Improvement Journey

Improvement journey

The Importance of the Improvement Journey in Healthcare

Consistent improvement in healthcare is a prerequisite of effective patient safety, but for an organisation to successfully carry out its improvement journey in healthcare requires preparation, thought and vision. The way in which Quality Improvement (QI) is approached within healthcare organisations has changed and shifted in recent years, leading to the thinking that an organisational approach is necessary for a successful QI journey.

Why is an organisational approach to quality improvement important?

An organisational approach to QI is proving ever more important in healthcare today, as evidenced in the lean improvement journeys of several NHS trusts that have been rated ‘outstanding’ by the Care Quality Commission (CQC) in England. These include the East London NHS Foundation Trust, the Northumbria Healthcare NHS Foundation Trust and the Western Sussex Hospitals NHS Foundation Trust – all of these trusts have used this approach in their CQC improvement journey.

The six stages of the improvement journey

There can be many steps in the improvement journey which lead to a successful transformation within a healthcare setting. The Health Foundation has created a very helpful visual piece outlining six stages of the improvement journey. This focuses on QI in hospital trusts - and sets out the various stages of the improvement journey and helpful ways to overcome any barriers.

According to this approach, the six stages of the QI journey range from assessing readiness to sustaining an organisational approach. We’re going to take a look at these steps here:

1. Assessing Readiness

The first stage of the QI journey is assessing the readiness of your organisation. This key stage sets the scene for the QI process and encourages you to ‘check the pulse’ of your organisation, to find out whether the culture is right for change and whether the climate for learning is good. If this seems like a daunting task – there are tools that can assist you with this, including the Health Foundation’s ‘Are you ready to build and sustain improvement? An organisational checklist.’

2. Securing board support

Another key element of the QI journey and the Health Foundation’s approach – and vital to the success of your quality improvement journey - is securing support from the board. The CQC states that those organisations with a ‘mature quality improvement approach often have made improvement a priority at board level.’ You will need genuine commitment from your board, as well as from other leaders, to ensure a good start to the improvement journey.

3. Securing wider organisational buy-in and creating a vision

As well as commitment from your board and other leaders in your organisation, you will also need buy-in from the wider team and from others. Identifying other potential QI enthusiasts who you can share your vision with, in the early stages, can really help you start to embed QI and introduce organisation-wide improvement.

4. Developing improvement skills and infrastructure

Developing specialist improvement skills within teams across the organisation is vital, as is a systematic approach to building improvement capability. There are a range of tools and frameworks that can support your improvement journey, as well as tools that can measure and report benefits. Life QI is an online system that is used by QI teams to help streamline and speed up the working processes associated with quality.

5. Aligning and coordinating activity

Once you have a vision, a team that is on board, and a solid infrastructure, you need to start aligning and coordinating activity across your improvement programme. This alignment needs to be rolled out across your team, and also the organisation as a whole, in order to ensure coordination across improvement activities, workforce functions and organisational strategy. Again, this can seem like a daunting task, but there are tools to help you with this element of the programme.

6. Sustaining an organisation-wide approach

If you have achieved an organisation-wide approach to QI - congratulations! Now you’ve got there, it’s really important to maintain the momentum and sustain the approach – not only in your immediate team – but across your organisation. You can do this by encouraging the board to remain motivated and focused on the project, even if the QI wins are fragmented and return on investment is taking time. By sharing and communicating from the outset that the healthcare quality improvement journey can be a long process, means that you are managing expectations.

Good luck in your QI journey!

Although the journey to organisational and quality improvement can be a slow one, this should not put you off! By taking time to embed ideas and visions, creating and developing training and organisational tools across the organisation, it can help really bring about genuine change. As many organisations have shown, you can use slightly different approaches. Some may choose a six sigma improvement approach or a lean improvement journey, it’s up to you to decide whatever will work best within your organisation.

We really hope that this has helped you with your healthcare quality improvement journey. Read more in our series to find out how you can be supported in your continuous improvement journey in healthcare and your quest towards organisational improvement.