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Developing an effective local quality improvement programme and supporting staff to deliver quality care

Kat Young, Chair National Quality Improvement & Clinical Audit Network (NQICAN) & Senior Quality Improvement Lead, Royal Berkshire Hospitals NHS Foundation Trust discusses developing an effective local quality improvement programme and supporting staff to deliver quality care  at today’s Clinical Audit for Improvement conference.

In her presentation Kat discussed:

  • supporting and enabling clinicians to test changes and sustained improvement  
  • how do you measure the effectiveness of your quality improvement programme? 
  • how do you identify where patient care activities require immediate improvement? Working with risk registers and assurance
  • our experience in Royal Berkshire

In her presentation Kat Young stated: 

“I see Clinical Audit as quality improvement”

“Sometimes we can go into work with what we need to do in a day, and sometimes, particularly for non-clinical staff we can lose sight of why we are here.”

“We should be really proud of what we have achieved the NHS is one of the best healthcare systems in the world, but that doesn't mean we can't improve.”

“Our organisations are made up of systems and processes and people.”

“In our organisation we have some pretty disengaged staff in terms of clinical audit, Trainees particularly were feeling massively dis-heartened and that they often didn't get to see the benefits of audit in terms of patient care.”

“It's OK to spend money, but you really beed to be demonstrating that you are improving value for patients.”

“It's about improving the reliability of the system, how we can improve waste.”

“We wanted to design a system that put us into the patient's point of view and worked with patients.”

“We need to be looking at variation, understanding trends and reducing that variation.”

“Traditional clinical audit, collect your data, implement change, come back and see if things have improved or not.”

“Variation can make us assume we have made improvements when we actually haven't. That shows how important measurements, and little and often.”

“Thinking about it from a patient' perspective, what should we be measuring, are we fulfilling our aims?”

“We have got so many data systems but do you actually need the amount of people going through and pulling data out of notes. It's trying to shift the culture from assurance to improvement, so we're not just feeding the beast, but we're focusing on improvements from the patients and freeing the shackles of data collection.”

“You need to be absolutely clear on your priorities and focus down on what's important and not try to do everything and do nothing well.”

“It's really important that clinical audit staff are supported to develop their skills. They need to be out facilitating change and they need to have the skills to do that.”

“We did a lot of process mapping and I had a lot of kickback from surgeons who said, 'we know what we need to be doing, let us get on and do it.”

“A lot of the work that we did to analyses data at a local level, could have been done by the national audit.”

“We identified a lot of areas of the back of the national audit and have encouraged trainees and students to come up with their own ideas, to look with their own eyes at what the problems are and to address those patient safety issues. It's really important that people own the problem and are invested in taking that forward.”

“We can't do everything, so it's about prioritising ideas. Is it easy or hard to implement and is the benefit big or small. It may be that you want to do something that is of big benefit, but it's hard to implement and that will take longer. If something is hard to do and of little benefit, don't do it.”

“We need to know whether our data is sound, we can't say we have improved quality if we are not sure our data is reliable.”

“Do people know about your quality improvement programme? Have you got notes up on your walls that people understand? Is it proactive? Yes, we would like to see every single quality improvement project making improvements for patients, but where that doesn't happen is there learning from that we can take away?”

“Something I'm starting to see is trusts looking at the whole national audit programme and how they are performing against that.”

“Use the appropriate method, clinical audit is fantastic but it needs to be used in a dynamic real time way.”

“Measure, measure, measure, so you know what works.”

“The best facilitators or quality improvement I don't see at their desks, they are getting out and talking to people and looking in those nooks and crannies for where they can get results.”

Kat Young Biography:

Kat has worked in the NHS/health sector since 2003 holding a variety of roles relating to the field of quality, clinical governance and clinical audit/improvement (both at the national and local level).  Kat has worked for organisations including the National Institute for Health and Care Excellence (NICE), Kings College Hospital NHS Foundation Trust and the Royal College of Physicians. 

In April 2013 Kat took up the Chair of the National Quality Improvement and Clinical Audit Network (NQICAN) which links the various regional clinical audit networks and provides a ‘voice’ for those working in quality improvement and clinical audit.  Kat is pleased to have joined the National Advisory Group for Clinical Audit and Enquiries (NAGCAE) and will be working to strengthen the links between staff working in clinical audit and quality improvement / NQICAN and NAGCAE.  

Also of interest:

Data Quality and Clinical Coding for Improvement
Thursday 3 December 2015
Manchester Conference Centre, Manchester

Clinical Audit Masterclass
Tuesday 10 November 2015
Hallam Conference Centre, London

Clinical Audit for Improvement 2016
Tuesday 8 March 2016
Hallam Conference Centre, London


Download: Kat Young Full Presentation

7 October 2015

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