Table 3

Examples of changes in learning skills in the facilitated improvement teams

ProjectLearning styles before the projectLearning styles developed during the project
  • Individual learning and skills training

  • Training events ‘done to us’ and not easily applicable in practice

  • Unable to share cross-sectoral learning

  • Concerns about opening a Pandora’s box of organisational concerns

  • Collective member-led learning about practical application of skills

  • Unexpectedly successful large-scale cross-sectoral information sharing

  • ‘Healing’ and ownership through open discussions

  • Lack of information sharing between sectors

  • Lack of group learning opportunities

  • Top-down training to meet goals

  • Start of cross-sectoral learning about each other’s services

  • Genuine joint planning based on dialogue across former boundaries

  • Still some key players not included

  • Fear of exposing concerns

  • Didactic provision of evidence for change

  • ‘Business’ meetings to run improvement project

  • Hierarchical provision of clinical guidance (often rejected)

  • Closer team working and interactive information/skills sharing

  • Less hierarchically dominated discussions, including greater attention to ‘patients’ stories’

  • Open discussion of obstacles and potential ways forward

  • Didactic skills training

  • Avoidance of key concerns

  • Interprofessional mistrust

  • ‘Silo’ discussions with minimal information sharing between ‘tribes’

  • Cross-sectoral information sharing

  • Open discussion of concerns

  • Interprofessional collaborative planning for change