy’n gwneud gwaith gwella. Efallai y bydd “Rwy’n gwneud prosiect gwella” yn ennyn diddordeb ychydig mwy o bobl gan ei fod yn swnio’n rhywbeth allan o’r cyffredin. Mae’r trydydd yn denu sylw pawb. Y data.

O’i wneud yn iawn, y data yw eich iaith gyffredin. Maent yn rhoi fframwaith cyfeirio ar gyfer eich taith ar unwaith. Ac maent yn esbonio maint eich cyflawniad. Maent yn ennyn ymateb.

Ac ni ddylent fod yn gymhleth neu’n feichus i’w casglu na’u hesbonio.

Mae’r geiriau “data” neu “mesurau” yn aml yn ysgogi cwynion nad oes gan rywun feddwl mathemategol neu bod y cyfan yn rhy anodd. Gall deimlo ei fod yn rhywbeth ychwanegol i’w wneud ar ben yr holl waith gwella hyfryd rydych chi’n ei wneud.

Mae cysylltiad annatod rhwng eich gwaith gwella a’r newid rydych chi’n ei wneud. Mae eich data o’ch amgylch chi. Y cyfan sydd angen i chi ei wneud yw edrych o amgylch gyda’ch prosiect mewn golwg a meddwl sut y gallwch wirio a yw hyn wedi gwella?

Os nad ydych yn gwybod y rhifau ar y dechrau (eich llinell sylfaen), sut y gallwch wybod i sicrwydd eich bod yn canolbwyntio eich ymdrechion ar y peth cywir?

Drwy fonitro eich cynnydd (mesur rheolaidd), rydych yn ymwybodol o ganlyniadau cadarnhaol a all fod yn hwb enfawr i forâl a’ch helpu i ddal ati. Neu sut mae gwybod mai gwyriadau yw gwyriadau ynteu a oes rhywbeth mwy difrifol yn bod.

Ac yna pan ddaw’n amser i roi gwybod i’ch cydweithwyr, eich cyfoedion, eich rheolwr cyfarwyddiaeth neu’r cyfarwyddwr cyllid am eich llwyddiant. Rydych am iddynt gydnabod a dathlu eich cyflawniadau ond rhaid i chi ddweud wrthynt mewn ffordd sy’n ystyrlon iddyn nhw yn ogystal â chi.

Gallech feddwl am enghraifft arall – mae llawer o bobl yn ymgymryd â phrosiect gwella personol ar ryw adeg yn ystod eu bywydau, er mwyn colli ychydig o bwysau. Yn yr achos hwn, gwneir penderfyniadau ynghylch pa amser o’r dydd i bwyso, pa mor aml, neu a ddylid troi at glwb lleol am gymorth. Y pwynt allweddol yw nad oes neb yn dechrau heb wybod eu pwysau cychwynnol a heb gofnodi eu cynnydd bob tro y byddan nhw’n pwyso eu hunain. Mesur yw sut rydych yn cadw eich hun ar y trywydd iawn, sut rydych yn parhau i wthio ymlaen gyda’ch prosiect.


Dyma sut rydych yn profi i’r difriwyr bod eich ymdrechion yn gwneud gwahaniaeth gwirioneddol.

Dyma sut y byddwch yn argyhoeddi’r rhai ar y lefelau uwch i’ch cefnogi ac i fuddsoddi.

A phan fyddwch yn edrych yn ôl, dyma fydd yn crisialu eich llwyddiant.

Mwynhewch y mesur!