Implementing a QI system for an ICS

Regional Integrated Care Systems (ICSs) are a mechanism to partner organisations to meet health and care needs and provide a collaborative approach to improve population health and reduce inequalities. It removes traditional divisions between hospitals and GPs, between physical and mental health, and between NHS and council services.

Establishing these better connections between NHS trusts, primary care providers, local councils, and other important strategic partners (voluntary, community and social enterprise sectors), offers a unique opportunity to make improvements across the entire continuum of care, rather than siloed efforts within the remit of individual organisations. Multi-discipline, trans-organisational collaboration allows the bringing together of expertise, innovation and learning to strive for collective improvement, sustainability, and transformation.

However, it also provides some significant challenges! How do we best connect individuals and organisations with differing backgrounds to facilitate meaningful improvements? How do we track activity and progress aligned with the priorities of the ICS? And, how do we also facilitate the individuality of the constituent organisations and their local improvements?

You can address these challenges by establishing robust and accessible QI infrastructure, including a system for facilitating, running and tracking quality improvement work.

What you should consider when looking for a QI system for your ICS

Constituent organisations of an ICS are connected through their common geography and populations they serve. However, that can sometimes be where the similarities end. Regarding quality improvement, each organisation is likely to have its own focus, approach, and measures of success. To deliver the desired improvements across the full spectrum of population health there needs to be a joined-up strategy for the ICS. A QI system provides a platform to deliver that, but there are a few things to consider along the way…

1. The technology challenge

The first objective for the QI system is likely to be getting system-wide improvement work into a central repository, where it can be accessed by stakeholders from any of the ICS organisations. This is going to be critical in delivering joined-up improvement. With such trans-organisational collaboration comes at technical challenge, particularly as each organisation has its own IT infrastructure and limitations. A cloud hosted platform is a perfect solution to provide access to everyone who needs it.

2. Catering for all experience

By their nature, ICSs are composed of a range of organisations with varied backgrounds, experience, and skills. Regarding quality improvement - each organisation in an ICS is likely to have its own way of working and its own understanding of the process. Naturally, some organisations will be more advanced in their ‘QI journey’ and more capable of delivering and tracking improvement than others. To be effective for an ICS, quality improvement must be inclusive and therefore a system needs to cater for different experiences and capabilities – from improvement experts to novices.

One consideration is the method for running improvement work. Options range from universally applicable methods like the Model for Improvement or Lean to more specialist such as Six-Sigma. One of the big challenges is going to be engaging those with less experience of improvement. Therefore, when it comes to method, simplicity is likely to be all important.

3. A common approach

It is likely that within any ICS there is variation in the way QI work is run and tracked. Firstly, it's important to understand any established or embedded approaches of organisations in your ICS, along with their similarities and differences. In an ideal world, everyone would use an identical approach, method, and language but this may not always be realistic. For the biggest impact it will be important to align these as much as possible.

A QI system will establish common standards for evaluating project progress and for measuring and reporting on improvements delivered. The aim here is not change the system for them if it works, but more so try to adapt to what they have in place with the aim to bring everyone along together at the same pace.

4. Weigh up the options

Being able to efficiently collaborate with your partner organisations adds a level of complexity to your QI work. It’s unlikely that a spreadsheet is going to suffice for coordinating cross-organisation improvement efforts. And who would want to maintain that!? Ask around your ICS to understand what system other organisations are using to run and track their QI work. It may be that the simplest approach is to use a system that is already in use elsewhere.

Implementing a QI system at the organisation level

When implementing any new system or process, there is a certain amount of change management required. A new QI system is no different, and due to is widespread applications its implementation warrants some careful planning.

Change is most successful when supported from the top. Executive sponsorship is important to secure budget (money and time) to procure, manage and support the new system. This sponsorship should be backed up with a clear set of objectives for implementing the platform. Life QI is the quality improvement platform of choice for hundreds of organisations, and the most common objectives are around facilitating bottom-up improvements, enhancing the visibility of QI work, and allowing consistent reporting at any level in the organisation. Clear objectives from the outset help with gaining buy-in from other parts of the organisation and help evaluate future success.

Once the stage it set, the realities of a software implementation should get underway. Assuming you are opting for a cloud-based solution, you will not need any local installation or IT support. However, a plan should be in place for rolling out the system, training power users and other staff and for supporting ongoing use of the system to achieve your organisational objectives.

Spreading a QI system in your ICS

Initiating QI within your own organisation is one challenge but coordinating that across an ICS adds additional complexity that should not be overlooked. However, with some basic planning, it should be very achievable.

Firstly, you’ll need to ensure executive support at the other organisations within the ICS. Are they onboard with using a common system for improvement? Given the aim of an ICS, it shouldn’t be hard to gain that alignment.

You may find that, with so many more stakeholders, the objectives for using a QI system for the ICS are slightly different than on a more local level. There is likely to be more collaboration across organisations and the ability to share results and learning. You may also find that there are additional reporting requirements for this new cross-organisation work.

Quality improvement is rarely a one-size-fits-all approach so there will need to be some balance with the needs of individual organisations, including their internal reporting and the ability to maintain control of some local projects and programs of work.

In terms of the physical roll-out and management of QI work, it would be great to have a like-minded team with representatives from several of the ICS partners who can work together on supporting the use of the system and for encouraging wider uptake of QI across the ICS.

How Life QI can help

An ICS is a complex combination of organisations of varying sizes and states of readiness in QI. Providing consistency in approach and reporting will act to improve efficiency and visibility of the improvement work being undertaken.

Life QI provides an out-of-the-box solution for running, managing, and tracking improvement and is a perfect tool for cross-organisation collaboration. It is widely used in the NHS and by other healthcare services and provides a solid foundation for your ICS improvement work. Read more about how you can use Life QI to track improvement in an ICS.