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In 2021, 38 healthcare teams across England and Wales took part in the national enjoying work quality improvement collaborative, which aimed to enhance staff wellbeing and create joy in work. Participating teams were supported to use quality improvement methodology and tools as part of a national learning network. At the end of the programme, 16 teams saw an improvement in at least one outcome measure, while 17 teams saw a sustained deterioration in at least one outcome measure. Aggregate data from all teams demonstrated improvements from baseline in all three outcome measures, with a 51% average improvement in the percentage of people who frequently enjoyed being at work, a 41% average improvement in the percentage of people experiencing no symptoms of burnout and a 42% average improvement in the percentage of people who were extremely likely to recommend their team as a place to work. As the first programme on this topic at a national scale, these findings provide ideas for change that can be adapted or replicated by clinical and non-clinical teams to improve their joy and wellbeing at work, and build their understanding of the barriers they may face and what is needed to overcome them. From the ideas tested and the learning from across the collaborative, a theory of change for enhancing staff wellbeing and joy in work has been created to inform future work in this area. [ABSTRACT FROM AUTHOR]

As healthcare systems emerge from the COVID-19 and begin the process of recovery and rebuilding, it is more important than ever to find systematic ways to ensure that all healthcare staff are focusing on their wellbeing, are able to reflect on new ways of working and find methods to improve their experience at work. This article, the second in a three-part series on the practical application of quality improvement in healthcare, presents four case studies that demonstrate the learning from four healthcare systems that have been applying both quality improvement and the Institute for Healthcare Improvement's 'joy in work' framework to enhance staff wellbeing and experience. These case studies demonstrate the benefits of involving staff deeply in the process of understanding factors that impact on experience at work, developing and testing creative ideas that can make a difference. The ideas that emerged were diverse and highly contextualised to the local service. Ideas related most strongly to four areas: wellness and resilience, daily improvement, camaraderie and teamwork, and recognition and reward. The systematic approach that quality improvement brings is potentially replicable across all healthcare settings, and can provide a way for all teams to have greater ownership and control over their wellbeing and experience at work. [ABSTRACT FROM AUTHOR]

Applying quality improvement methods to solve complex quality issues involves people deeply. People discover solutions, test and adapt ideas, thereby giving them autonomy and control over the system in which they work. Focusing quality improvement on what matters most for staff and service users creates the opportunity to bring a deeper sense of meaning and connection to purpose, both of which are integral to joy in work. When applying quality improvement at scale within large organisations or systems, bringing teams together in learning systems can provide a critical structure to build skills, collaborate and learn from one another. This article describes the core elements of learning systems designed to support quality improvement and joy in work, illustrated through two examples. The framework can be applied at different levels of a system, including the individual, the team and the organisation, or even to a large improvement effort across organisational boundaries. The next article in this series will discuss the application of the joy in work framework to healthcare settings. [ABSTRACT FROM AUTHOR]