When you are starting out on your Quality Improvement (QI) journey and setting up a Healthcare Collaborative, there are a range of preparations you can carry out to help ease the way.
There are a lot of QI collaboratives out there already, so you could prepare for your journey by reading about and learning from other teams who have already been through the collaborative process. You are going to be instrumental in the success of your collaborative, and if you have a motivated team that is accountable, your collaborative is more likely to be successful.
Here are some top tips to consider before starting your Healthcare Collaborative:
1. Have clear objectives
It’s really important to have a very clear vision as to why a quality improvement approach should be pursued (Kings Fund). You should agree with your team as to what your ‘areas of change’ should focus on and decide what the associated goals are. How should the collaborative run? What do you want to achieve at the end of the process? This is where a team approach is vital. The article ‘Collaboration in Health Care’ states that it is important to find ‘a team vision and strategies that help the team find clarity and direction as a cohesive group.’
2. People - who should be included?
As a key benefit of a Healthcare Collaboratives is learning from other people, you need to think carefully about who you should include in your team. It’s a really good idea to involve multidisciplinary teams in your improvement work, as this brings a whole new dimension to the project. You could also consider involving patients and carers as part of improvement teams. ‘The members of a multifunctional team bring together a range of functional expertise to the task at hand, whether for a one-time project or ongoing operational work'. This is facilitated by clinical experts and experts in quality improvement.
3. Decide on a topic
It is really important that you focus on a specific topic for your healthcare collaborative. In their report, Improvement Collaboratives in Healthcare, the Health Foundation suggests that you could consider selecting a topic based on where there is ‘established good practice and a large gap between current and ideal performance’. They also suggest that you begin with a ‘theory of change’ so that you can demonstrate a link between the proposed outcome and current activities. Focus on topics where there is established good practice and a large gap between current and ideal performance.
4. Decide on processes
The article ‘Collaboration in Health Care’ 2 states: ‘Processes are the organisational structures in which the team operates, including tools, procedures, policies, and management influences. Such processes can make team interactions more transparent, objective, and inclusive, while at the same time less personal and emotional.’ Successful collaboratives often include a series of structured learning activities, for example, creating PDSAs and other activities. If you can plan these in advance and work out how you are going to carry them out, it will stand you in good stead.
5. Decide on means of measurement
You need to be clear from the outset of you Quality Improvement journey how you are going to measure the results of your collaborative – and decide on a time limit. If you set clear goals that team members can buy into and measure success against, this will really support your improvement project. There are simple measurement tools and solutions that you can use to help benchmark and measuring against, such as Life QI.
6. Agree on what resources are needed
You will need to make sure that you provide organisational support and appropriate resources for your Healthcare Collaborative. Ensure that you have a sound IT infrastructure for collating data and sharing best practice and it might be an idea to make sure that organisational coaching is part of the collaborative, as well as ongoing learning sessions. Online systems such as Life QI can help streamline working processes and provide the tools to speed up the processes associated with Quality Collaboratives. This makes it quick and easy to create change ideas while minimising duplicate reporting.
7. Get your board on side
It’s really important to gain buy-in from senior leaders when establishing your Healthcare Collaborative. The Kings Fund report emphasises that leadership and organisational commitment is vital to support quality improvement activities and states: ‘However challenging, participants spoke of the importance of board-level engagement in and commitment to quality improvement: ‘We decided that it had to come from the board and it had to start with the board... I think that it’s really important that your chair supports you 100 per cent on this’.
8. Good Communication
Good communication is key as you will be engaging with people across multiple disciplines and job roles. Build up a tight network by using multiple methods of communication across your Healthcare Collaborative, including online and telephone support for your team.
9. Celebrate Success
The Kings Fund report says that QI leaders should ‘engage staff in a continued commitment to quality improvement by celebrating successes and ensuring that staff are able to take ownership and feel proud of their achievements.’
Evaluation of your Healthcare Collaborative is absolutely vital. You need to make sure that you can evaluate your outcomes carefully, as there is value in your team members learning both from teams that succeed and those that do not.
According to the BMJ article5, Quality collaboratives: lessons from research: ‘The evidence to date is that some collaboratives have stimulated improvements in patient care and organisational performance. Which points to the positive message that creating a Healthcare Collaborative is a truly worthwhile endeavour. We hope that these top tips will help prepare you for your QI journey!