Using the World Café process to develop a ReQoL Community of Practice (CoP)

Patient reported outcome measures (PROMs) are a means of assessing the quality and effectiveness of care from the patient’s perspective. However, the routine use of PROMs in clinical practice can be difficult to implement. New challenges arise at different stages of the implementation process and organisations need to invest time and financial resources into designing an appropriate strategy, information systems, providing technical support and preparing staff.

Recovering Quality of Life (ReQoL) is a PROM that was specifically designed to measure mental health service users’ perspectives of recovery and quality of life. It is a co-produced, service user-centred outcome measure tested by over 6000 mental health service users. It can detect change across a broad spectrum of mild to severe mental health conditions.

The team that developed ReQoL has continued to collaborate with mental health trusts across the country to support the implementation of ReQoL. In recent years we have focused on the development of a ReQoL Community of Practice. Communities of Practices (CoPs) have existed in sectors such as education and business for over 30 years, operating as networks and support groups for people who share a common set of problems or interests. Members of CoPs maintain and build links with each other for the purposes of social interaction, knowledge sharing, knowledge creation and identity building.

During a national event we used a modified ‘World Café’ process to explore delegates’ expectations and priorities for a ReQoL Community of Practice (CoP). The World Café process aims to bring people together to discuss issues that matter to them, tapping into tacit wisdom through interactive group discussions. The process allows participants to engage in evolving rounds of dialogue in smaller groups while remaining connected to a larger conversation. The process can last several hours, however, in this case, the process was modified to fit into a 60-minute workshop (see Figure 1).

Figure 1 – The Modified World Café Process

The data was recorded and collected in the form of notes, lists and key phrases, on flip-chart sheets and post-it notes. After the workshop, two of the facilitators transcribed these notes, producing an initial account of the discussions. Thematic analysis of the initial account was undertaken which involved familiarisation with the data; coding; searching for themes; reviewing, defining and naming themes. The themes were discussed and agreed upon with the other facilitators and a summary was sent to participants for comment. Analysis of the data collected during the workshop identified five key themes which were: Making links; Sharing learning and tasks; Creating change.

The modified World Café process offered participants an opportunity to influence the way the CoP was set up, commenting on what would work best for them and ensuring it is more likely to succeed. The process proved to be a quick and efficient way to elicit information, albeit requiring skilled facilitators and high levels of engagement from participants particularly when high numbers of participants are involved. On reflection we found it to be a useful technique for time-pressured co-production.

It is clear from the results that participants thought that developing an infrastructure to support the CoP would be key. Organisations seeking to establish similar CoPs would need to consider how the necessary infrastructure can be funded, something which could present a challenge in the NHS and social care at the current time.

This blog is a summary of a published short report:

Taylor Buck, E., Smith, C.M., Lane, A. et al. Use of a modified World Café process to discuss and set priorities for a Community of Practice supporting implementation of ReQoL a new mental health and quality of life Patient Reported Outcome Measure (PROM). J Patient Rep Outcomes 4, 38 (2020).

The full report can be accessed here: https://doi.org/10.1186/s41687-020-00202-z

This blog was written by Dr Lizzie Taylor Buck, Amanda Lane, Dr Christine Smith, Dr Anju Keetharuth, Professor Tracey Young, and Professor Jo Cooke, Health Economics, Evaluation and Equality theme, Yorkshire and Humber ARC.

28th January 2021