10. Share learning

Shared learning is a key principle for effective health care improvement. It is the practice of collectively exchanging insights and experiences gained in undertaking comparable tasks or addressing common problems. Sharing learning requires:

  • Encouragement of multi-disciplinary approaches
  • Establishment of an environment conducive to interaction
  • Acknowledgement of all participants and their points of view
  • Having the right people in the room—ensuring that the meeting brings together individuals with experience trying to improve services

Opportunities to share learning in VMMC CQI programs include:

  • CQI team meetings – Health care facility staff who are members of the CQI team meet regularly to review performance data, analyze root causes of gaps, and plan interventions to improve service quality.  CQI teams need to discuss their improvement work as a team so that all team members are knowledgeable of changes tested and results and can share that knowledge with others outside the team.
  • Learning sessions – Interactive meetings where representatives of VMMC CQI teams present on their experiences and outcomes (both positive and negative) introducing specific changes aimed at quality improvement
  • Coaching visits – When CQI coaches and district management team representatives visit a site, they meet with the CQI team to review data and progress on action plans, and to discuss what steps the team can take next to continue to improve.  
  • Quarterly stakeholder meetings – Regular gatherings of Ministry of Health (national and district levels), donor agency, implementing partner, and CQI technical support partner representatives to collectively review how VMMC sites are performing across standards areas and discuss successes and challenges, has proven effective in multiple countries to address above-site issues and disseminate good practices.

Events to promote sharing and integration of insights across sites require good meeting facilitation and thoughtful design to allow those who have implemented improvements in care to talk with and answer the questions of those who can learn from them.  Such sharing may involve verbal, visual, and/or written communication. Learning can be shared most effectively through small group conversation.  Video clips, photographs, diagrams, and other visual aids can often convey key information more effectively than written documents.  While written products may be the least effective method of sharing on their own, they can help to summarize key messages and points of learning.

In Uganda, VMMC CQI learning sessions have often taken place over two or three days to build in many opportunities for sharing and integration of insights between sites and even include a field trip to a VMMC site.  (See a sample learning session agenda from Uganda in the Resources below.)

In South Africa, ASSIST has convened both national and provincial learning sessions to bring together representatives from the Department of Health, implementing partners, VMMC sites, and ASSIST staff to share challenges and solutions.  (See the national lesson sharing workshop report from South Africa in the Resources below.)

Why learning across CQI teams is important: Lessons learned/experiences in implementing quality improvement interventions in one health care setting can be useful to teams facing similar challenges in another setting. Shared learning facilitates identification and replication of good practices and avoids teams “reinventing the wheel” by learning from others who have successfully addressed a gap. Hearing from other teams how they have improved VMMC care processes is often helpful to show that “improvement is possible” and can spur friendly competition among sites.