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Systems and culture
Experiences of healthcare professionals undertaking quality improvement
Background
Health and care organisations have thousands of operational processes that impact both patients and staff. However, many of these processes are inefficient or poorly designed, which impacts the effectiveness, efficiency and appropriateness of care, as well as the experiences of patients and staff. Attempts to fix these issues often fall short, leading to what’s called improvement waste – where efforts to improve healthcare processes don’t deliver any real benefits for patients or the healthcare system. This is a growing problem.
Many of the challenges exist because of the way quality improvement work is currently organised. Many improvement projects are small, short-term, and not connected to any wider efforts. They’re carried out by healthcare staff who are often still in training and have been asked to lead projects without the necessary support, skills, or authority to make the impactful changes that are needed. As a result, these efforts often don’t have much impact. In some cases, they may even lead to new risks, and they rarely lead to long-term change.
Even when a project does work, it’s unusual for its success to be maintained or rolled out more widely. These issues can lead to missed learning opportunities, frustration, inconsistent care processes, and in some cases, worse outcomes for patients. All of this adds up to wasted effort and resources in trying to improve care.
We want to explore the current experiences of healthcare professionals from a range of professional backgrounds, including those in training programmes, of involvement in quality improvement across the UK, to generate insights that can help with the development of new ways to undertake quality improvement.
Approach
We want to understand the experiences of a range of healthcare professionals – including those in training – who take part in quality improvement work across the UK. Our goal is to learn from these experiences to support new ways of approaching quality improvement.
Our objectives are:
- To learn more about the type of quality improvement projects healthcare professionals, including those in training, are involved with.
- To learn more about healthcare professionals’ experiences of carrying out quality improvement.
- To find out healthcare professionals’ views about quality improvement activity around environmental sustainability.
We will run a national survey involving professionals from different backgrounds asking them about their most recent experience of involvement in quality improvement, that they’ve lead, worked on with a team or helped to deliver. We want to know what’s worked, what hasn’t, and what challenges they’ve faced.
The final section of the survey will look at quality improvement in environmental sustainability and ask for suggestions for future quality improvement projects in this area. Following the 2015 Paris Agreement and the introduction of the UK National Health Service net zero carbon strategy, the issue has become a bigger priority in healthcare and a focus of quality improvement work but if people continue to work on small, disconnected projects, there’s a risk of wasting time and effort without making real progress.
Funding and ethics
This study is funded by Addenbrookes Charitable Trust and Cambridge NIHR Biomedical Research Centre. It is independently led by THIS Institute with Cambridge University Hospitals NHS Foundation Trust. The study was reviewed by the University of Cambridge Psychology Research Ethics Committee