How and why did you first get involved in improvement and what has your journey been since then?
Quality Improvement (QI) has been a constant throughout my nursing career. I have always had a keen interest in how quality of care impacts patient outcomes, and how services can be improved. In this field, I have coordinated several QI projects, including the implementation of Hourly Rounding on Medical and Surgical wards. Hourly rounding is the practice of nurses making scheduled visits to the rooms of hospitalised patients and performing specific nursing interventions every hour.
I can confidently say that my nursing background has afforded me the foundation to make QI a second nature.
At this time, I worked in nursing administration, but I wanted to broaden the scope of my impact. This led me on a path of becoming the Director of Quality, where I provided oversight of the quality and accreditation program at my previous health care institution. In this role, I focused on quality management with the ISO 9001 standard and QI methodology in process and performance. The hospital accreditation framework of Det Norske Veritas (DNV) was utilised, and the institution achieved international hospital accreditation status. I can confidently say that my nursing background has afforded me the foundation to make QI a second nature.
What most inspires you professionally?
People inspire me; be it patients and families I have cared for in my career or colleagues with whom I have partnered on projects, initiatives, and wider programmes. I always feel privileged to be involved in those exciting moments where the change or improvement has created ‘magic’ or even a social movement to inspire others in positive action. As Simon Sinek says, ‘people do not buy what you do but why you do what you do.’ I believe it is the ‘why’ that drives and sustains persons to keep improving and promoting the culture of QI. Thus, I gain inspiration by seeing others become a part of transformation, despite the size.
Can you share a hard-won lesson you’ve learnt about what makes for a successful (or unsuccessful) improvement project?
I have learned the most from positive experiences in successful projects. These taught me the importance of engaged teams who share a passion for improvement. It is not always easy to build engagement when the adage is, ‘we have always done it this way.’ QI is dynamic, it challenges the status quo, and gives fruit to innovation. Sometimes people may get excluded because their ideas may appear too ‘disagreeable’ or ‘challenging’, but innovation involves new insight, and thinking outside the box can offer perspectives that are more sustainable.
What change could we make that would do most to embed continuous improvement in health and care?
Development of a quality culture where improvement is second nature at every level of the organisation. Additionally, bringing the Model of Improvement and the Plan-Do-Study-Act (PDSA) methodology to the forefront at the frontline, whilst supporting teams to develop, and become self-awareness of how they contribute to the bigger picture of strategic objectives is key.
Everyone has the power to be a change agent, and improvement innovator, no matter their job role.
Further, providing staff with the tools: education, training and development, and support can help to empower them. This will give staff the confidence to answer ‘yes!’ if asked, ‘are you working on any process improvement or quality improvement projects on your ward?’, and to follow up with their improvements. This shows that everyone has the power to be a change agent, and improvement innovator, no matter their job role. Imagine what can happen if this attitude is multiplied trust wide in clinical and non-clinical areas. This is a change we all can make together, and a culture we can build further, promote, and maintain.
Why did you join Q?
To learn, share, and engage in the wider discussions about QI, whilst networking with professionals who share the same passion.
The QI community offers rich perspectives, and avenues for contributing to the wider picture for positive change.
Further, I wanted to gain more insight on the experiences of staff within other institutions and trusts who continually do great work. The QI community offers rich perspectives, and avenues for contributing to the wider picture for positive change.
What new connections have you made as a result of joining the Q community – and what have you learnt so far?
The connections I have made so far have been remarkable. I have participated in the Quality Management Systems webinar series and exchanged ideas and experiences with other QI professionals from other NHS trusts within the region. Also, I have gained insights and resources through forums that I utilise in my current work at the University Hospital Bristol and Weston NHS Foundation Trust.
I work with the Transformation team as an Improvement Coach in a model called Proactive Hospital. This model supports continuous improvement to inpatient flow. Proactive Hospital has four key drivers of flow: Efficient Arrivals, Swift Assessment, Seamless admission and transfer, and Prompt Discharge. There are two portfolios under this model, which are urgent care, and flow and discharge. My work is mainly with the flow and discharge portfolio, currently with the Every Minute Matters (EMM) programme, where I support adult inpatient wards in board and ward rounds improvements.
Can you tell us about something you’re currently working on that Q members might be able to get involved with?
I am currently involved in the Quality Management in Healthcare Special Interest Group (SIG). This group explores application of the ISO 9001 standard and implementation of the Quality Management System in health care. We encourage other Q members to join the discussion on what the implementation of a Quality Management System in the NHS may look like. An upcoming forum event is taking place in October, and we are looking for panellists. The event will also include an audience to join in the discussion. Panellists should have knowledge of ISO 9001 standard, and the NHS.
For more information, join us at the Quality Management in Healthcare SIG.