Healthcare quality improvement – policy implications and practicalities

Esain, Ann Elizabeth, Williams, Sharon Jayne, Gakhal, Sandeep, Cooke, Matthew W. and Caley, Lynne 2012. Healthcare quality improvement – policy implications and practicalities. International Journal of Health Care Quality Assurance 25 (7) , pp. 565-581. 10.1108/09526861211261172

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Abstract

Purpose – This article aims to explore quality improvement (QI) at individual, group and organisational level. It also aims to identify restraining forces using formative evaluation and discuss implications for current UK policy, particularly quality, innovation, productivity and prevention. Design/methodology/approach – Learning events combined with work-based projects, focusing on individual and group responses are evaluated. A total of 11 multi-disciplinary groups drawn from NHS England healthcare Trusts (self-governing operational groups) were sampled. These Trusts have different geographic locations and participants were drawn from primary, secondary and commissioning arms. Mixed methods: questionnaires, observations and reflective accounts were used. Findings – The paper finds that solution versus problem identification causes confusion and influences success. Time for problem solving to achieve QI was absent. Feedback and learning structures are often not in place or inflexible. Limited focus on patient-centred services may be related to past assumptions regarding organisational design, hence assumptions and models need to be understood and challenged. Practical implications – The authors revise the Plan, Do, Study, Act (PDSA) model by adding an explicit problem identification step and hence avoiding solution-focused habits; demonstrating the need for more formative evaluations to inform managers and policy makers about healthcare QI processes. Originality/value – Although UK-centric, the quality agenda is a USA and European theme, findings may help those embarking on this journey or those struggling with QI.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Business (Including Economics)
Subjects:	H Social Sciences > H Social Sciences (General) H Social Sciences > HD Industries. Land use. Labor > HD28 Management. Industrial Management H Social Sciences > HV Social pathology. Social and public welfare J Political Science > J General legislative and executive papers R Medicine > RA Public aspects of medicine
Uncontrolled Keywords:	Clinical systems improvement; Evaluation; Health care; Organizational learning; PDSA; Quality; Quality improvement; United Kingdom; Workplace training
Publisher:	Emerald
ISSN:	0952-6862
Related URLs:	http://www.emeraldinsight.com/journals.h...
Last Modified:	10 Oct 2017 14:31
URI:	https://orca.cardiff.ac.uk/id/eprint/33525

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