Thomas John Rose
University of Birmingham, Institute of Applied Health ResearchEngland - West Midlands
Standards in the NHS are very high, unfortunately they are sometimes not all met. Standards are maintained through quality control. Good quality control provides quality assurance to clients. I have a view that a first step in a good quality control system is good process management. A first step in good process management is a clear understanding of your processes. I have another view that is that the best way to gain a clear understanding of your processes is to map them. To this end I have set myself the task of mapping all the processes used in the NHS and to identify best practice in each. The process maps, or visualizations as I call them, could be used, by hospitals, to reduce variation in the NHS.
Whilst working in industry some years ago I was tasked with designing and implementing Quality Management systems to meet the International standard for quality management ISO9000, for four SMEs. One of these SMEs undertook the design of software so the TickIT requirements were included in the certification. Experience to date had shown that many such quality management systems consisted of a vast array and volume of printed documentation, often beyond the reach of the people actually doing the work, thus defeating the initial objective.
My solution to overcome the documentation overload issue was, for every process, to create a simple process map to show what was done that in turn referenced written procedures that showed how it was done. The process maps and supporting procedures implemented all the requirements of the quality standard ISO9001. Lloyd's Register Quality Assurance Ltd. certified all four SMEs as having met the required standard for quality management, and commended the pioneering approach taken.
I then went on to further develop process mapping and procedure writing skills whilst undertaking research at Cranfield University in 2002. The 'process management approach' is gaining popularity in the UK and, in fact, the ISO9000-2015 standard, which must be implemented by September 2018 for certified organisations, has fully adopted this approach. Many organisations, like the NHS, still rely on too many written documents.
Advances in 'digital technologies' have enabled a big step forward in the design, development and promulgation of the 'process management approach'.
In the NHS quality improvers talk like academics, in industry quality improvers get on with it. Tom Rose May 2018
Q Exchange ideas
It's important that everyone understands the meaning of the words being used when the conversation is about quality. Juran, in his Quality Handbook, even has two definitions for quality. Herein lies the problem. Which of the two quality definitions are we talking about when we talk about QI?
To embed patient self management and an associated peer support facility into newly formed Neighbourhood Teams and existing GP practices in a large, mainly rural, county.
There are around 40 professional engineering institutions in the UK many of which have health care related special interest groups amongst their members. Lets communicate with them!
To explain and promulgate process management as a key requirement of continuous process improvement in the NHS. To demonstrate that performance is a key measure of quality. To design a methodology.
Social Prescribing for young people is an exciting opportunity for development. The national focus has been very much on working with adults through primary or secondary care, with pre-existing health conditions. In Shropshire, a large rural county in the West Midlands we are looking at how we can support young people, 16-24 years who are potentially isolated, in particular those young people who have not progressed into higher education, who may be in low paid roles, or who are unemployed. A recent national loneliness report found 16-24 years at higher risk than other age groups, this was part of the Community Life Survey (CLS) 2016-17.
Thomas Rose - Research Fellow, Institute of Applied Health Research, University of Birmingham - shares his improvement journey from electrical engineering to the NHS, and invites new members to join the Process Visualisation SIG.
Areas of interest
- Exploring Adaptive Space – community of practice
- Improvement Capability framework project
- Mental health and persistent pain
- Radiotherapy Quality
- Process Visualisation in the NHS
- Q Lab – peer support group
- Communities of Practice