September 21, 2020

Embedding improvement in healthcare

Through our events, we aim to bring awareness and collaboration to the healthcare community around improvement. An ongoing commitment to improvement is vital to delivering better healthcare – both in making backend operations more efficient and providing outstanding patient care.

At the Healthcare Partnership Network event in November, we were lucky enough to hear from Hugh McCaughey, National Director of Improvement at NHS England and NHS Improvement, about the importance of embedding improvement across the NHS. Having spent time in senior leadership roles in a number of health Trusts, he knows firsthand the challenges and opportunities that come with delivering improvement initiatives within NHS organisations. He highlighted the importance of not chasing after a particular “shiny” tool, but embedding a culture and an approach.

Building on Hugh’s sentiments, in this post we’ll explore and expand on some of the key ways NHS organisations can embed continual improvement.

 

People

Embedding any sort of culture into an organisation starts with the people. Not just having the right people, but enabling them to drive improvement. Truly embedding a culture of improvement means moving away from imposing traditional top-down solutions to blending in bottom-up solutions from frontline staff and service users. 

Many healthcare systems – in the UK and worldwide – have adopted techniques such as frequent rapid improvement sessions, gathering feedback and ideas from a large cross-section of the organisation and in some cases, service users, to increase efficiency and quality of care.  

 

Building a shared vision

Once you know you have the right people and the right processes in place to enable them to deliver quality, you need to point them at the same thing. In a healthcare system, as in any organisation, to truly deliver quality and improvement, there must be a unified vision and values which are perpetuated by everyone from frontline staff to senior management. You can’t hope for your staff to improve services if they don’t know what they’re working towards, or why. 

The NHS Leadership Academy outlines the importance of leaders conveying a “vivid and attractive picture of what everyone is working towards in a clear, consistent and honest way”. Ostensibly, a shared vision for improvement in the NHS is both of system-wide and organisation-specific concern. Ensuring that everyone in your organisation understands both high level objectives all the way down to granular departmental ones is vital to the success of your improvement journey.

 

Measuring success

Any senior leader is no stranger to the importance of having measurable objectives that map to a broader vision. Whether against national standards or self-imposed ones, it’s vital to understand where you are on your improvement journey, what’s working well, and where adjustments should be made. 

There are obviously a whole host of different models and systems for measuring the quality or efficiency of different processes or areas of service, but a significant one for measuring quality care is Donabedian’s model. The model outlines the importance of improvement projects having outcome, process, structure and balancing measures. Namely:

  • Outcome measures: the impact on the patient. Examples include mortality, length of stay, reduced hospital acquired infections and emergency admissions. 
  • Process measures: the way your systems work to deliver your outcomes. Examples include how long patients wait for a senior clinical review, whether staff wash their hands, proper recording of incidents and communication with patients around delayed appointments.
  • Structure measures: also known as input measures, they reflect the attributes of the organisation which affect the process and outcomes, such as staff to patient ratios, operating times.
  • Balancing measures: unintended or wider consequences of change that can be positive or negative. Examples include monitoring emergency readmission rates following an initiative to reduce length of stay. 

Source: NHS Improvement

 

Truly embedded, ongoing improvement is the lifeblood of a successful NHS organisation which delivers quality care to its service users. We strive to create a space where NHS leaders and suppliers can come together to collaborate and innovate to find new routes to embedding improvement. 

Healthcare Partnership Network is a unique 2 day event where 100+ NHS senior leaders and suppliers share ideas and build relationships. Register your interesting attending Healthcare Partnership Network North, 17th-18th March 2020 at Oulton Hall Hotel Leeds.

 

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