Favorite Resources for Building a Culture of Learning & Improvement

Improvement teams and leaders seek to create impact so that their systems reliably achieve equitable outcomes. This will not come from one singular project, but rather orchestrated work across everyone in the system to continuously change and improve. This requires not only the technical understanding of how to do continuous improvement, but also as a nimble organizational culture where improvement can flourish and be sustained over time. 

We call continuous improvement continuous because we are constantly seeking how we can do better.

We've compiled a list of some of our favorite resources and tips to help you and your team to create these conditions (or as we call them at Shift, essential elements to Build a Culture of Learning & Improvement):

• Motivation & Momentum:  In his book Drive, Daniel Pink builds upon Deming’s teachings about the limitations of extrinsic motivation (rewards) and the power of intrinsic motivation (joy that comes from work well done). Learn more about Pink’s theory for how to foster intrinsic motivation through autonomy, mastery and purpose in this short animated video
• Core Values create direction for a shared way to work together on improvement efforts. This is especially important to reinforce a commitment to quality, equity, and coproduction. Core values aren’t just a poster on the wall, but can be broken down into specific behaviors of what they look like in action. Check out Shift’s Principles that we created with our coaches CoCreate Work in our journey to build inclusive workplace culture.  
• Equity Commitment: Improvement methods are agnostic to equity. When implemented without a conscious effort to improve equity, there is a risk of improving for some while others are left behind, or of exacerbating inequities through scaling inequitable solutions. Listen to Adelric McCain of Network for College Success and Xiomara Padamsee of Promise 54 explore their own journeys and personal reflections about the intersections between improvement and education in this HTH Unboxed Podcast.
• Learning & Communication: Improvement efforts generate a mountain of valuable experiences, know-how, and data. It is no small task to capture and sort this important information to find the most impactful changes to disseminate to the wider field. Setting up systems from day one of your improvement initiative will help you to do this WITH your community. At the Carnegie Summit 2023, we shared tips and resources to consolidate actionable knowledge (aka, create change packages). If you missed our session, sign up for our newsletter as a new video trilogy on this topic will be released soon!
• Shared Responsibility: Working towards a big, audacious goal requires many teams working collectively and interdependently. This looks different than the traditional org chart with organizational boundaries and hierarchical structures. Instead, Dr. Marshall Ganz describes this type of leadership as a snowflake, where leadership and responsibility are shared and there is a commitment to building many leaders. Learn more about Ganz’s snowflake model to build power for change in this resource: Organizing: People, Power, Change.
• Coproduction is based on the idea by Nobel prize winning economist, Elinor Ostrom: when we aren’t learning from everyone in the system, we waste opportunities to get better results. Coproducing improvement efforts requires deep collaboration between those working in the system (healthcare providers, educators) and clients (patients, students). A key pitfall is to build the infrastructure to make coproduction equitable, drawing in those most negatively impacted by the system to contribute their lived expertise. Some concrete examples include meeting agendas and times that are inclusive, clear roles to encourage authentic participation, and a budget to compensate community representatives for their expertise. Check out Shift’s Foundations for Authentic Coproduction for practical tips and resources!
• Leadership: Organizational cultures with centralized decision making may feel at odds with the nimble culture of improvement. Especially in the early stages of improvement, it’s important to create opportunities for leaders to learn and practice improvement with a clear role of resolving obstacles and helping to spread improvement to other parts of the organization or system. Read more about the critical role of leaders in The Institute for Healthcare Improvement’s paper: Seven Leadership Leverage Points.
• Capacity Building: It can be a big challenge— especially for organizations early in their improvement journey—to build a shared language and approach to continuous improvement. We’ve heard from many partners say that it is really hard to teach and spread the methods to others as they are just starting to learn and practice them! That is one of the major reasons that motivated our team at Shift to create our library of free, accessible videos and templates. There are lots of great, free resources out there to build improvement capacity. For example, check out the video series by Improvement Science Consulting: Improvement Science in a Minute. I also love The Institute for Healthcare Improvement’s Science of Improvement Whiteboard Videos!

This doesn’t happen by accident!

Building a culture where this happens across all roles doesn’t happen by accident. By intentionally addressing each of these essential elements, your organization can create the conditions where improvement can become a sustained way of working with intentional commitment to deeper organizational transformation.