Comments

1. 

   Sharon Love 13 Mar 2024

   I am excited to see a new and fresh approach to drive forward improvement and increase compliance with Quality indicators, and ultimately increase  patient safety and experience. If we keep doing the same thing, expecting to get different answers/results, we are just sitting on a merry-go-round going nowhere. It is apparent that many actions plans associated with Quality Indicators are just a copy and paste, tick box exercise with no ownership or real change coming forth from same. This approach will bring a freshness, incorporating visuals, tangible actions and capturing the hearts and minds of staff to promote participation and engagement in the process. As stated, I am excited to see the outcome of this project and believe that this approach will have transferable knowledge and skill for scale and spread into many other areas/Trusts.

   Wishing you the best, hoping you are successful in this application for funding as I know this innovated in approach will make a difference.

    

   Regards

   Sharon

   1. 

      Julianne Lee 19 Mar 2024

      Hi Sharon,

      Many thanks for taking the time to comment. We totally agree that if we keep doing the same thing, we are not going to get a different result. We believe this new approach which we have refined and developed based on comments on our initial idea will promote ownership, participation and engagement, ultimately increasing  patient safety and experience.

      Regards

      Julianne

2. 

   Amber McCloughlin 6 Mar 2024

   Colleagues, this sounds like a fresh approach to the important issue of developing and realising Nursing Quality Indicators/Key Performance Indicators and Quality Improvement Plans that make a difference to patients, and populations.  While every nurse and midwife's business, this work often is often seen as onerous. I particularly like the Actions Speak Louder than Words, the interactive  resources, monthly themed quick wins that will reduce feelings of being overwhelming that will hopefully sustain engagement in the work. Bringing this to staff who are closest to the issue will also promote the development of NQIs that mean the most to patients/clients. This work fits with, will inform and demonstrates commitment to the regional nursing and midwifery quality  assurance framework. Good luck

   1. 

      Julianne Lee 7 Mar 2024

      Hi Amber,

      Thank you so much for commenting on our idea. We acknowledge that NQI’s and the associated work can feel onerous for nurses and midwives. We hope that this focused piece of work, dedicated face-to-face support, interactive resources and a monthly theme/s will move NQI/KPI’s and Quality Improvement Plans to be viewed by our registrants as not an additional task but a critical element in the nursing/midwifery professional tool kit to provide assurance, ensure accountability, transparency, and continuous quality improvement.

      Regards, Julianne

3. 

   Dawn Mackin 6 Mar 2024

   We know the delivery of nursing care is complex and often difficult to measure – the NQI’s have provided some assurances in the  quality of nursing care across the directorates but without sustained commitment to capturing and analyzing the data &  the production of QIP’s then there is little we can do to improve in the areas that fall below the mark

   Quality improvement plans should give the nurses closest to issues affecting care quality, the time, permission, skills and resources they need to solve them with support from the PS&QC team

   I support the aim to provide dedicated face to face engagement with staff  to create meaningful QIP’s and close the gap that is sometimes a tick box exercise for the NQI’s within the busy care environments

   Wishing the project team good luck with this proposal

    

   1. 

      Julianne Lee 8 Mar 2024

      Hi Deirdre,

      Thank you for sharing your experience of completing QIP’s .We fully acknowledge that they can feel like a tick box exercise in their current format and fail to engage staff.

      We are hopeful that through committing time, energy and resources and adopting a new focused approach we will be able to engage our frontline nurses and midwives and make QIP’s meaningful and visual.  This in turn will translate to sustained learning and improvement, improving safety and quality of care for our patients.

      regards

      Julianne

       

   2. 

      Julianne lee 8 Mar 2024

      Hi Stephanie,

      Many thanks for your suggestions from your lived experience of completing QIP’s and the experiences of your ward managers. This will help inform and develop our project.  Focusing on one specific improvement each month will definitely be more powerful and more realistic and achievable for staff. QIP’s are currently completed monthly in line with monthly auditing, but I totally take on board that with this level of frequency there may not be sufficient opportunity for sharing the learning/improvement.  Your suggestion of bi-monthly completion to help increase their value and promote engagement is definitely something to be considered.

      The involvement of frontline staff and the development of champions is key to the success of this project. We are really excited and motivated by the interest our idea is generating and the comments/suggestions are all helping us refine and shape our project proposal

      Regards Julianne

   3. 

      Deirdre Grant 8 Mar 2024

      Hi Dawn, Julianne and Stephanie,

      As frontline staff we are all committed to delivering safe quality care and have welcomed (back) the NQI process.

      I have only been involved for a short-time in creating Quality Improvement Plans (QPI) but completing the QPI does unfortunately feel like a tick box exercise and, in their current format, fail to engage staff in making and sustaining improvements. I welcome the idea of face-to-face engagement and the development of visual interactive resources and also agree with Stephanie that focusing on specific improvements at a time could be more productive. Good luck with the project.

   4. 

      Stephanie McCarragher 8 Mar 2024

      Hello Dawn and Julianne,

      From my experience with NQI's, as well as myself or the ward managers completing the QIP's; I totally agree QIP's can very easily become a tick box exercise.  I feel that the managers should be empowered to look at one particular area as the main focus for improvement for the month, this would be a much more powerful message to staff instead of a diluted message when we are trying to focus on all area's at all times.  Also consideration is needed around the frequency of QIP's, when these are completed it may be middle of the month, this can be too late for improvement/sharing the learning as charts can already be audited or documentation completed.  If this was bi-monthly this would increase the value in completing QIP's which hopefully would lead to increased engagement from teams.

      I do think it is also important that the frontline staff are involved, this is how we improve and make a difference, champions is a fantastic idea but it is providing them with the time, resources and information to make that positive impact on their service area.

      I think this project is a fantastic idea, I wish you all the best with your application.

      Stephanie

   5. 

      Julianne Lee 7 Mar 2024

      Hi Dawn,

      Thank you for your comment. We totally agree that we need to give frontline nurses who are closest to the issues affecting the quality of care the time, permission, skill and resources needed to lead to sustained improvement. This project should do just that. We certainly do not want QIP’s to be a tick box exercise, but know that in some situations that is the reality which can be attributed to system and staffing pressures. This project will provide the opportunity to address this.

      Regards

      Julianne

4. 

   Sharon Burnside 6 Mar 2024

   Great to see this suggested approach to sustain and improve patient safety and quality across all of the care that our frontline nurses and midwives provide across all Directorates.  face to face support and engagement to support our nursing and midwifery staff to improve/maintain good compliance with  NQI/KPI/QIPs. Looking forward to hearing what the outcomes/impact of this increased support and use of the interactive resources will have on compliance levels and patient safety and quality. Just a suggestion as part of evaluation, will you be building in a method to look at how many times staff access the interactive resources that you will be creating as part of this?

   1. 

      Caroline Agnew 11 Mar 2024

      Hi Sharon, many thanks for your comment.  Yes we hope that with both the increased support to nursing and midwifery staff and the availability of interactive resources will improve compliance levels and patient safety and quality.   Yes, we plan to build in a process to monitor staff access to the interactive resources to assess that they are being used and how often.

      Thank you

      Caroline

       

       

5. 

   Emily Roberts 5 Mar 2024

   There is no question that patient safety is paramount in healthcare and using NQIs and QIPs to enhance safe, quality care is fundamental. I think this project has the potential to address the gap between research and practice. I particularly like the idea of   “Actions speak louder than words”  and feel that face-to-face engagement is a likely to develop a sense of ownership that will improve compliance with the QIPs.  Developing and providing an up to date suite of visual interactive resources is very exciting and innovative. I think this project has the potential to really benefit patients, clients, families and the nursing profession as a whole. The project also has great potential for scale and spread across the rest of NI.
   I look forward to watching your progress and seeing the improvements you accomplish. Good luck

   1. 

      Julianne Lee 5 Mar 2024

      Hi Emily,

      Thank you so much for taking the time to comment. We believe this new approach will bridge the identified gap, in that, despite the completion of Quality Improvement Plans (QIP’s), achieving high compliance rates and sustained improvements is not being achieved. Dedicated face-to-face engagement, identification of NQI Champions and meaningful QIP’s will create that much needed sense of ownership and achieve sustained improvements, which will translate to improved patient safety and quality of care.

      Embracing technology through the development of visual interactive resources will make just in time learning and provision of information a reality, increasing nurses and midwives understanding of the whole NQI process.

      We totally agree that there is real potential for scale and spread across Northern Ireland, and further afield.

      Regards

      Julianne

6. 

   Laura Spiers 5 Mar 2024

   I am really excited to hear of this project and can see real benefit to service users in terms of both patient safety and  the delivery of high quality care. Sustaining compliance with NQI'S/KPI'S has been challenging for many reasons and often the feedback elements can become lost in a process which is  data driven. It is great to see such a refreshing approach to really promote nursing engagement within the process, and in turn, bring this meaningful data to the bedside. It is a welcome development to see opportunity afforded to front line nursing staff to have a steer in terms of setting and developing performance indicators of particular relevance for their service areas.

   Will there also be opportunity to explore qualitative indicators which may help track service user experience and the impact of high quality nursing care on patient outcomes?

   Bets of luck

   Laura

   1. 

      Julianne Lee 7 Mar 2024

      Hi Laura,

      Through a previous QI project, completed in 2023, looking at the completion and submission of Quality Improvement Plans (QIP’s) resulted in 100% compliance. However, despite improvement actions, being identified sustained improvement is not being achieved. This is not enough; we need to move to the next level to positively impact patient care and experience.

      Additionally, empowering our frontline registrants through training, provision of resources and dedicated support will create ownership, confidence and competence.

      This project will drive forward development of meaningful QIP’s, explore qualitative indicators and capture feedback elements, which as you point out, can be lost in the process which is often data driven. We will use care opinion to hear and understand our patient’s stories and support triangulation of data.

      I hope this answers you question

      Regards

      Julianne

7. 

   Susan Sandford 4 Mar 2024

   Having worked  with successful  Quality Improvement Initiatives in the past, I applaud the Trusts vision to continue to maximise the professional contribution of nurses and midwives and reinvigorate our workforce making them feel valued, respected and supported to deliver optimal care.

   As some available studies report to show that quality improvement projects improve staff satisfaction , but have not been clearly shown to improve overall outcomes, how will the Trust intend to show proven patient outcomes  ?

   1. 

      Julianne Lee 4 Mar 2024

      Hello Susan,

      Many thanks for your comment. In relation to your question regarding how we intend to show proven patient outcomes, we plan to undertake this in various ways. We will adopt a grass roots approach, capturing the hearts and minds of our registrants. We will be actively visible on wards and in community teams, providing dedicated face to face support and in partnership with frontline staff focus on selected ward/service specific improvements each month. We will  put systems and processes in place to boost the culture, capabilities and structures needed for sustained learning and improvement. We will undertake quantitative and qualitative  audit, collect patient and registrants stories, collate findings and act on these.

      Regards

      Julianne

8. 

   Julie McConville 4 Mar 2024

   I strongly agreed that the actions already in place to increase compliance are not working and that the active engagement of frontline nurses and midwives is crucial to ensuring system wide, sustainable focus on safety and quality.   The potential of scaling up learning from the project through PHA, DH, SPPG and the Child Health Partnership Board is also welcome.  Is the project team aware of any other organisations that have implemented quality improvement methodology to embed nursing quality indicators?

   1. 

      Stephanie Hunter 7 Mar 2024

       

      Hi Julie

      Thank you for the support and comment. We agree the active engagement of frontline nurses and midwives is crucial to ensuring system wide, sustainable focus on safety and quality.  As a team we are currently not aware of any other organisations that have implemented quality improvement methodology to embed nursing quality indicators. Our goal is to utilise all resources and contacts through the Q community for networking, learning and developing our quality improvement project.

      Kind Regards

      Stephanie

9. 

   Colm McCafferty 4 Mar 2024

   Nursing is a diverse  profession across the Trust, including Acute  with many community based nursing services.  Increased focus on Patient safety, coproduction and potentially increasing direct support to front line teams and practitioners in this pursuit, is to be welcomed. I believe this initiative would greatly compliment and strengthen Nursing Governance and improvements on a Trust wide basis and assist with affording the same degree of rigour  to all nursing specialisms and services.

   1. 

      Julianne Lee 4 Mar 2024

      Hi Colm,

      Many thanks for your constructive comments.  It is very much appreciated. This project proposal will allow an increased focus on patient safety and coproduction. It will  increase direct support to our registrants, strengthen nursing and midwifery governance and promote staff engagement.   We will cover all care directorates in both acute and community settings, which will include nursing specialisms.

      Julianne

10. 

    Grace Hamilton 4 Mar 2024

    This is a much needed project to test a new approach to obtaining and sustaining quality improvement in order to improve the quality and safety of care for our service users and has the potential to have board ranging impact.  Has this type of approach been tested before and if so was it successful?

     

    1. 

       Stephanie Hunter 6 Mar 2024

       Hello Grace

       Thank you for your comment  we also agree this is a much needed project to test a new approach within the Trust in obtaining and sustaining quality improvement in order to improve the quality and safety of care for our service users.  Previously our team completed a QI project looking at the completion and submission of Quality Improvement Plans, this project had an end result of 100% completion. Although the quantitative data is present and successful the qualitative data is not. We aim for sustainable improvement across our NQIs QIPs and patient safety by applying a refreshing approach to really promote nursing engagement within the process. To our knowledge this type of approach for NQI/KPIs has not  been tested before within the Trust or Regionally, our goal is to utilise all resources and contacts through the Q community for networking, learning and developing our project.

       Kind Regards

       Stephanie

11. 

    Jacqueline Morton 1 Mar 2024

    This is a significant project that crosses a number of operational boundaries. What level of executive sponsorship have you secured?

    Is this project identified as an improvement  priority?

    1. 

       Julianne Lee 4 Mar 2024

       Hi Jacqueline, thank you for your comment. The focus is on improving Quality  and Safety  of care across all operational boundaries and this project has been identified as an improvement priority within the Trust.  Executive support for our project has been secured and we look forward to working in partnership with our colleagues to strengthen Quality Improvement Plans across all directorates and divisions.

       Regards

       Julianne

        

12. 

    Joan McMahon 29 Feb 2024

    A much welcomed new approach for NQI/KPI/QIP. This will support our frontline Nurses and Midwives to make a difference by sustaining and improving safety and quality of care across all Directorates.

    The suite of visual interactive resources will allow for  more meaningful learning and  understanding of the need for NQI.

    1. 

       Julianne Lee 4 Mar 2024

       Hi Joan,

       Thank you for taking the the time to comment on our improvement idea. We totally agree the development of visual interactive resources will allow for  more meaningful learning and  understanding of the need for NQI's which in turn will support us in assuring, sustaining and improving safety and quality of care.

       Regards

       Julianne

13. 

    Una Hughes, Children's Nursing Services Training Coordinator 29 Feb 2024

    Patient safety is paramount in healthcare and using NQIs and QIPs to enhance safe, quality care is essential. It has long been recognised that there is a gap between research and practice and you are highlighting another gap between the QIP and actual practice. I think that your theme of “Actions speak louder than words” is great; face-to-face engagement is bound to increase ownership and hopefully make it more meaningful and improve compliance with the QIPs.
    Stakeholders (patients, families and staff) becoming more involved may help in your goal of capturing the hearts and minds of the nurses and midwives.
    I like your idea of creating a suite of visual interactive resources and I was wondering if there is a way to help the stakeholders to see what the monthly theme for improvement is and to be able to see what has been improved previously?
    This project will really benefit the patients, their families and the morale of staff to be able to see tangible changes. I look forward to watching your progress and seeing the improvements you accomplish. Good luck

    1. 

       Stephanie Hunter 4 Mar 2024

       Hello Una thank you for your comment it is much appreciated in helping us develop our improvement idea. We totally agree that patient safety is paramount in healthcare and using Nursing Quality Indicators/Key Performance Indicators and Quality Improvement Plans to enhance safe, quality care is essential.

       We have identified that there is a gap between Quality Improvement Plan compliance rates and sustainable change is needed. We are hopeful that the theme of “Actions speak louder than words” and the opportunity of  face-to-face engagement will help us achieve our project aim.
       A co-production approach will be employed with Stakeholders, which is key and invaluable in working through PDSA cycles and shaping the project outcomes.
       We have created Safety Quality boards for all our in-patient areas were we will visually display the monthly theme for improvement and celebrate success and strive for continual improvement. The creation of  visual interactive resources which are easily accessible to all will support NQI/KPIs across the Trust and positively impact on patient care and experience.

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