Care Quality Commission spotlights effective quality improvement initiatives

2018 ◽  
Vol 27 (20) ◽  
pp. 1202-1203
Author(s):  
Alan Glasper
Keyword(s):  
Quality Improvement ◽  
Care Quality ◽  
Care Quality Commission

How do explicitly stated hospital trust values relate to their CQC ratings?

BMJ Leader ◽  
2018 ◽  
Vol 2 (2) ◽  
pp. 68-70
Author(s):  
Nathan Hamnett ◽  
Naomi Patel ◽  
Kathryn Nelson ◽  
Tom Harrison ◽  
Nicholas White
Keyword(s):  
Quality Improvement ◽  
National Health Service ◽  
Health Service ◽  
Service Delivery ◽  
National Health ◽  
Care Quality ◽  
A Value ◽  
Care Quality Commission ◽  
Organisational Values ◽  
Range Of Values

IntroductionFor National Health Service(NHS) Trusts in the process of setting internal organisational values, it would be useful to see if there was a correlation between certain organisational values and Care Quality Commission (CQC) ratings to enable quality improvement.MethodsTo examine this, we identified the CQC ratings of the NHS England provider trusts and identified and listed the trust’s values. These values were then categorised and a comparison made of well-performing and underperforming trusts.ResultsA total of 43 different values were identified, with a total of 800 values being used across all 188 trusts. In the reviewed hospitals, a broad range of values were found with some not meeting common definitions of what a value is. All trusts included some aspect of behaviour in their values.ConclusionWell-performing hospitals are more likely to be open and honest with aspirational values, whereas those which are not are more likely to be focused on day to day service delivery with operational or proscriptive values. There was considerable variation from the published NHS constitution values with outstanding and good trusts having more variance from the values in the NHS constitution than trusts rated requiring improvement or inadequate.

Sharing learning from hospital trusts on a journey of quality improvement

BMJ Leader ◽  
2019 ◽  
Vol 3 (1) ◽  
pp. 24-26 ◽  
Author(s):  
Iona Thorne ◽  
Jeremy Cox ◽  
Edward Baker
Keyword(s):  
Quality Improvement ◽  
Systematic Approach ◽  
Healthcare Providers ◽  
Care Quality ◽  
Magic Bullet ◽  
Frontline Staff ◽  
Positive Effects ◽  
Consistent Model ◽  
Care Quality Commission ◽  
And Control

BackgroundQuality improvement (QI) has been shown to deliver better patient outcomes, and improved operational, organisational and financial performance when led effectively and supported by organisational systems and training. Surveys of staff and patient satisfaction also show positive effects. In many trusts that Care Quality Commission (CQC) has rated as outstanding, a culture of QI has been embedded throughout the organisation.ObjectivesWe wanted to hear trusts’ experiences of using QI as a systematic approach to improving service quality, efficiency and morale, and share learning from these organisations to drive further improvement to quality of care.MethodsUsing CQC’s comprehensive inspection programme of all healthcare providers nationally, we identified 19 trusts for inclusion and carried out an in-depth review of their improvement journeys.ResultsWe found that commitment from the board and senior leadership is crucial to ensuring success on the QI journey, modelling effective leadership behaviours that enable all staff to deliver improvement. These organisations have a systematic approach to QI, using a consistent model, anchored in a systems perspective, and often across a health system. The model of improvement requires leaders of all backgrounds and frontline staff to work together in improvement, and can help to break down barriers between managers and clinicians, and providers and patients, so there is a shared purpose to deliver better care to patients.ConclusionsQI is not a magic bullet, but is an important factor in the evolution of an organisation from a traditional ‘command and control’ form of management towards higher performing approaches to the design and management of work.

scholarly journals What Does a Systems Approach to Quality Improvement Look Like in Practice?

2022 ◽  
Vol 19 (2) ◽  
pp. 747
Author(s):  
Sharon J. Williams ◽  
Stephanie Best
Keyword(s):  
Quality Improvement ◽  
Systems Approach ◽  
Secondary Data ◽  
Healthcare Systems ◽  
Care Quality ◽  
Secondary Case ◽  
Care Quality Commission ◽  
Leadership Structure ◽  
The Uk

Universally improving healthcare systems is difficult to achieve in practice with organisations implementing a range of quality improvement (QI) approaches, in varying and changing contexts, and efforts ranging from project-based improvements to whole system change. This study aimed to identify how organisations overcome the challenges to improving the quality of the services they deliver. Drawing on the eight challenges from the ‘Quality and Safety in Europe by Research (QUASER) hospital guide, we assessed eight cases reported by the UK-based regulator Care Quality Commission as improving their performance. A thematic analysis of these secondary data established that all eight challenges had been addressed or considered in varying degrees. Education and physical and technological challenges seemed less prominent than developments made to address other challenges such as developing leadership, structure, and culture to support improving quality. This paper relies on the analysis of secondary case data and one framework to assess improvement efforts. Further research is required to consider other models and frameworks and to collate longitudinal data to capture the dynamics and increasing the maturity of improving healthcare systems in practice.

scholarly journals Determining the skills needed by frontline NHS staff to deliver quality improvement: findings from six case studies

2021 ◽  
pp. bmjqs-2021-013065
Author(s):  
David Wright ◽  
John Gabbay ◽  
Andrée Le May
Keyword(s):  
Quality Improvement ◽  
Case Studies ◽  
Care Quality ◽  
Snowball Sampling ◽  
Healthcare Staff ◽  
Frontline Staff ◽  
Care Quality Commission ◽  
Nuanced Understanding ◽  
Practice Knowledge ◽  
The Right

BackgroundPrevious studies have detailed the technical, learning and soft skills healthcare staff deploy to deliver quality improvement (QI). However, research has mainly focused on management and leadership skills, overlooking the skills frontline staff use to improve care. Our research explored which skills mattered to frontline health practitioners delivering QI projects.Study designWe used a theory-driven approach, informed by communities of practice, knowledge-in-practice-in-context and positive deviance theory. We used case studies to examine skill use in three pseudonymised English hospital Trusts, selected on the basis of Care Quality Commission rating. Seventy-three senior staff orientation interviews led to the selection of two QI projects at each site. Snowball sampling obtained a maximally varied range of 87 staff with whom we held 122 semistructured interviews at different stages of QI delivery, analysed thematically.ResultsSix overarching ‘Socio-Organisational Functional and Facilitative Tasks’ (SOFFTs) were deployed by frontline staff. Several of these had to be enacted to address challenges faced. The SOFFTs included: (1) adopting and promulgating the appropriate organisational environment; (2) managing the QI rollercoaster; (3) getting the problem right; (4) getting the right message to the right people; (5) enabling learning to occur; and (6) contextualising experience. Each task had its own inherent skills.ConclusionOur case studies provide a nuanced understanding of the skills used by healthcare staff. While technical skills are important, the ability to judge when and how to use wider skills was paramount. The provision of QI training and fidelity to the improvement programme may be less of a priority than the deployment of SOFFT skills used to overcome barriers. QI projects will fail if such skills and resources are not accessed.

Clinical outcomes, quality improvement and professional recertification: lessons from UK cardiac surgery

2010 ◽  
Vol 92 (5) ◽  
pp. 168-169
Author(s):  
Ben Bridgewater ◽  
Owen Nicholas ◽  
Leslie Hamilton ◽  
Graham Cooper
Keyword(s):  
Cardiac Surgery ◽  
Quality Improvement ◽  
Clinical Outcomes ◽  
Healthcare Professionals ◽  
Care Quality ◽  
Published Data ◽  
Form Part ◽  
Care Quality Commission ◽  
The Uk ◽  
Cardiac Surgeons

At the time of writing this paper, mortality outcomes for cardiac surgeons in the UK are being updated on the Care Quality Commission (CQC) website. The initial clamour for results to become available followed events in paediatric cardiac surgery at Bristol and recommendations from the subsequent inquiry (see http://www.bristol-inquiry.org.uk/). A decade later these published data remain unique in British medicine. More recently legislation was introduced to regulate healthcare professionals and outcomes data will form part of the evidence required. What are the lessons from cardiac surgery?

Patient-Centered, Integrated Health Care Quality Measures Could Improve Health Literacy, Language Access, and Cultural Competence

2019 ◽  
Author(s):  
Ignatius Bau ◽  
Robert A. Logan ◽  
Christopher Dezii ◽  
Bernard Rosof ◽  
Alicia Fernandez ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Health Literacy ◽  
Cultural Competence ◽  
Health Care Quality ◽  
Care Quality ◽  
National Committee ◽  
Patient Centered ◽  
Organizational System ◽  
Language Access

The authors of this paper recommend the integration of health care quality improvement measures for health literacy, language access, and cultural competence. The paper also notes the importance of patient-centered and equity-based institutional performance assessments or monitoring systems. The authors support the continued use of specific measures such as assessing organizational system responses to health literacy or the actual availability of needed language access services such as qualified interpreters as part of overall efforts to maintain quality and accountability. Moreover, this paper is informed by previous recommendations from a commissioned paper provided by the National Committee for Quality Assurance (NCQA) to the Roundtable on Health Literacy of the National Academies of Sciences, Engineering, and Medicine. In the commissioned paper, NCQA explained that health literacy, language access, and cultural competence measures are siloed and need to generate results that enhance patient care improvements. The authors suggest that the integration of health literacy, language access, and cultural competence measures will provide for institutional assessment across multiple dimensions of patient vulnerabilities. With such integration, health care organizations and providers will be able to cultivate the tools needed to identify opportunities for quality improvement as well as adapt care to meet diverse patients’ complex needs. Similarly, this paper reinforces the importance of providing more “measures that matter” within clinical settings.

scholarly journals Evidence-Based Practice Implementation: Case Report of the Evolution of a Quality Improvement Program in a Multicenter Physical Therapy Organization

2015 ◽  
Vol 95 (4) ◽  
pp. 588-599 ◽  
Author(s):  
Joel M. Stevans ◽  
Christopher G. Bise ◽  
John C. McGee ◽  
Debora L. Miller ◽  
Paul Rockar ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Case Report ◽  
Physical Therapy ◽  
Care Quality ◽  
Routine Practice ◽  
Evidence Based ◽  
Implementation Barriers ◽  
Improvement Program ◽  
Improvement Project ◽  
Systems Perspective

Background and Purpose Our nation's suboptimal health care quality and unsustainable costs can be linked to the failure to implement evidence-based interventions. Implementation is the bridge between the decision to adopt a strategy and its sustained use in practice. The purpose of this case report is threefold: (1) to outline the historical implementation of an evidence-based quality improvement project, (2) to describe the program's future direction using a systems perspective to identify implementation barriers, and (3) to provide implications for the profession as it works toward closing the evidence-to-practice gap. Case Description The University of Pittsburgh Medical Center (UPMC) Centers for Rehab Services is a large, multicenter physical therapy organization. In 2005, they implemented a Low Back Initiative utilizing evidence-based protocols to guide clinical decision making. Outcomes The initial implementation strategy used a multifaceted approach. Formative evaluations were used repeatedly to identify barriers to implementation. Barriers may exist outside the organization, they can be created internally, they may result from personnel, or they may be a direct function of the research evidence. Since the program launch, 3 distinct improvement cycles have been utilized to address identified implementation barriers. Discussion Implementation is an iterative process requiring evaluation, measurement, and refinement. During this period, behavior change is actualized as clinicians become increasingly proficient and committed to their use of new evidence. Successfully incorporating evidence into routine practice requires a systems perspective to account for the complexity of the clinical setting. The value the profession provides can be enhanced by improving the implementation of evidence-based strategies. Achieving this outcome will require a concerted effort in all areas of the profession. New skills will be needed by leaders, researchers, managers, and clinicians.

scholarly journals Margaret McCartney: The Care Quality Commission is not fit for purpose

BMJ ◽  
2014 ◽  
Vol 349 (dec12 3) ◽  
pp. g7460-g7460 ◽  
Author(s):  
M. McCartney
Keyword(s):  
Care Quality ◽  
Care Quality Commission ◽  
Fit For Purpose
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