Quality improvement is everyone's job

Dr Bob Klaber is a consultant paediatrician with a special interest in medical education and the development of leadership skills. Over the past year, Bob has led the development of a quality improvement programme at the Trust. Here he talks about how frontline staff are responding to the opportunity to drive change.

One of our biggest achievements last year was developing a quality improvement (QI) programme that we are embedding across our organisation. At the heart of this programme is making quality central to everything we do, building on our refreshed organisational values and behaviours.

So far, we’ve had the opportunity to talk to 3,000 of our 10,000 staff about improvements they want to make on the ground. Despite the pressures of working on the frontline, I’ve been struck by the energy and ambition of so many colleagues who are committed to making improvements to services. The message from our staff is clear: finding ways to do our job a little better or helping others to do theirs, not only improves the quality of care we provide but also gives us greater job satisfaction.

But even though we have some of the most talented people in the health service working with us, and a great history of innovation, we still struggle to deliver the change we want and need to see. The QI programme has been designed to address this issue by building quality improvement capacity across our organisation – this means giving everyone the tools to make changes and empowering people to take the lead, regardless of their role or seniority.

We want to see at least half of all our QI projects being initiated and led by frontline staff. We know from experience, and evidence that the most successful and sustainable changes are implemented in this way. For example, frontline staff at our renal satellite unit in Northwick Park, are currently looking into having Wi-Fi installed. This may seem like quite a simple change, but it acted directly on the feedback of patients who spend hours a week having dialysis at the unit and felt access to the internet would vastly improve their experience.

And it’s just one example of many projects where our staff have involved patients and the public to identify, design and develop improvement projects. This concept of ‘co-design’ is a big focus for our organisation in 2016. Our chief executive, Tracey Batten, has written a blog on this topic too – and we want to grow the links between patient involvement and quality improvement.

Other first wave projects range in focus from improving clinical pathways, to recruiting and supporting new starters.

Another example has Dr Clare Ross, consultant in respiratory medicine, leading the development of a plural disease service for patients in North West London. This service development is being shaped by insights gleaned from patient interviews on what they’d like to see the service deliver.

Similarly, our neonatal team, led by Dr Aniko Deierl and Dr Jayanta Banarjee, has pioneered a new approach to patient involvement – a family integrated care programme .The aim of this programme is to involve parents directly in the care of their pre-term babies and it is the first of its kind in the UK.

We are in the process of assembling a QI hub team who are here to listen to ideas, and provide the training and expertise needed to empower staff to take up the challenge of quality improvement. So far we’ve held team-based training days and coached teams on improvement methods such as process mapping and experience based co-design.

And this is just the beginning of our quality improvement journey. We want all staff to have the skills and confidence to make improvement happen - in partnership with their patients.

If you would like to get in touch with the QI team or register your interest in being involved quality improvement across the Trust please contact us here.

Have a look at our short animation explaining how our QI programme works:


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