Improvement Approach

Measurement is the first step that leads to control and eventually to improvement. If you can’t measure something, you can’t understand it. If you can’t understand it, you can’t control it. If you can’t control it, you can’t improve it.
— H. James Harrington

The following are the guiding principles of our approach:

  •  Identify, value and nurture leaders and participants in clinical teams to drive continuous quality improvement.

  •  Value and develop both clinical and managerial skills in clinicians and clinical teams.

  • Accept that most continuous quality improvement is a series of planned experiments within a Learning Healthcare System (LHS), not the result of large plans drawn up in offices.

  •  Help clinical teams acquire the skills and resources to experiment in the LHS.

  • Temper standardisation with an acceptance that there isn’t a ‘perfect system’ for us to copy.

  • Make the most of what you’ve got by collaboration - internally and with neighbours.

  • Be able to measure the small gains acquired from lots of experiments.

  • Use information to manage the organisation by fact, not just intuition.

  • Be bold in bringing cost as a component of efficiency squarely into the remit of ‘quality’.

  • Put the needs of patients at the centre of clinical decision making.

  • Transformational change (rather than ‘developmental’ or ‘transitional’) will be needed to achieve the vision and mission described above.


Methodology for establishing Quality Programmes

  • Each clinical system participates with full project management, data and financial analytic support & QI support as required.

  • A Clinical Lead is identified within each service with time allocated to support the work.

  • The QI team engages in the diagnostic phase to try to understand the current state and to inform improvement priorities.

  • Front line clinicians involved in interpreting data, identifying key clinical processes, using evidence based decision making to infomr agreed standards of care.

  • All interventions are designed and delivered around the needs of the patient and patient involvement is expected in all areas.

  • QI support is provided for each multidisplinary team at service level and through access to training in the Quality Academy.

  • Regular reviews and progress monitored by the service supported by improvement advisors, coaches and project management.

  • Following intervention with evidence of improvement will be embedded into clinical systems and reported through local management structure to ensure sustainability.

Full process.PNG