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We are inspired by the great work that is going on in quality improvement across the globe and we can really learn - and take guidance from - QI leaders in the industry. We’ve put together a group of quotes from inspirational quality leaders who have effected transformational change to get an insight into their thoughts on QI Leadership.
Donald M. Berwick, MD, MPP, President Emeritus & Senior Fellow, Institute for Healthcare Improvement
“So what can we do about it? Move from inspection to improvement. Move from surveillance and contingency and reward and punishment, remove from asking people to try harder to asking people how we can help them to learn.” [1]
‘The first is to enable local activity. Improvement is a local phenomenon. Even though common knowledge can be crucial it will emerge as a characteristic of the individual hospitals and trusts and clinics and local organisations and the NHS that improves will be one in which the in-house capacity & local environments for continuous quality improvement is robust.’ [2]
Derek Feeley, President and CEO, Institute for Healthcare Improvement
“We can still do a lot more than we're currently doing around improving quality, understanding patients' needs, engaging patients in their care, redesigning care to provide for people with long-term conditions rather than acute episodes. What we are encouraging people to do is to focus on those things. Let's focus on the stuff we can really change. And my sense is there are still a significant number of organizations that would like to do just that.” [3]
Gary Kaplan, Chairman and CEO, Virginia Mason, Seattle
‘Although Virginia Mason has a longstanding reputation for innovation and clinical excellence, our journey to design a better system of care actually began just over 10 years ago. It was prompted by a simple question from our board. Community leaders from companies like Microsoft, Starbucks, Boeing, they asked us 'Who is your customer?' and of course our immediate response, just like everybody in health care, was 'our patients.' But upon further reflection and challenge by our board, we realized that our systems were not designed for the safety and convenience of our patients, but based on the preference of providers.' ‘Since adopting the VM production System we have saved millions of dollars in planned capital investment, we have dramatically reduced inventory cost…. ...that shows you that it is possible to improve quality and be wise stewards of resources.' [4]
Amar Shah, Chief Quality Officer, East London NHS Foundation Trust (ELFT NHS)
"We needed a way to allow everyone to contribute and get involved and share their ideas and be able to learn from each other, and for that purpose quality improvement is an amazing way to harness the assets and strengths that everyone has to bring and align that with the priorities that we set as an organisation.” Amar Shah, , East London Foundation Trust. [5]
Jason Leitch, National Clinical Director of Healthcare Quality and Strategy NHS Scotland
“Humans change because you empower them, you give them the data, you allow them to put the data on the wall, that’s how change happens. It doesn’t happen because you write them a letter.” Leitch mentions three examples of improvement. [5]
The first is ‘What matters to you?’ which is now a global movement led by Scotland and Norway. Leitch says that if you go into the Queen Elizabeth Hospital in Glasgow, you will see charts where patients have filled out what is important to them personally. “It’s all about the individual,” he says. “And therefore, the ward rounds and the interaction with the staff are different”. [6]
Carrie Marr, Chief Executive, Clinical Excellence Commission, NSW, Australia.
“ In the world of improvement we talk about improvement science and it’s important for us to work with hospitals and health care organisations to help them build a critical mass of staff who understand improvement science. They’ve got the knowledge, the skills and the tools which support change in areas like measurement, understanding the theory of change and understanding how they test for change in a way that creates sustainability. Big bang change, really works.’ ‘New South Wales Health regularly measures itself against international benchmarks around healthcare outcomes and quality and safety and we have an international – almost network alliance – between ourselves, America, the nations of the UK, Scandinavia and New Zealand.
So the value proposition for us around safety and quality is that it all starts with culture and leadership. And in a hospital or health care system, if that leadership and culture isn’t positive and strong then the opportunity to create real improvement is actually going to be a challenge. So the role of the leader essentially for us is to create the conditions for improvement and for change.” [7]
Greg Adams, Chairman & CEO, Kaiser Permanente
“All leaders need the ability to listen to team member feedback and incorporate recommendations from our team members. We must be genuine in our leadership. It is the collective mission that drives our people to show up every day. Living out the mission of this organization, with integration, partnership and a shared commitment to community, is essential if we are to achieve the organizational goals. Our effectiveness must be measured by our ability to bring everyone on board. It is our people collectively who make it happen”. [9]
Library:
[1] https://www.kingsfund.org.uk/audio-video/don-berwick-quality-improvement
[2] As per note 1
[4] Improving Quality, Lowering Costs: The Role of Health Care Delivery System ...
By United States. Congress. Senate. Committee on Health, Education, Labor, and Pensions
[5] https://www.kingsfund.org.uk/audio-video/don-berwick-quality-improvement
[6] As per note 1
[8] Improving Quality, Lowering Costs: The Role of Health Care Delivery System ...
By United States. Congress. Senate. Committee on Health, Education, Labor, and Pensions
[9] https://www.nurseleader.com/article/S1541-4612(19)30220-4/fulltext
NURSELEADER - LEADER TO WATCH| VOLUME 17, ISSUE 5, P385-388, OCTOBER 01, 2019
