How can we create a ripple effect of quality improvement in the NHS?

Why do we need a common language for quality improvement in healthcare?

There are two important reasons. We need to:

1. Have a way of working together to make improvement in a way everyone understands.
2. Understand collectively that improvement work is directly informed by how it affects the patient.

And these combine together when creating our common language. In short, not only do we need to be able to talk with one another about our ideas for improvement, we also need to be able to talk about them with our patients.

I believe that it’s the staff who make this change. Since they are the people who see the issues and problems in the work they do, then they need to be listened to and given the best tools to help them.

This understanding of how to make our services better is why this time last year 1000 Lives Improvement launched Improving Quality Together in NHS Wales.

Improving Quality Together is a training opportunity that gives staff ownership in quality improvement, split into 3 main levels: Bronze, Silver, and Gold (with an additional Board Level).

At Bronze Level, staff can complete some simple online training modules, introducing them to the principles of quality improvement, and the terms and language that go along with it.

Silver involves taking the lessons learnt at Bronze Level and doing an improvement project of their own. These projects can be run by any member of staff in any part of NHS Wales. It involves laying out a clear strategy for change and then making the change happen.

Staff at the Gold Level are becoming quality improvement mentors themselves, learning how to guide and help people taking on future projects of their own.

Change for the sake of change is not helpful when it comes to quality improvement. And so Improving Quality Together helps staff to understand the importance of small-scale testing and analysis, before scaling the improvement work up.

In the programme’s first year, 5,752 people have completed the Bronze Level, and the number keeps rising. These NHS Wales staff have chosen to learn about quality improvement and where to start with making change that matters. I think this is telling and indicative of staff wanting to be heard, and wanting to make improvements in the healthcare system.

We recently hosted guests from the Southcentral Foundation in Alaska. They were invited to tell their story about how they transformed a system of care in Anchorage. The Nuka System of Care began with a simple question – what do the patients want?

And so they asked them. And they used their responses to completely change the way their healthcare system works.

NHS Wales, like the NHS throughout the UK, has grown organically. Some parts of it are functioning at a good level, but some parts of it are not. Improving Quality Together means that staff can consider areas in need of improvement, and that they can be the ones to make that change.

And I think that this could well create a ripple effect of transformation through the whole system. It’s something which helps staff to do their jobs with less hassle and be more effective in their day to day work, and it works towards a healthcare system for a happier, healthier population.

And so, I am adding something important to my answer to the opening question of this blog post – Why do we need a common language for quality improvement in healthcare?

Because it benefits the people who need our care.

Alan Willson is Director at 1000 Lives Improvement, www.twitter.com/dralanwillson