Thanks to all the sites that were part of the VMI partnership. Their generosity in helping us learn has been really important #QIhour #LeadingQI

Q5. The tweet chat process has been an eyeopener. Must be one of the most effective and cost effective ways to get meaningful conversations about significant academic and policy findings. #QIhour #LeadingQI

@jamespeskett @WarwickBSchool Spot on

NHS Impact is a step in the direction of moving away from a failed approach in which we "improve" things regarded as less significant, but when something is really important we "performance manage" it. #QIhour #LeadingQI

A4 (Part 2), but equally, scarce and experienced improvement resources should be available to support the organisation's most pressing challenges. These two approaches are not incompatible.#QIhour #LeadingQI

A4. An improvement culture is a bit like a set of Russian dolls. If people are helped to learn how to lead improvement they will apply the approach to what matters where they work. Not every effort has to be of strategic importance.#QIhour #LeadingQI

And don't get me started on RAG ratings. #QIhour #LeadingQI

The real stretch happens when local people, understanding their real position and passionate to improve, make a promise to the people they serve that they will deliver a better service. Better is never finished. #QIhour #LeadingQI

A3. Almost all nationally imposed measures risk "HTTBMTP". They are not based on starting positions, natural variation, and most importantly are seldom owned. #QIhour #LeadingQI

When the outcomes are too far into the future to use to monitor improvement we need "impact measures"; process measures where the evidential link to a good (or bad) outcome is strong enough for them to be a proxy. #QIhour #LeadingQI

@VM_Institute @WarwickBSchool I would say those are the wrong way round! #QIhour #LeadingQI

This may be old, but it is still really good #QIhour

Things to avoid: Only measuring things we already have to collect for some other purpose; not being granular about the detail (who will measure, what, when , how and how will they report). #QIhour #LeadingQI

A basket of measures. As close to outcomes that service users will recognise as possible. "Balancing measures" designed to spot unintended consequences of our change early. #QIhour #LeadingQI

@Whoseshoes it would be good to hear more about your "interesting relationship with measurement". #QIhour #LeadingQI

Driver diagrams are a great way of making the link between the important issues you need to impact, and the small tests of change you want to try. Investing time in developing them well is a key to the Golden Thread. #QIhour #LeadingQI

@cascleicester @HelenBevan @LouWaters_QI @HughMcCaughey @mountfordjames @karas01 @KathrynPerera @ZoeLord1 @DianeKetley @LeighAKendall @KateSlater2 @LauraJYearsley Hi, The national audits have a lot of advantages; some standardisation, clinical endorsement and often the support of Colleges and Specialist Associations with patient group involvement. But as long as people can say "this data is old" the impact is diminished#QIhour #LeadingQI

@jamespeskett @WarwickBSchool Hi James, good to see you here. Let us know about your evaluation #QIhour #LeadingQI

Hi Bernard here, part of the WBS team and looking forward to our final TweetChat #QIhour #LeadingQI

RT @WBAFoundation: Our SEND Multi-Sports Camp have had a fantastic day, celebrating their favourite superheroes & sports stars 🦸 ⭐️ Shout…