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Increasing quality improvement (QI) capability amongst those clinicians who deliver direct care to patients

Improving quality is about making healthcare safe, effective, patient-centred, timely, efficient and equitable. In the history of the NHS, there has never been such a focus on improving the quality of health services (The Health Foundation 2013) and it is widely agreed that staff engagement is an essential ingredient of any sustainable approach to quality improvement (QI) (NHS Employers 2017, The Health Foundation 2011). However it has also been suggested that QI initiatives in the NHS have not generally secured the full engagement of clinicians (The Health Foundation 2011). This is of particular significance to the nursing profession who, with over 319,000 nurses employed across England make up the largest staff group in the NHS, out numbering their medical and allied health professional colleagues by almost 3 to 1 (NHS Digital 2017) but can also be assumed of all clinicians; with perhaps the exception of medical staff who maintain strong links with their clinical work throughout their careers and take part in QI during their training and beyond. We are looking to understand the barriers that stop frontline staff engaging and leading improvement work and develop enablers that help to address and remove those barriers.

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  • Idea
  • 2018

Meet the team: QI at the Frontline

Who?

The Y&H Improvement Academy will work with our Q members across the region to understand their level of involvement in frontline QI work, their current role including the amount of face to face contact they have with patients

What?

We will work specifically with those who are functioning at the frontline to develop an understanding of the barriers and enablers to undertaking effective QI work with a focus on less represented clinical groups; for example Nurses, Midwives, Allied Health Professionals and Paramedics.

Why?

Early analysis of the Q founding cohort identified 16% as involved in the delivery of frontline care; this would suggest there is reduced quality improvement (QI) capacity within clinicians who primarily deliver frontline services.

How?

We have used the Yorkshire and Humber’s Improvement Academy’s “Theoretical Domains Framework” to develop a survey which seeks to understand the barriers that prevent Clinicians leading QI initiatives. Early testing with a cohort of 30 Nurses has already yielded helpful results.

Our plan would be to join forces with our existing Q community across the region and use the same tool to understand their level of involvement in frontline QI work, their current role including the amount of face to face contact they have with patients and then work specifically with those who are functioning at the frontline to develop an understanding of the barriers and enablers to undertaking effective QI work with a focus on less represented clinical groups; for example Nurses, Midwives, Allied Health Professionals and Paramedics. We also plan to run some bespoke focus groups.

Finally, we will work with the same group of Qs in order to develop and test those enablers which help overcome barriers.

Our experience is that with the process involved in this methodology starts to help lead to the improvement in an identified behaviour.

How you can contribute

  • Please comment, critique and support this idea. If you have any similar projects or ideas lets talk!

Comments

  1. Crucial to bring QI to the forefront of clinical practice and supporting personnel. . Everyone’s job includes this role. Not an added extra, but we all need to develop the skills too.

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