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
- 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.
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 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:
- Reducing defects from the viewpoint of the patient or carer – this focuses on the quality of all aspects of the service being provided
- 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.