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.

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?

Do we need medical leadership or medical engagement?

2015 ◽  
Vol 28 (3) ◽  
pp. 173-184 ◽  
Author(s):  
Peter Spurgeon ◽  
Paul Long ◽  
John Clark ◽  
Frank Daly
Keyword(s):  
Care Quality ◽  
Current Evidence ◽  
Organisational Performance ◽  
Content Type ◽  
Care Quality Commission ◽  
The Uk ◽  
Medical Leadership ◽  
First Time ◽  
Practical Implications ◽  
A Current

Purpose – The purpose of this paper is to address issues of medical leadership within health systems and to clarify the associated conceptual issues, for example, leadership versus management and medical versus clinical leadership. However, its principle contribution is to raise the issue of the purpose or outcome of medical leadership, and, in this respect, it argues that it is to promote medical engagement. Design/methodology/approach – The approach is to provide evidence, both from the literature and empirically, to suggest that enhanced medical engagement leads to improved organisational performance and, in doing so, to review the associated concepts. Findings – Building on current evidence from the UK and Australia, the authors strengthen previous findings that effective medical leadership underpins the effective organisational performance. Research limitations/implications – There is a current imbalance between the size of the databases on medical engagement between the UK (very large) and Australia (small but developing). Practical implications – The authors aim to equip medical leaders with the appropriate skill set to promote and enhance greater medical engagement. The focus of leaders in organisations should be in creating a culture that fosters and supports medical engagement. Social implications – This paper provides empowerment of medical professionals to have greater influence in the running of the organisation in which they deliver care. Originality/value – The paper contains, for the first time, linked performance data from the Care Quality Commission in the UK and from Australia with the new set of medical engagement findings.

scholarly journals Quality indicators of dental health care in Serbia

2019 ◽  
Vol 66 (1) ◽  
pp. 36-42
Author(s):  
Svetlana Jovanović ◽  
Maja Milošević ◽  
Irena Aleksić-Hajduković ◽  
Jelena Mandić
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Health System ◽  
Quality Indicators ◽  
Health Care Quality ◽  
Care Quality ◽  
System Quality ◽  
Quality Health Care ◽  
Quality Health

Summary Health care has witnessed considerable progresses toward quality improvement over the past two decades. More precisely, there have been global efforts aimed to improve this aspect of health care along with experts and decision-makers reaching the consensus that quality is one of the most significant dimensions and features of health system. Quality health care implies highly efficient resource use in order to meet patient’s needs in terms of prevention and treatment. Quality health care is provided in a safe way while meeting patients’ expectations and avoiding unnecessary losses. The mission of continuous improvement in quality of care is to achieve safe and reliable health care through mutual efforts of all the key supporters of health system to protect patients’ interests. A systematic approach to measuring the process of care through quality indicators (QIs) poses the greatest challenge to continuous quality improvement in health care. Quality indicators are quantitative indicators used for monitoring and evaluating quality of patient care and treatment, continuous professional development (CPD), maintaining waiting lists, patients and staff satisfaction, and patient safety.

The essence, content and characteristics of medical services’ quality

2021 ◽  
pp. 40-43
Author(s):  
Constantin Etco ◽  
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Health Care System ◽  
Health Care Quality ◽  
Services Quality ◽  
Care Quality ◽  
Medical Services ◽  
Total Quality ◽  
Care System

One of the priorities of the health care system in Moldova is the medical services’ quality improvement. Th is article presents various defi nitions for health care quality and the principles connected with quality improvement. An important part in this article is allocated to the structure and main principles of total quality management in the health care system. Th is part reveals the problems of the commissions that are studying the quality of medical services in healthcare establishments.

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.

scholarly journals Effectiveness of a Psychosocial Care Quality Improvement Strategy to Address Quality of Life in Patients With Cancer

2021 ◽  
Vol 4 (10) ◽  
pp. e2128667
Author(s):  
Caterina Caminiti ◽  
Maria Antonietta Annunziata ◽  
Claudio Verusio ◽  
Carmine Pinto ◽  
Mario Airoldi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Quality Improvement ◽  
Psychosocial Care ◽  
Care Quality ◽  
Improvement Strategy ◽  
Quality Improvement Strategy ◽  
Patients With Cancer

scholarly journals 1423 Quality and Efficacy of Multidisciplinary Team (MDT) Discussion Quality Assessment Tools and Checklists: A Systematic Review

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
G Brown ◽  
A Young ◽  
R Rymell
Keyword(s):  
Quality Improvement ◽  
Quality Assessment ◽  
Practical Method ◽  
Included Study ◽  
Assessment Tools ◽  
Current Evidence ◽  
Validity And Reliability ◽  
High Standards ◽  
The Uk

Abstract Aim MDT discussion is the gold standard for cancer care in the UK. With the cancer incidence and complexity of treatments both increasing, demand for MDT discussion is growing. The need for efficiency, whilst maintaining high standards, is therefore clear. Paper-based MDT quality assessment tools and discussion checklists may represent a practical method of monitoring and improving MDT practice. This review aims to describe and appraise these tools, as well as consider their value to quality improvement. Method MEDLINE, Embase and PsycInfo were searched using pre-defined terms. PRISMA methodology was followed throughout. Studies were included if they described the development of a relevant tool/checklist, or if an element of the methodology further informed tool quality assessment. To investigate efficacy, studies using a tool as a method of quality improvement in MDT practice were also included. Study quality was appraised using the COSMIN risk of bias checklist or the Newcastle-Ottawa scale, depending on study type. Results The search returned 6888 results. 17 studies were included, and 6 different tools were identified. Overall, methodological quality in tool development was adequate to very good for assessed aspects of validity and reliability. Clinician feedback was positive. In one study, the introduction of a discussion checklist improved MDT ability to reach a decision from 82.2% to 92.7%. Improvement was also noted in the quality of information presented and the quality of teamwork. Conclusions Several tools for assessing and guiding MDT discussions are available. Although limited, current evidence indicates sufficient rigour in their development and their potential for quality improvement.

Weekly variation in quality of care for acute ST-segment elevation myocardial infarction by day and time of admission: a retrospective observational study

2020 ◽  
pp. bmjqs-2019-010121
Author(s):  
Chao Wang ◽  
Xi Li ◽  
Wantong Sun ◽  
Jingkun Li ◽  
Yupeng Wang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Quality Improvement ◽  
Quality Of Care ◽  
Care Quality ◽  
Weekend Effect ◽  
Study Cohort ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

BackgroundThe admission time of patients with ST-segment elevation myocardial infarction (STEMI) may affect the quality of care they receive. This study aimed to explore the pattern and magnitude of variation in quality of care for patients with STEMI in both the process and outcome domains.MethodsWe performed a retrospective study based on STEMI data from China. We estimated the adjusted ORs of six process indicators and one outcome indicator of STEMI care quality by fitting multilevel multivariable regression models across 42 4hour time periods per week.ResultsThe study cohort comprised 98 628 patients with STEMI. Care quality varied by time of arrival to the emergency department. We identified three main patterns of variation, which were consistent across days of the week. In the first pattern, which applied to electrocardiographic examination within 10 min of arrival and to aspirin or clopidogrel use within 10 min of arrival, quality was lowest for arrivals between 08:00 and 12:00, rose through the day and peaked for arrivals between 24:00 and 04:00. Percutaneous transluminal coronary intervention treatment within 90 min showed the same pattern but with maximal performance for those arriving 20:00–24:00. In the third pattern, applying to lipid function evaluation within 24 hours and beta blocker use within 24 hours, quality was best for arrivals between 04:00–08:00 and 16:00–19:00 and worst for arrivals between 24:00–04:00 and 12:00–16:00.ConclusionsThe quality of care for STEMI shows three patterns of diurnal variation. Detecting the times at which quality is relatively low may lead to quality improvement in healthcare. Quality improvement should focus on reducing the weekend effect and off-hour effect and the diurnal temporal variation.

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