Improving quality is about making healthcare safer, effective, patient-centred, timely, efficient and equitable. There is no single definition of quality or quality improvement, and no one approach appears to be more successful than another. However, here are a couple of useful definitions:
“The conception of improvement finally reached as a result of the review was to define improvement as better patient experience and outcomes achieved thorough changing provider behaviour and organisation through using a systematic change method and strategies”.
“The combined and unceasing efforts of everyone to make the changes that will lead to better patient outcomes (health), better system performance (care) and better professional development (learning)”.
Six aims for improvement – Institute of Medicine
The Institute of Medicine in the United States has identified six aims for improvements to achieve the ideal healthcare system. These aims are often used within quality improvement literature. They are all linked but the challenge for the NHS is to balance them.
“In order to begin achieving real improvement in healthcare, the whole system has to change”
For example, good healthcare should be:
Be as safe for patients in healthcare facilities as in their home.
Match science, with neither under use nor overuse of the best available techniques.
Revolve around the patient who should play an active role in making decisions about their own care.
Mean that patients do not experience waits or delays in receiving care and services.
Be cost effective and reduce/remove waste.
Disparities in care should be eradicated.
A number of pivotal national reports, published in England over the last decade, have highlighted failings in the quality of healthcare provision in a number of areas, but also the importance of quality improvement in improving this care. More recently, a national strategy for safety was launched, which also included a focus in the importance of quality improvement:
- NHS Patient Safety Strategy 2019
- Francis Report 2013 – Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry
- Keogh Report 2013 – Review into the quality of care and treatment provided by 14 hospital Trusts in England
- Berwick Report – A promise to learn – a commitment to act: improving the safety of patients in England. National advisory Group on the safety of Patients in England