Phase 3 – Overcoming barriers and challenges

Challenges and barriers to our QI work are inevitable. In phase 3 we work together to overcome these. We will also explore more about the sequence of improvement and sustaining and gaining.

Phase 3 introductory video – Overcoming barriers and challenges

Since you embarked on your QI journey, your team has no doubt experienced a range of challenges, problems and barriers as you have gone about designing and implementing changes. These may have included things like – difficulties getting feedback, time management, staffing, challenges presented by the pandemic or getting senior leader buy-in for an idea. This session will be focussed on problem solving and overcoming barriers and we will be getting your team into small working groups to present, discuss and work through barriers and difficulties together.


We would like to ask each team to prepare a 5 minute presentation to include the following (slides template below if you wish to use these) –

  • A quick summary (1-2 minutes) of where your QI project is now. It would be great to include any pictures and data as well as the verbal/written descriptions on the slides.
  • One or your main barriers/challenges that your team is experiencing or has experienced in your ongoing QI work.

You will then work together with other teams within your small working group to discuss ideas, possible solutions, QI methods or possible adaptations to your work in order to overcome and work through these barriers.

The overall aim is to provide you with some space in which to share your progress with others and work through your problems/barriers related to your QI work with other teams.

More details are provided in the videos above.

With your team, work your way through the videos and exercises below – 

Change model for improvement and measurement

• What strategies can we put in place to make it easier to get on with the change?
• How are we gathering data to inform us whether the change is an improvement? (Feel free to review these videos on Measurement for Improvement if needed)

Sustain and gain

Tricia advises on how teams can work to maintain their improvements and spread these to other areas of their organisation (contains: diffusion curve, components of an improving system).

How might you design to sustain and spread?

How may you map these plans over to those who are either early adopters, majority, late adopters or laggards?

Video for those leading on QI projects

Are we nearly there yet!…

This video is made for QI Champions and leaders and offers some useful advice on maintaining motivation for your improvement work during challenging times.

We look forward to working with you in Session 3!

Please let us know if you have any questions. 


Feedback and suggestions about this site

Additional videos

If you would like to explore more, then feel free to view the below videos to view QI concepts in more detail –

Session 3 presentations –

In the third session of the QI programme, we invite a QI Champion from a previous wave to present their QI project, with a focus on how they overcame their barriers and challenges. Feel free to view our presentations from previous sessions below:

Dr Fiona Campbell provided the Birmingham and Leicester waves with an overview of her team’s QI journey at Leeds Children’s Hospital from the pilot wave in 2017 to the present day. This documents the gradual improvement in average HBa1c through a series of QI interventions including local QI training, DigiBete and schools workshops (contains: team working, driver diagrams, run chart, self-management education, sustainability and spread, team ambitions, goals and values).

We ask all teams in the QI collaborative to define their purpose, and produce an overarching aim as to what their service strives for. Have a look at figure. 1 below which gives an overview of the Leed’s team’s approach to this.

Leeds Quality Improvement Journey – Presentation slides

FYOC Timeline June 2020 (2)


Figure. 1


One team – One Message’ The QI Champions at Torbay and North Devon talk about their project aimed at improving consistency in communication in clinics (contains: common language, clinic experience, drifters, fishbone analysis, improving team meetings, team questionnaire, ‘ten top tips’)

Resources to download:
Top 10 Tips
High HbA1c Scan

Anne Berry (QI Champion, City Hospitals Sunderland) presents her team’s QI journey from the start of the programme in 2018, to the present day. This covers how the Sunderland team have adopted QI into service improvement, and how they have overcome the barriers and challenges throughout (Contains: staff communication, patient feedback, measuring success, overcoming challenges, fundraising, Covid19, project management, Digibete, patient education).

Recordings of Session 3

What keeps a project on track

In keeping with the theme of ‘overcoming barriers and challenges’, this is a recording the ‘What keeps a project on track’ presentation from Session 3.

This is a recorded presentation on ‘Six principles for learning for improvement’

A recording of the ‘Thinking Hats’ presentation from Session 3.

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