Gaps are often found between how healthcare should be delivered, as defined by high-quality evidence, and the care that patients actually receive. Closing these gaps is an important priority for health systems everywhere. But finding the right structures to facilitate improvement is not easy.
This report introduces an approach – the clinical community – used by the Health Foundation’s Closing the Gap through Clinical Communities programme to support and secure improvements in health systems across multiple sites. The programme supported 11 clinical communities to come together around shared goals, to learn from each other but with the latitude to develop and apply local solutions. The programme has led to a range of improvements in the quality of care which continue to be sustained today.
Drawing on the evaluation of the programme, the report outlines ten key lessons for getting the approach to work in practice and avoiding potential pitfalls:
- Choose the right challenge for a clinical community approach
- Build a strong core team
- Recruit a community
- Resource the community properly
- Start with a clear ‘theory of change’, but review and adapt in light of learning and experience
- Foster a sense of community and belonging
- Recognise and deal with conflict and marginalisation
- Find a balance between ‘hard’ and ‘soft’ tactics
- Use data wisely
- Recognise the contextual influences on improvement and the need for customisation
At a time when working through networks and across organisational boundaries is becoming increasingly important, this learning report provides valuable insights for those wanting to improve the quality of care.
The full programme evaluation report is also available on request. Please contact firstname.lastname@example.org for details.