Name: William Joseph Ltd.
Price range: $

In September 2024, the trust launched its Quality Strategy for 2024–2027, emphasising that the principles of QMS can ‘help us continually improve as an organisation’. They developed four guiding questions derived from the components of QMS to enhance service delivery. The strategy developed over 12 months with staff and service user input. Ongoing discussions explore whether to apply quality management at the micro or macro level. They have established a QMS Design Group and pilot work stream to progress work further.

About the project

In September 2024, the trust published its first ever Quality Strategy, setting out its ambition and strategic priorities for delivering high-quality and compassionate care for 2024–2027. The strategy states that the principles of Quality Management Systems (QMS) can ‘help us continually improve as an organisation’.

Derived from the four components of quality management, they have developed four questions that act as ‚guiding principles to use when planning and delivering services:

What do we need to do well?
How do we know we are doing it well?
How do we do it better?
How do we know it has made a difference?

Infographic depicting Northern Health and Social Care Trust’s Quality Management Approach

The development of the Quality Strategy has taken place over the past 12 months, involving conversations with hundreds of staff and service users.

There is a strong foundation of enthusiasm for quality improvement to build their work around. Discussions are ongoing about whether their quality management approach will build on this to operate at the micro (service or problem) level, or at the macro (organisational) level.

How do we as an organisation identify patient and population needs, measure (control) the metrics to show that we’re delivering well, and if we’re deviating? How do we improve those? How are we assured externally? And how do we take things back into a planning cycle?… or [do we] use a QMS cycle more specifically for instance, to improve falls prevention or pressure ulcers? In all the discussions that I hear… it isn’t clear to me exactly where’s best to apply the quality management system methodology.

They held a series of top leader’s forums with visiting speakers from other countries, discussing different aspects of quality management systems. That led to some ‘iterative conversations’, followed by the establishment of a QMS Design Group and a QMS pilot work stream.

Challenges

One of their biggest challenges has been to understand, ‘how do you pick out what to improve first, how to improve it, and how to scale that up?’ Their early work focused on identifying ‘the big five’ issues within the organisation. They began by looking at the key metrics, triangulating these with a range of different sources.

However, it has been a challenge, with ongoing discussions to try to gain consensus on their priority areas. When engaging hundreds of staff about the need for a quality strategy and asking ‘what do we need to do well?’ Staff overwhelmingly want to focus on areas like care and compassion. ‘We thought they would present strategic safety or quality issues, but rather than specific safety and quality concerns, we heard much more about how care should be delivered – with compassion, and with patient experience at the fore’.

Results

…as we were talking about quality management, we’d find people began to switch off, because we’re not in a factory setting, we are about people.

Following feedback from colleagues, they changed the formal descriptions of the quality management components into the four questions. As a result, “people feel much less threatened by them”, with some senior colleagues finding the original model and concepts “too theoretical”. The new questions aren’t rigid interpretations of the components, but instead reflect the importance that the model for improvement has within the organisation.

Despite actively engaging with other Q community members with an interest in QMS, and organisations involved in developing their own approach, Sarah and her colleagues are still working through how to “nail down” the core principles and apply them in a way that will provide an evidence-based outcome for improved service delivery.