Quality Improvement

Good practice guide
i
Good practices guides focus on providing information on a clinical topic.
Authors:
Susan Went
Date Published:
21 March 2018
Last updated: 
21 March 2018

Anyone involved in the care and treatment of people in health or social care settings, will understand the importance of providing the best care possible. High quality care which is safe, equitable, efficient, effective, timely and person centred.

Although much progress has been made in defining best practice, setting standards for delivery and improving the processes of care, there is still variability; there is no consistent delivery or outcomes.

Anyone involved in the care and treatment of people in health or social care settings, will understand the importance of providing the best care possible. High quality care which is safe, equitable, efficient, effective, timely and person centred.

Although much progress has been made in defining best practice, setting standards for delivery and improving the processes of care, there is still variability; there is no consistent delivery or outcomes.

Health care is a highly complex system, full of very professional people trying to do their best, but on a daily basis clinicians, managers, support staff, and students will come across processes which do not work well. These poor processes can lead to harm, delays and waits, repeated work, frustration and complaints.

Quality improvement is about enabling those who work in the health and care system to take responsibility, not just for the care which they provide but for improving the system within which they work. To redesign and continually improve care to meet the changing needs of patients and communities so the care system supports delivery of the best care possible.      

Over the past decade the robust “organisational approaches” to quality improvement have spread from manufacturing, nuclear and aviation industries to health care.  The use of these methods is about creating environments in which change and improvement can flourish, where leadership fosters a culture of innovation and provides the tools, techniques and training so that staff can take ownership of improving the quality of care.  

Over the years, several national and international organisations have developed reputations for championing the use of these tools and techniques in healthcare. As experience in these settings has deepened, many of the same organisations have developed freely accessible resource sites which act as repositories of their learning and sources of knowledge, learning and expertise. Most of the sites listed also provide information about national training opportunities or grants and allocations.

Some sites will focus on a single subject or a specialist area; others will target their resources for a specific level of experience for example Foundation level for those needing a general overview; Advanced levels of training for those who may be leading a practical improvement project or for senior staff supervising a student; to Expert level for those contemplating a move into an Improvement role.

The following summary of sites is a starter for ten, it is not an exhaustive list, nor is intended to rank one source above another. 

NHS Improvement (NHSI)

Home page - https://improvement.nhs.uk/resources/

NHS Improvement is responsible for overseeing foundation trusts and NHS trusts, as well as independent providers that provide NHS-funded care. NHSI offers the support these providers need to give patients consistently safe, high quality, compassionate care within local health systems that are financially sustainable. NHSI also holds providers to account and, where necessary, intervenes to provide short-term solutions.

From 1 April 2016, NHS Improvement is the operational name for an organisation that brings together:

 

NHSI builds on the best of what these organisations did, but the priority is to offer support to providers and local health systems to help them improve.

Resources - https://improvement.nhs.uk/improvement-hub/

A theme based repository of improvement tools, ideas, case studies and resources, allowing teams to share projects and learn from others undertaking similar work

 

Resources - https://improvement.nhs.uk/resources/

A search tool,  allowing users to drilldown into all resources on the NHSI site. The data base can be searched by theme, by management or operational categories, or by activity specific to one component part of NHSI.

The Health Foundation

Home page - http://www.health.org.uk/

The Health Foundation is an independent charity committed to bringing about better health and health care for people in the UK.

 

Resources - http://www.health.org.uk/collection/improvement-projects-tools-and-resources

The Health Foundation funds hundreds of projects around the UK that are testing ways to improve the quality of health services. Their listing has a range of categories you can search by to help you find work that the health foundation has funded that relates to the areas you're interested in, offering ways to get ideas and inspiration for your improvement work.

Healthcare Improvement Scotland (HIS)

Home page - http://www.healthcareimprovementscotland.org/

Healthcare Improvement Scotland’s (HIS) aim is: ‘Better quality health and social care for everyone in Scotland’

HIS deliver’s this through a powerful combination of skills and experience, which brings together the national functions of Evidence, Improvement and Scrutiny in one organisation.

 

Resources - http://ihub.scot/

The ihub is part of Healthcare Improvement Scotland and was established to support those delivering health and social care across Scotland to redesign and continuously improve services.

The International Society for Quality In Health Care

Home page- https://isqua.org/

ISQua’s mission is to inspire and drive improvement in the quality and safety of healthcare worldwide through education and knowledge sharing, external evaluation, supporting health systems and connecting people through global networks. They have a network which spans 100 countries and 5 continents. Access to resources is offered through several routes, some are open access, others as part of a defined educational programme other on a membership basis.

Resources- ISQua offers material as part their fellowship programme https://isqua.org/education/the-isqua-fellowship

 

Targeted training as part of Specialist certificates

https://isqua.org/education/Specialist-Certificates

There is a free White Paper on aging

https://isqua.org/interest-groups/innovation-and-systems-change

The Institute for Healthcare Improvement

 

Home page - http://www.ihi.org/Pages/default.aspx

 

Free QI Resources - http://www.ihi.org/resources/Pages/default.aspx

 

To help you with your improvement efforts, IHI offers free tools, change ideas, measures to guide improvement, IHI White Papers, audio and video, improvement stories, and more.

On this site you can learn about the Model for Improvement, forming the improvement team, setting aims, establishing measures, and selecting and testing changes. The importance of measures, and the types of measures you will need to tell a team whether the changes they are making actually lead to improvement. The types of changes to select and which ones are most likely to lead to the improvement you are trying to achieve.

The site also hosts Improvement stories and many tools which organisations have developed as part of their local improvement projects.

IHI white papers, audio and video content is also accessible through this page.

IHI Open School

http://www.ihi.org/education/ihiopenschool/Pages/default.aspx

 

The IHI Open School brings you essential training and tools in an online, educational community to help you and your team deliver excellent, safe care. When you engage with the Open School courses and Chapters, you join more than 500,000 learners from universities, organizations, and health systems around the world in building core skills in improvement, safety, and leadership.

 

Teaching Resources: Tools for Training Students and Staff in QI

​​​​​​​​​​​Institutional faculty and organizational leaders around the world rely on the Open School courses as an easy way to bring essential training in quality improvement and patient safety to students and staff — creating a common language around improvement and giving learners crucial skills to become leaders and agents of change in health care.

 

To help make it easier to provide this training, the Open School offers a Team Tracking Tool and Educator's Toolkit as part of a group subscription. Learn more about subscription options here​.

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