What To Improve
This may seem like a strange question, you’ve come onto these pages to get ideas on QI, so you already know what needs improving – well, maybe! This section sets out some issues to consider, to ensure that your efforts are focused on issues and projects that are amenable to QI approaches and that are important to patients, staff and the service. Everyone will have ideas, but how do you choose the right ones so that your improvement work is most likely to deliver the change you want to achieve?
The Health Foundation has produced a simple introductory guide ‘Quality Improvement Made Simple’ which is a good first step to start to get the team familiar with the concepts of quality improvement in healthcare: https://www.health.org.uk/publications/quality-improvement-made-simple
Improvement is useful and has meaning when it is defined by characteristics such as healthier, safer, more efficient, more patient-centred care. Although change will not always result in improvement, all improvement requires change. The principles to maximise the results of improvement effort include:
- Outline a clear aim: Know why you’re improving.
- Having a feedback mechanism to tell you if improvements are occurring.
- Developing effective ideas for changes that will result in improvement.
- Testing and adapting changes before attempting to implement.
- Aim for sustainability: Changes should be lasting and integrated seamlessly into our healthcare system.
These are described in Langley, K, Nolan, K and Nolan, T et al. (1996) The Improvement Guide: A Practical Approach to Enhancing Organisational Performance, San Francisco: Jossey-Bass
With these resources and insights, you're well-equipped to spearhead impactful Quality Improvement projects within the NHS.
Essential Readings:
Dixon-Woods M. How to improve healthcare improvement—an essay by Mary Dixon-Woods BMJ 2019; 367 :l5514 doi:10.1136/bmj.l5514
https://www.bmj.com/content/bmj/367/bmj.l5514.full.pdf
Perla, R. J., Provost, L. P., & Parry, G. J. (2013). Seven propositions of the science of improvement: exploring foundations. Quality Management in Healthcare, 22(3), 170-186.
