Good leadership goes hand in hand with good patient outcomes. Studies show that the majority of the NHS trusts in England holding an outstanding CQC rating have implemented an organisational approach to quality, while other research shows that a board’s commitment to QI (quality improvement) can be linked to enhanced patient care.
As a leader, you have the opportunity to embed QI and introduce organisation-wide improvement by encouraging your team and sharing your vision. With effective leadership comes change - which is why good leadership in Quality improvement is so vital.
The report ‘Leadership in Health Care: A Summary of The Evidence Base’ by the Faculty of Medical Leadership and Management (FMLM), the King’s Fund and the Center for Creative Leadership (CCL) [1], reviews the evidence for leadership. One of the key points to came out of this report, is that leadership experience is ‘the most valuable factor in enabling leaders to develop their skills, especially when they have appropriate guidance and support. Focusing on how to enhance leaders’ learning from experience should be a priority’.
The NHS Academy sets out nine key attributes in its report, the NHS Leadership Model [2], which is designed to help those who work in healthcare to become better leaders. The points demonstrate what is important in leadership and give good examples of attributes that leaders can aspire to:
All these points – or ‘leadership dimensions’ are broken down into what the dimension focuses on and why it is important and provide excellent detail for leaders of QI.
There is a wide range of training available for those looking at embedding quality improvement into their healthcare organisations.
The Virginia Mason (VM) Institute [3] has developed its Leadership in Quality Improvement Pathway, which was created to align with its mission to prepare team members to become innovative leaders in health care. [4] The pathway uses the internationally renowned Virginia Mason Production System (VMPS) to train people in change management, leadership and quality improvement methodology, and includes techniques such as mentorship and one-to-one coaching.
The Scottish Quality and Safety Fellowship Programme (SQS Fellowship) is a quality improvement and clinical leadership course managed by NHS Education for Scotland (NES), Healthcare Improvement Scotland and NHS Scotland . It has been designed for healthcare staff who work in clinical practice and for those who have a role in improving patient care or safety. Its main aim is to develop clinical leaders who are capable of improving quality and safety of healthcare within Scotland. Its virtual Quality Improvement development programme: Scottish Improvement Foundation Skills (SIFS) supports people in developing the associated skills to become confident and effective members of improvement teams, as well as being able to test, measure and report on changes made.
The University of Massachusetts’ Medical School runs a course entitled: The Preparing Future Leaders: An Integrated Quality Improvement Residency Curriculum, using The Institute of Healthcare Improvement (IHI) methodology.
Life QI also provides training for teams and helps provide a structure, framework and a vision for QI planning and measurement, which is vital in the QI journey. The range of tools is readily available and helps develop teams’ skills and measure results.
There are many different tools you can use to help support your QI leadership development. Simply identifying what you need to do can kick off the process, and the Kings Fund helpfully sets out 10 steps for quality improvement , which can support you to better manage culture change as a healthcare leader.
The Healthcare Leadership Model is an evidence-based research model which has been developed by the NHS Leadership Academy specifically for QI development.
You could also look at the online quality improvement platform, Life QI – which supports leaders and teams running QI projects, enabling reporting, sharing of information and resources and connecting with other members of the QI community. It supports teams in their planning, monitoring and progress of their improvement projects, as well as facilitating cross-organisational boundary working.
Here are a few wonderful examples of leaders paving the way for quality improvement:
The board at East London Foundation Trust (ELFT) have a strategic, long-term, board-level commitment to QI and have developed a culture of improvement and organisation-wide improvement programmes. With an aspiring mission, clear vision and a strong set priorities in place, the scale of ELFT's quality improvement work has grown significantly over the past four years, so now almost 300 teams (clinical and non-clinical) across all areas of their operations are using systematic, continuous improvement methodology to tackle complex issues and testing ideas that could lead to significant, positive change.
Central and North West London NHS Foundation Trust (CNWL) built a small centralised team to coordinate its new QI programme [8], allowing the actual improvement work to be driven by staff within their own teams. The results were an efficiently and successfully run programme with excellent leadership, resulting in staff QI engagement exceeding expectations and staff independently running QI projects and actively recording them.
[3] - www.virginiamasoninstitute.org
[4] - https://www.virginiamason.org/leadership-in-quality-improvement-pathway
[5] - https://learn.nes.nhs.scot/814/quality-improvement-zone/learning-programmes/scottish-quality-and-safety-sqs-fellowship-programme
[7] - https://blog.lifeqisystem.com/elft-use-life-qi-to-drive-quality-improvement-at-scale
[8] - https://blog.lifeqisystem.com/cnwl-empowers-staff-and-significantly-increases-quality-improvement-capacity-and-capability
https://www.virginiamason.org/leadership-in-quality-improvement-pathway
https://escholarship.umassmed.edu/cgi/viewcontent.cgireferer=
https://www.google.com/&httpsredir=1&article=3825&context=oapubs