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What is Quality Improvement?

Continuous improvement is a skill requirement for all staff working across healthcare.

Quality Improvement (QI) is not just a method or model, but more an approach to personal or organisation learning, development and improvement.

QI helps to bring a systematic approach to tackling complex problems by:

  • Focusing on outcomes
  • Flattening hierarchies
  • Giving everyone a voice
  • Bringing staff and service users together to improve and redesign the way that care is provided

QI can be defined as the application of a systematic approach that uses specific techniques to improve quality. Although there is a range of approaches that fit under this umbrella, they all have the following in common:

  • The concept of a cycle of improvement which involves:

– Problem definition and diagnoses

– Planning and testing of change ideas

– Data collection and analysis

– Implementation

– Evaluation

  • A set of tools and techniques that support individuals to plan and implement improvements
  • A recognition of the importance of engaging stakeholders, including patients and carers
  • Recognition of the importance of culture and the need for leadership – clinical and management.

When done successfully, QI can help change the culture of a system, whether the system is a single team, a department, an organisation or a whole health-economy.

Improving quality

The following dimensions of healthcare are widely recognised and universally accepted as describing ‘quality’:

Safe: avoiding harm to patients from care that is intended to help them

Timely: reducing waits and sometimes harmful delays

Effective: providing services based on evidence and which produce a clear benefit

Efficient: avoiding unnecessary waste

Equitable: providing care that does not vary in quality because of a person’s characteristics

Person-Centred: establishing a partnership between practitioners and patients to ensure care respects patients’ needs and preferences

Any aims to improve on these six dimensions should focus on:

Avoiding needless deaths

Avoiding needless pain or surgery

Eliminating waste

Eliminating unwanted waits

Eliminating patients and carers feeling helpless

Consistently: everyone, every time

Types of improvement

It is broadly recognised that there are three types of improvement that can be made:

  1. Reducing defects from the viewpoint of the patient or carer – this focuses on the quality of all aspects of the service being provided
  2. Reducing cost/waste to improve efficiency – see examples below taken from Lean methodology.

3. Providing a new product or service or an old one at an unprecedented level – this focuses on new attributes that can exceed the patient or carer’s expectations. For example, bringing new research into practice or the use of innovative technology.


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