Assessing improvement capability in healthcare organisations

A qualitative study of healthcare regulatory agencies in the UK

Funded by

The Health Foundation Logo

1 April 2018

Published journal: Oxford Academic

Title

Assessing improvement capability in healthcare organisations: a qualitative study of healthcare regulatory agencies in the UK

Authors

Joy Furnival, Ruth Boaden, Kieran Walshe  

Published journal

Oxford Academic

Objectives

Healthcare regulatory agencies are increasingly concerned not just with assessing the current performance of the organisations they regulate, but with assessing their improvement capability to predict their future performance trajectory. This study examines how improvement capability is conceptualised and assessed by healthcare UK regulatory agencies.

Design

Qualitative analysis of data from six UK healthcare regulatory agencies was conducted. Three data sources were analysed using an a priori framework of eight dimensions of improvement capability identified from an extensive literature review.

Setting

The focus of the research study was the regulation of hospital-based care, which accounts for the majority of UK healthcare expenditure. Six UK regulatory agencies that review hospital care participated.

Participants

Data sources included interviews with regulatory staff (n = 48), policy documents (n = 90) and assessment reports (n = 30).
Intervention

None—this was a qualitative, observational study.

Results

This research study finds that of eight dimensions of improvement capability, process improvement and learning, and strategy and governance, dominate regulatory assessment practices. The dimension of service-user focus receives the least frequency of use. It may be that dimensions which are relatively easy to ‘measure’, such as documents for strategy and governance, dominate assessment processes, or there may be gaps in regulatory agencies’ assessment instruments, deficits of expertise in improvement capability, or practical difficulties in operationalising regulatory agency intentions to reliably assess improvement capability.

Conclusions

The UK regulatory agencies seek to assess improvement capability to predict performance trajectories, but out of eight dimensions of improvement capability, two dominate assessment. Furthermore, the definition and meaning of assessment instruments requires development. This would strengthen the validity and reliability of agencies’ assessment, diagnosis and prediction of performance trajectories, and support development of more appropriate regulatory performance interventions.

You might also like...

Research report

The spread challenge

This report shines a light on the challenges facing the NHS in improving the uptake of new ideas and practices, and the need ...

Event

How can the NHS get better at spreading new ideas?

This event will be a launch of our latest report, looking at the challenges often faced by health care teams and organisation...

Press release

NHS long-term plan must commit dedicated investment to help the NHS spread innovation more effectively

As NHS leaders develop the long-term plan for the health service in England, the Health Foundation is today urging them to se...

Citation

Joy Furnival, Ruth Boaden, Kieran Walshe; Assessing improvement capability in healthcare organisations: a qualitative study of healthcare regulatory agencies in the UK, International Journal for Quality in Health Care, , mzy085, https://doi.org/10.1093/intqhc/mzy085

Kjell-bubble-diagramArtboard 101

Work with us

We look for talented and passionate individuals as everyone at the Health Foundation has an important role to play.

View current vacancies
Artboard 101 copy 2

The Q Community

Q is an initiative connecting people with improvement expertise across the UK.

Find out more