QUALITY AND SERVICE IMPROVEMENT

Quality and Service Improvement



Executive Summary

Efforts to improve processes or systems must be driven by reliable data, it is difficult whether we have in fact achieved improvement and to know exactly what to improve, unless we measure. To the function of quality improvement in any health service, analysing and collecting and data are therefore central. Fundamentally it requires us to understand how we can influence them to achieve improvement, what factors affect delivery and what is happening in the delivery of our health services. When the outcomes and processes are examined more closely, these opportunities become evident. Making healthcare more equitable, efficient, timely, and patient centred, effective, and safer is what improving quality is about. Ensuring that healthcare is as safe as it can possibly be, is what it is about. Healthcare is not always safe, is clear evidence at present. This is a challenging agenda, for some, nevertheless. Sometimes clinical practice, and improving systems and processes is what quality improvement approaches are focused on. Whether a clinical practice, process, or system is in control is what many quality improvement approaches assess. To make decisions about sequencing or scheduling of initiatives, and to be able to identify the change and react to it is what leaders need, and may need to do in these circumstances. Good leadership is required for all improvement in quality. In order to demonstrate an unerring focus on implementation, the ambition to set high-level goals, and the will to make change happen, organisational transformation requires leadership that is exceptional. We have seen where quality improvement approaches have come from and have looked at what we mean by improvement of quality, and quality itself. To ensure and to improve the required focus for successful implementation, vital in terms of building the organizational will, is both managerial and clinical senior leadership and research into the characteristics of successful quality improvement approaches demonstrates that. Playing a vital part in engaging clinicians in quality improvement approaches, clinical directors and medical directors are particularly important as role models. To engage staff in understanding how the different steps in a patient journey fit together, or do not, processes mapping is extremely useful as a tool. For building clinical commitment to improvement, facilitated support and capability building are key elements. Of quality improvement in healthcare, and of the whole-scale application of industrial models, there are relatively few examples. Requiring the measurement of impact over a considerable length of time, quality improvement is a long-term strategy. When staff engagement and motivation is high, particularly at the start of the initiative, most health organizations that have used quality improvement approaches report some benefits. The governance role involves seeking assurance that the performance targets reached, that reporting and monitoring are carried out, and throughout the organisation, and the necessary actions are being taken. Good leadership is required for all quality improvements. To bring about sustainable change, improvement approaches are unlikely without sound leadership.

Table of Contents

Introduction5

Importance of Quality5

Development of Quality & Service Improvement Agenda6

Quality Improvement ...