Quality improvement is everybody’s business

For change to happen, healthcare staff need to hold a mirror up to their practice and learn more about quality improvement, says Sue Hooton. 

For change to happen, healthcare staff need to hold a mirror up to their practice and learn more about quality improvement, says Sue Hooton 

Picture: iStock

Over the past few decades, international interest in quality improvement in health and social care has grown exponentially.

We are experiencing a global wave of improvement activity, set against a backdrop where much of health and social care is delivered in complex and often chaotic settings. Health and social care practitioners are facing unprecedented challenges and working in increasingly complex networks.

It is generally assumed that healthcare leaders have the skills, knowledge and confidence to create a culture for quality improvement. But a report from think tank The Health Foundation, published in October 2015, found that ‘while some health and social care professionals receive formal training for improvement, many receive nothing, either as part of their initial training or as subsequent professional development.’ 

The 2013 Berwick Report - which looked at the cultural aspects of events at Mid Staffordshire NHS Foundation Trust - acknowledged the complexity of contemporary practice, stating that the NHS must become ‘a system devoted to continual learning and improvement of patient care.’ 

Challenges and responsibilities

If we are to learn from recent history, and respond to the challenges set out in the report, we need to ask ourselves: what part do I have to play in ensuring my practice and the care I provide is continually improving? We need to hold up the mirror and make it personal. 

Quality improvement is logical and pragmatic, which is why it is easily adopted by so many busy practitioners. It moves from ‘what’ needs to be done to ‘how’ to get things done within safe, staged and reflective cycles of improvement.

The Institute for Healthcare Improvements’ Model for Improvement is gaining worldwide popularity. This asks three basic questions applicable to any health or social care situation:

•    What are we trying to accomplish?
•    How will we know (measure) that a change has led to an improvement?
•    What change(s) can we make that will lead to improvement (PDSA cycles)

The model considers patient engagement essential, and focuses on those who understand the clinical context and have local, tacit knowledge. 

So if you sometimes feel dispirited that nothing ever changes for the better, get involved and make change happen.
Let’s make this personal and commit to learning more about quality improvement. 

Sue Hooton is professor of nursing and quality improvement at the University of Chester

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