Why does quality improvement matter?
It is crucial to understand why quality improvement is important in healthcare because of the vital role it plays in all aspects of service provision. From improved patient outcomes and satisfaction, to increased efficiency and compliance with regulations, quality improvement in healthcare benefits everyone involved.
By implementing a quality improvement strategy, providers are able to assess performance and quantify organisational processes and structure. Whilst the vast majority of healthcare staff and managers are well intentioned people with good values, things can and do go wrong. Healthcare is a highly regulated environment with quality measures and a safeguarding framework which aims to protect vulnerable adults, but which can sometimes feel punitive. Navigating your way through the inevitable challenges that face any organisation providing services is tricky.
Sometimes, the priorities and pressures make it difficult to see the wood for the trees and an outside perspective can be really helpful. In addition, in an environment where commissioners sometimes assume a lack of openness and transparency on the part of providers, it can be highly beneficial to be able to say that a completely independent investigation has been carried out to measure quality, and its findings shared.
Verita has operated for almost 20 years carrying out the most rigorous and thorough investigations, consultancy and complaints work for charities, business and other organisations. Verita is best known for its healthcare consultancy work in quality improvement and has carried out high profile investigations and consultancy assignments for the government, regulators, commissioners and providers.
5 reasons why quality improvement is important in healthcare
- Improved patient outcomes: By implementing quality improvement initiatives, healthcare organisations can improve the quality of care and achieve better patient outcomes. This can reduce healthcare costs and improve the overall health of patients.
- Increased patient satisfaction: Quality improvement measures that focus on patient-centred care can increase patient satisfaction and improve their overall experience with the healthcare system.
- Increased efficiency: By focusing on quality improvement, healthcare organisations can identify and eliminate wasteful practices, streamline processes, and increase efficiency. This can lead to cost savings and better resource utilisation.
- Better communication: Quality improvement initiatives often involve the implementation of standardised communication protocols, leading to improved communication between healthcare providers and patients. This can improve the accuracy and effectiveness of care delivery.
- Compliance with regulations and standards: Quality improvement is essential for healthcare organisations to comply with regulations and standards set by accrediting bodies. This ensures that healthcare organisations are providing care that meets or exceeds minimum standards of quality and safety.
Understanding why quality improvement is important in healthcare organisations allows measurement and improvement of service provision, as well as learn lessons and hopefully spot early warning signs so that problems can be prevented before they happen. In the learning disability sector, the best indicators of a service that’s in trouble are high sickness, high turnover and low training compliance.
If you can implement quality measures and spot the problem early it’s not too difficult to fix; all too often it isn’t spotted until it’s too late, for example when CQC turn up and give the service a bad rating. The message to all is to self-reflect, what does your clinical governance really look like? Which quality improvement structures does your healthcare organisation have in place?
Driving quality improvement in healthcare
Baroness Cumberlege’s report ‘First Do No Harm’ gives everyone involved in healthcare a lot to think about. The report examines the consequences of the use of Primodos, Sodium Valproate and pelvic mesh. It highlights serious quality failings and describes the industry’s response as “disjointed, siloed, unresponsive and defensive”. The reader is left with the dispiriting feeling that the progress that we all hoped was being made in improving patient safety in recent years amounts to nothing.
Most controversial, perhaps, are the report’s recommendations as to what to do about this. They include the setting up of an independent Patient Safety commissioner, outside the healthcare system, whose responsibility it is to represent the interests of patients.
While Baroness Cumberlege has done a great service by bringing out these issues and making the voices of those effected heard, it is less clear that the solutions she advocates are correct.
There are two fundamental questions here:
- Why do things go wrong?
- What can we do to stop them going wrong in the future?
These are big questions, but we at Verita, have some suggestions from what we have learnt in our extensive experience of investigating.
There are obviously a variety of factors which cause things to go wrong – and mistakes are an inevitable consequence of a complex system with people at its heart. That is not to say that the individuals are to blame – we know that people will never perform like computers. So we need to put systems in place to ensure that problems are identified before they turn into incidents and it is made easy for individuals to do the right thing first time.
This requires action at two levels – the individual and the system.
Any healthcare role involves not only providing care, but being responsive to thinking about how the system can be improved. Time and time again we see situations where someone knew something was wrong but were not able to do anything about it. That is not because they don’t care, but because they don’t feel empowered to resolve the problem themselves. Creating a culture where individuals feel listened to and empowered to bring about change is therefore essential. That comes from the top.
When individuals have spoken up there needs to be action. That requires organisations to understand what has happened, take responsibility for it and act to fix it. Two things are essential for that – they need the courage to act, but most importantly they need the data to make informed decisions. Fortunately, technology offers exciting opportunities in providing that data so that action can be taken.
Understanding why quality improvement is important in healthcare will help to improve patient safety but that ultimately requires those at board/executive level to act – just as much as each individual involved in patient care. Whatever commissions, agencies, watchdogs or ombudsmen are set up, these realities won’t go away.
At Verita, we have a long and successful history of working with healthcare organisations to make improvements through investigation, training, and development throughout both the NHS and the private sector.
We also provide a patient safety incident investigation training course which gives organisations the information needed to carry out an investigation into a range of incidents including safety breaches, complaints and capability concerns.