Quality improvement: speaking the same language on a national scale

One of the advantages of Wales being a small nation is that rapid improvement on a national scale is manageable within a short time. And yet, like almost every other nation on an improvement journey, we find that innovation is patchy, best practice takes too long to spread and embed and the quality of care offered is highly variable.

While our national programme – 1000 Lives Plus – has helped accelerate the spread of best practice, we know we need to foster a widespread understanding of improvement in our workforce. For improvement to happen everywhere staff involved need to understand why it matters and how to do it successfully.

We have been inspired by the work of the Qulturum in Jonkoping to ensure that quality improvement training is normal in the health service workforce. A white paper that captured our learning from Jonkoping suggested that we aim to train a quarter of the NHS Wales staff and contractor workforce in quality improvement methodology to begin embedding the idea of continuous improvement in the culture of our health service.

Improving Quality Together, which launched on 1 March this year, is our attempt to nurture mass improvement expertise across our organisations. There are three levels within it: bronze, silver and gold, with an additional element for board members.

Improving Quality Together has been developed recognising that improvement has to be everybody’s business. The framework has been created to be equally accessible and applicable to frontline clinical staff, primary care workers, administrators, managers, department heads and directors. We want everybody speaking the same language and understanding why improvement matters, and we need to engage every level of our organisations to make sure it happens.

The more I’ve worked in healthcare improvement, the more convinced I am that people want to do a good job. They want to help people. They want to provide a quick and efficient, caring service. But the structures and procedures hinder rather than help them. My hope is that Improving Quality Together will help them overcome those hindrances and offer a level of care they can be proud of.

The response so far has been positive, with local leads in health boards and trusts reporting multiple enquiries from colleagues wanting to get started. Staff interviewed on a pilot version spoke very highly of Improving Quality Together. They could see its potential to help them transform the way they work and improve the care they offer to people.

It would be interesting to know if embedding quality improvement on such a large scale would be possible in other countries or districts. It has worked in Jonkoping. We will have to wait and see if it will work in Wales, but we are optimistic.

Dr Alan Willson is a director of 1000 Lives Plus, Wales’ national healthcare improvement programme. www.twitter.com/dralanwillson