Sustainability in Quality Improvement

Why should we be concerned? doi: 10.7861/futurehosp.5-2-88 Future Hosp J June 1, 2018 vol. 5 no. 2 88-93 Why should we be concerned? Waste – time and financial Sustainability quality improvement required to “provide high-quality care to patients not just of today but of the future.” 1 High performing hospitals have QI embedded into trusts culture2 Disenfranchised staff due to repeated “projects” Mortimer et al. doi: 10.7861/futurehosp.5-2-88 Future Hosp J June 1, 2018 vol. 5 no. 2 88-93 CQC 2018. https://www.cqc.org.uk/news/stories/how-hospital-trusts-are-embedding-quality-improvement-deliver-high-quality-sustainable

Project level Quality control vs quality improvement Rotational staff ie junior doctors Interventions not embedded in wider mechanisms/routine activities and seen as “projects”1 Poor selection of outcomes – mainly process measures. Limited effectiveness of the system to monitor progress Projects rely on individuals Limited involvement or training of staff outside the “project team” to sustain the process Limited training and understanding of QI methodology Quality improvement methodology applied retrospectively ie 1 PDSA cyle 1. The Health Foundation 2012. Overcoming challenges to improving quality https://www.health.org.uk/sites/health/files/OvercomingChallengesToImprovingQ uality_fullversion.pdf Project level

Organisational Issues Lack of investment in allowing frontline staff to dedicate time to the development and roll out of programs Lack of senior or clinical leadership engagement Limited infrastructure for sustainability Fit with organisational strategic aims and culture Individual organisation adoption of bespoke QI methodologies Organisational Issues