Staff ‘be the change’ for quality improvement

NHS Employers

Case study looking at Ashford and St Peter’s Hospitals NHS Foundation Trust’s approach to quality improvement.

Part of our series focusing on staff involvement for quality improvement, the case study looks at how Ashford and St Peter’s has used innovative staff involvement techniques to help all staff improve quality of patient care. Beginning as an initiative solely for medical staff engagement, it has now been adopted across the organisation.

Advertisements

Quality improvement

Establishing quality improvement approaches which actually work has much to do with suitable leadership and organisational culture, according to a new King’s Fund report.

chart-1545734_1920

This report explores the factors that have helped organisations to launch a quality improvement strategy and sustain a focus on quality improvement. It identifies three common themes for successfully launching a quality improvement strategy: having a clear rationale; ensuring staff are ready for change; understanding the implications for the organisation’s leadership team in terms of style and role.

The report finds that NHS leaders play a key role in creating the right conditions for
quality improvement. Leaders need to engage with staff, empower frontline teams to
develop solutions, and ensure that there is an appropriate infrastructure in place to
support staff and spread learning.

Full reference: Jabbal, J| Embedding a culture of quality improvement | Kings Fund

Engaging staff to drive quality improvement

NHS Employers has published Making it better: staff engagement for quality improvement. This case study highlights work that the Sheffield Teaching Hospital has undertaken on staff engagement as part of its programme of quality improvement, such as the collaborative development of the Sheffield Microsystems Coaching Academy, Listening into Action groups and the creation of trust values. The case study also highlights the benefits the organisation has seen as part of its ‘Making it Better’ transformation programme.

Making the case for quality improvement: lessons for NHS boards and leaders

King’s Fund

This briefing makes the case for quality improvement to be at the heart of local plans for redesigning NHS services. It does this by drawing on existing literature and examples from within the NHS of where quality has been improved and describing how this was done

Practical value in the NHS

The King’s Fund has previously highlighted the fact that addressing waste and variability in clinical work can create better value in the NHS. But what does value mean to people working in the NHS – and how it is being applied in practice? | The King’s Fund Blog

bank-17816_960_720.jpg

‘Value’ sounds like a familiar concept but it can mean different things to different people. One definition of value in the health and care sector is ‘health outcomes per dollar spent’, so attempts to increase value can look at either improving quality or reducing cost.

In early July we held a roundtable discussion with health service providers to better understand their approach to value improvement – initial research for a new project intended to understand the practical barriers and challenges that frontline clinical, operational and managerial leaders have encountered in pursuing better value health care. Experts who attended – including a chairman, chief executive, chief nurse, deputy chief operating officer, change leader, and representatives of national bodies – agreed that the emphasis should be on patient care. Clinicians are more likely to engage in a programme that revolves around the quality of services, and better care is typically less wasteful, so as one participant put it, ‘if you focus on quality, money will fall out’ [spending will reduce]. Consultants will often drive through successful programmes with change management teams, but we also discussed the role of junior doctors, nurses and therapists, who frequently witness low-value care and understand how to fix it. We know that substantial changes in practice can be delivered as we have seen, for example, in generic prescribing, reduced length of stay and the move towards day case surgery.

Read the full blog post here

Involving staff with quality improvement initiatives

NHS Employers has published Staff involvement, quality improvement and staff engagement:  the missing links.

This briefing aims to help managers and leaders understand more about how involving staff with quality improvement initiatives can have a significant impact on staff engagement levels.

Involving staff in quality improvement decision-making, planning and delivery has always been a good idea. However, at a time of unprecedented pressures and financial challenges it is an issue of the highest importance.

This new briefing explores the benefits, approaches and working examples of how organisations are involving staff with their quality improvement activities.

Read more about staff engagement initiatives across the NHS here.

Competition policy in five European countries

This working paper explores how policies affecting competition have been implemented and promoted in health systems in five countries: France, Germany, the Netherlands, Norway and Portugal | Health Foundation

abstract-1867035_960_720.jpg

  • In conventional markets, customers are attracted to particular suppliers by a more appealing combination of price and quality. But in health care, patients are usually insulated from costs and may find it difficult to judge quality due to information asymmetries and their infrequent use of services.
  • This means that the question – what do we expect or want of competition? – is not so easily answered in health care settings, and lessons from other sectors might not apply.

Key points:

  • Proximity to the health care provider, rather than quality, remains the key driver of patient choice.
  • There is potential tension between stimulating quality competition and controlling expenditure because restrictions on hospital treatments imply that money does not follow the patient, and hospitals may react by making access more difficult or letting their waiting times increase.
  • Information for assessing proposed hospital mergers requires improvement, particularly information on quality.
  • There is limited scope for further expansion in the use of private providers to treat NHS patients given the current focus on controlling expenditure.
  • The economic rationale for controlling entry of providers into general practice is unclear.
  • Selective contracting for patients with chronic and multiple conditions to reduce fragmentation of care raises concerns for competition and regulation. This is because of the long-term nature of the implied contracts and the restricted pool of potential providers willing to bid for these contracts.

Read the working paper here