Board support for the improvement journey

Recent studies have shown the link between board commitment to quality improvement (QI) and better patient outcomes, demonstrating that if you want to be successful in embedding transformational change within your organisation, securing board support for your improvement journey is absolutely crucial.

In our last article we explored approaches to finding gaps in organisational skills before starting your QI journey. Now we’re going to be looking more specifically at ways you can secure your board support for improvement, in order to achieve QI success.

Board support for improvement - gaining commitment from the top

In the document ‘The Improvement journey. Why organisation-wide improvement in health care matters, and how to get started', The Health Foundation sets out elements that underpin organisational approaches to improvement, showing that QI activities are more likely to be aligned with the vision of the organisation with ‘visible and focused leadership at board level accompanied by effective governance and management processes.’ It also points to the fact that ‘a stable board with an established identity, and which is highly regarded externally, is well placed to embrace the challenges associated with a long-term, whole-organisation improvement programme.’

The Kings Fund agrees with this approach in its report: ‘Making the case for quality improvement: lessons for NHS boards and leaders', saying that:  ‘NHS leaders have a vital role to play in making this happen – leadership and management practices have a significant impact on quality.’

The Health Foundation references the Care Quality Commission (CQC) and its advice that those organisations with a ‘mature quality improvement approach’, have, among other things, ‘prioritised improvement at board level, put in place a plan for building improvement skills at all levels of the organisation, and developed structures to oversee QI work and ensure it is aligned with the organisation’s strategic objectives.’ These are all good reasons for securing your board’s commitment to QI.

There are real world examples of the positive impact of board support for improvement. The East London Foundation Trust had a ‘strategic, long-term, board-level commitment to QI, board-level leadership of quality, and investment in partnership with the Institute for Healthcare Improvement', which helped underpin and support its successful QI achievements.

Northumbria Healthcare NHS Foundation Trust also provides an interesting example, as - in partnership with the King’s Fund - it is delivering NHS Improvement’s Leadership for Improvement board development programme.

If a board can endorse any organisation-wide QI programme right from the start and show real leadership and a willingness for improvement, the overall project is more likely to be successful.

Making QI a priority

If you are reading this article, you will no doubt have an understanding that QI needs to be a priority in your organisation, and that there are many ways you can make QI a priority and help deliver organisational change. As we’ve discussed before, it’s really important that boards and leaders support the QI agenda – and that you also get wider support across your organisation. The CQC has said that system leaders and policymakers are also required to have a responsibility to support organisational change.

Making QI a priority in your organisation is all about good communication, and ensuring you have the resources available.  There is also evidence that if you encourage healthcare organisations by sharing learning, demonstrating proven QI track records and encouraging teams to build relationships with (and support) their peers, this can be a successful approach.

In order to be successful, your QI plans need to be a priority, sit front and centre of your QI agenda, and be recognised as a key element of achieving better patient care.

What resources might be required?

The Health Foundation sets out the four categories which are required for success in QI: leadership and governance; infrastructure and resources; skills and workforce; and culture and environment. These resources are needed for quality improvement and to ensure success in transformational change.

Along with the all-important board support for successful improvement, another key resource for QI is time. Improving quality of care is complex and takes time to achieve, and analysis of major improvements in NHS productivity shows that progress is normally achieved by taking small steps rather than a huge jump.

Investing in QI

Some studies have shown that barriers to embedding successful QI can be a lack of investment in IT or effective data collection systems. Conversely, if you dedicate and invest in resources that have been purpose built and help support you to collect accurate data, you can support your QI teams to collaborate and share, and this will put you on the road to better patient outcomes and higher quality care.

There is a range of excellent quality improvement resources you can look into using that - although require an investment – can be excellent value for the results they achieve. For example, Life QI is a solution which helps run QI collaboratives across multiple locations. It also helps you track and measure your progress and align with priorities, which in turn helps deliver improvement.

How can return on investment be measured and realised?

Demonstrating – and measuring - a ROI on quality improvement can be particularly tricky. By their very nature, QI projects can take time to show any real measurable benefits, which makes measuring ROI and success a really important element of the whole process.

This is another area where tools such as Life QI can really help you measure and keep an eye on what you do in QI project, as well as making it easy to share results with others. Resources such as Life QI can make the whole improvement process easier to prepare for, launch and sustain.

Good luck in your improvement journey!