New initiative to bring the rigour of science to improvement

The Health Foundation has launched a major programme to develop and champion a rigorous, scientific approach to improving healthcare. The independent charity is investing in four Improvement Science Fellows who have the potential to lead the field. They will be supported by an international Improvement Science Network of leading academics and practitioners who will develop cutting edge thinking and approaches.

The initiative is to address the problem of the lack of useful evidence to support work to improve quality. Many academic disciplines are relevant to improving healthcare from statistics to psychology. However, the academic disciplines have too often worked in isolation and academics and practitioners have not worked closely enough to ensure the work is applied.

After a rigorous application process, the Health Foundation selected four fellows to spearhead improvement science. Against competition from 74 high quality applicants from across the UK, the fellows were selected based on their outstanding research contributions and capacity for leadership.

The fellows will be funded over three years to carry out original research, as well as develop knowledge of improvement tools, methodologies and techniques, and leadership skills.

Martin Marshall, Clinical Director and Director of Research and Development at the Health Foundation, said:

‘The Health Foundation’s four new Improvement Science Fellows have a real passion for improving healthcare and we look forward to them becoming leaders of the emerging field of improvement science. 

‘They will deepen our understanding of the improvement methods and techniques that really work best and help to build a robust knowledge base that will support improved care across the health service. They will champion new thinking and ideas and we hope to encourage others to join in developing improvement science.’

Helen Crisp, Assistant Director of Research and Development at the Health Foundation, said:

‘The Health Foundation’s Improvement Science Fellowships and international network have been met with overwhelming enthusiasm from senior figures in health services research and leading improvers. They feel that the time is right to foster the development of improvement science as an academic discipline and build a stronger partnership between academics and practitioners, and so do we.’

Davina Allen

For Davina Allen, a sociologist who trained as a nurse in Cambridge before entering academic research, becoming an Improvement Science Fellow fulfils a personal and professional goal.

She left clinical practice early on because she felt frustrated at being unable to deliver better quality care. ‘I loved the patients but hated the system’, she said.

As a Health Foundation Improvement Science Fellow, she will build on her research strengths to study ‘the very challenges which led me to leave practice over 20 years ago: the system origins of poor service quality.’ 

She will look at ways of improving coordination between clinical teams and departments at critical interfaces such as those between accident and emergency units and hospital wards.

‘The aim of this research programme is to make a fundamental contribution to improvement science by addressing gaps in understanding,’ she added.

Tim Draycott

Tim Draycott, a consultant obstetrician at North Bristol NHS Trust, will study to what extent better team working in maternity units can improve safety and reduce harm to women and babies.

He says: ‘Quite apart from the individual and societal costs, over half the costs of NHS legal claims are associated with childbirth, amounting to more than £270 million in 2008/09 and over £3.7 billion to date for obstetrics and gynaecology.’

Tim’s project will review the birth outcomes in eight hospitals for two years before and after implementation of a specially-devised training programme to gauge its effectiveness.

If training is as effective nationally as has already been shown in one hospital, over 100 severe birth injuries could be prevented each year and potentially reduce £64 million per year in NHS litigation claims.

Tim says: ‘I firmly believe that we need to make quality improvement easier for NHS staff. In particular if we can make the right way the easiest way, then everyone will do it.’

Carl Macrae

Carl Macrae, a social psychologist with a background in healthcare and aviation, will examine the way NHS hospitals and staff respond to regulation and its impact on efforts to improve patient safety.

Carl said: ‘My project will analyse how patient safety regulation works: how it influences the improvement activities of organisations and healthcare staff, and how it can be better designed to support local organisations in their work to continuously improve patient safety.’  

He will focus on intensive care, which provides complex challenges around safety improvement and is subject to a wide range of healthcare regulations and other safety initiatives.

He hopes his research will help bring about lasting improvements in the quality, safety, and value of patient care by informing the selection and design of optimal regulatory strategies.

Julie Reed

Julie Reed, a research strategy manager and trained chemical and biomedical researcher, believes that academics need to share responsibility for sustainable service improvement with NHS organisations.

As an Improvement Science Fellow she is passionate about examining how improvement science can support frontline staff to put evidence into practice to deliver better care.

She says many complaints over poor quality care stem from the way services are designed, a lack of joined up working or ineffective communication by doctors, nurses and other staff.

She believes quality improvement tools and methods could help frontline staff and patients work collaboratively to solve these problems. But, there is uncertainty as to how well these work and they are not used routinely in the NHS.

She explained: ‘We need to understand how effective the tools are, what actually happens when staff (and patients) use them, what they find difficult or easy to do and whether we can demonstrate that an improvement has been made?’

‘Creating space for ideas to emerge is a great skill which I would like to develop further, as part of my professional development, to better lead people to find solutions.’