Embedding improvement to enable high quality care

The Challenge

The importance of an organisation’s culture has become more prominent in recent years following the publication of the Mid-Staffordshire Inquiry and the Berwick review and it is now accepted that healthy cultures are crucial to ensuring the delivery of high-quality patient care. 

The Five Year Forward View (5YFV) states that achieving quality requires a ‘caring culture, professional commitment and strong leadership’ recognising the need for positive culture and leadership for an organisation to be effective.

Facing the challenge

UCLPartners supports individuals, partner organisations and health economies in creating and embedding a culture of improvement in a range of ways, including Board-level support, leading patient safety focused programmes and increasing the capability of staff to lead and deliver improvement.

Highlights from 2016/17 include:

• Over 400 people received training in quality improvement and human factors
• Over 200 people participated in improvement collaboratives for sepsis and acute kidney injury
• 90 general practices across East London began working in improvement collaboratives to improve patient care for conditions such as diabetes, atrial fibrillation and hypertension
• 1,457 staff across primary and secondary care signed up to Life QI to manage their improvement projects.

One highly successful approach is the UCLPartners Improvement Fellows Programme, which aims to build improvement skills and capability, and creates a network of enthusiastic and motivated people to drive improvement in their organisations and professional communities.

Over the 12-month programme, the Fellows take part in workshops – including masterclasses on improvement, human factors and leadership – they have the opportunity to reflect and explore their ideas, challenges and priorities with faculty and colleagues. The programme enables the Fellows to build a network of like-minded people who can turn to each other for inspiration, support and expertise that go beyond their current local and professional networks and will endure over time.

To support capability-building, the Fellows use learning resources including a free subscription to the Institute of Healthcare Improvement’s Open School, they also have access to wider communities of improvers, such as the Q Initiative – an initiative connecting people with improvement expertise across the UK, led by the Health Foundation and supported and co-funded by NHS Improvement.

PROGRESS HIGHLIGHTS

• The Fellows have built valuable connections across organisations and continue to explore how they can work together more closely. Several Fellows have started working together as a direct result of the programme.
• Since joining the programme, many Fellows have moved into new roles where they can spread their improvement knowledge wider.
• Applications numbers for 2017 increased by 300% on 2016 and there is significant demand for the programme.

Expanding the reach

Following the success of the first cohort of fellows in 2016, a second cohort has been recruited. There are now 60 fellows from a wide range of backgrounds in health and social care, including doctors, nurses, trainees, finance, social care, local government, improvement and general management.

The Fellows welcome the opportunity to connect with others in a safe environment where there is opportunity for open dialogue away from the usual workplace.  Peer to peer support is invaluable, particularly in the context of a very challenged health and social care system. 

Cohort three will open for applications in Autumn 2017.

“It’s easy to fall into the trap of thinking that some of the challenges are specific to your own organisation. As soon as you connect with others you are reminded that we all face similar challenges. So for me, it’s a great chance to triangulate my experience with that of others and to learn about the strategies they are using.”

Dave Grewcock, Head of Improvement, UCLH Institute, University College London Hospitals NHS Foundation Trust