INTEGRATION AGENDA NOT NEW ! Key policy objective since 1970 Joint - - PowerPoint PPT Presentation

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INTEGRATION AGENDA NOT NEW ! Key policy objective since 1970 Joint - - PowerPoint PPT Presentation

Apr 08, 2024 122 likes •289 views

QUALITY IMPROVEMENT IN HEAL THCARE The Critical Success Factors June Wylie, Head of Implementation and Improvement, Healthcare Improvement Scotland INTEGRATION AGENDA NOT NEW ! Key policy objective since 1970 Joint working Partnership

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SLIDE 1

QUALITY IMPROVEMENT IN HEAL THCARE

The Critical Success Factors

June Wylie, Head of Implementation and Improvement, Healthcare Improvement Scotland

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SLIDE 2

INTEGRATION AGENDA NOT NEW !

Key policy objective since 1970

  • Joint working
  • Partnership working
  • Joint Improvement Fund
  • Single shared assessment
  • LHCC
  • Managed Clinical Networks and, and, and
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SLIDE 3

KEY FACTORS INFLUENCING INTEGRATED WORKING

  • Policy frameworks
  • Joined up
  • Realistic
  • Local planning context
  • Joint acceptance of unmet need
  • Vision owned at all levels
  • Operational factors
  • Relationships
  • Cultures
  • Behaviours
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SLIDE 4
  • Audit
  • Clinical Governance
  • Business Process Redesign
  • Total Quality Management
  • Clinical Effectiveness
  • Quality Assurance
  • HEAT Targets
  • Research

QUALITY IMPROVEMENT IN HEALTH

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SLIDE 5
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SLIDE 6

DEFINING QUALITY IN HEALTHCARE

To Err is Human-2000 Crossing the Quality Chasm-2001

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SLIDE 7

Safe Effective Person Centred Efficient Timely Equitable

HEALTHCARE QUALITY STRATEGY

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SLIDE 8

CRITICAL SUCCESS FACTORS IN QUALITY IMPROVEMENT

What the literature says

  • Need to understand system
  • Value role of customer
  • Reduce variation
  • Leadership at every level
  • Data and measurement
  • Resources to support implementation and staff development
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SLIDE 9

LARGE SCALE IMPROVEMENT

  • Culture
  • Context
  • Leadership
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SLIDE 10

CULTURE

  • Increasing recognition that culture of hospital or healthcare

system has a significant impact on its ability to achieve improvement

  • High profile failures have demonstrated that informal

psychological and social aspects of an organisation play a significant role in performance

  • Few hospitals taking steps to assess or understand their

culture

  • Organisations which focus on teams and supportive

infrastructures to support innovation and staff development perform better

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SLIDE 11

CONTEXT

  • Size
  • Teaching status
  • Leadership
  • Competition
  • Culture
  • Years involved in quality improvement activities
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LEADERSHIP

  • Identified in almost all literature as critical.
  • Leadership at every level (wicked problems cannot be solved

by one person alone)

  • Key leadership behaviours and skills
  • Engagement and relationship skills
  • Enabling and facilitating others
  • Clinical leadership essential- particularly medical staff
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SLIDE 13
  • What factors are influencing the implementation of

neurology standards?

  • To what extent is the implementation and improvement

support programme provided by HIS been successful in supporting NHS boards to implement standards?

NATIONAL IMPROVEMENT PROGRAMME

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SLIDE 14

IMPLEMENTATION SUPPORT Helpful

  • Identifications of an

improvement lead in every board

  • Improvement leads

network

  • Focused implementation

support from HIS

  • Funding support

Challenges

  • Two year programme too

short

  • Time limited funding
  • Integration challenging
  • Data on patient outcomes
  • Leadership and

engagement at local level

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SLIDE 15

PRACTICAL APPLICATION

  • Clear clinical engagement/ leadership engagement strategy

at start of any project

  • Culture/Language is important. Need to understand

difference and similarities

  • Measurement for improvement
  • Consider my own leadership style
  • Spend more time engaging with staff and stakeholders
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SLIDE 16

REFERENCES

  • Bate, P. Mendel, P. & Robert, G., 2008.Organizing for Quality: the improvement journeys of leading hospitals in

Europe and the United States. Oxford: Radcliffe Publishing.

  • Davies, HTO, Nutley,S. & Mannion,R., 2000. Organisational culture and quality of health care. Quality in Health

Care, 9, pp.111-119.

  • Davies, H. Powell, A. & Rushmer, R., 2007. Healthcare professionals views on clinical engagement and quality
  • improvement. ISBN 0-9548968-6-6. London, The Health Foundation.
  • Institute of Medicine, 2008. To Err is Human. Building a Safer Health System. 7th ed.USA: National Academy Press.
  • Institute of Medicine, 2009. Crossing the Quality Chasm: A New health System for the 21st Century. 9th ed. USA:

National Academy Press.

  • Mannion, R, Konteh, FH,& Davies HTO,.2009. Assessing organisational culture for quality and safety

improvement: a national survey of tools and tool use. Quality and Safety in Health Care, 18, pp. 153-156.

  • Mannion R,. et al 2010 Changing management Cultures and organisational Performance in the NHS (OC2).National

Institute for health research

  • Parker, V. A et al 1999. Implementing Quality Improvement in Hospitals: The Role of Leadership and Culture.

American Journal of Medical Quality, 14 (1), pp.64-69.

  • Stewart, A., Petch,A., Curtice, L., 2003 . Moving towards integrated working in health and social care in Scotland; form

maze to matrix. Journal of Interprofessional Care, 17, 4, pp.335-350

  • Ovretveit, J.,1997. A comparisons of hospital quality programmes: lessons for other services. International Journal
  • f Service Industry Management, 8 (3), pp. 220-235.
  • Ovretveit, J.& Gustafson. D.,2002. Evaluation of quality improvement programmes. Quality and Safety in Health

Care,11, pp, 270-275.

  • Ovretveit,J., et al, 2002. Quality Collaborative: lessons from research. Quality and Safety in Health Care, 11 pp. 345-

351.