Quality improvement at East London NHS Foundation Trust: the pathway to embedding lasting change

Abstract

PurposeEast London NHS Foundation Trust (ELFT) is a major provider of mental healthcare and community health services. Quality improvement (QI) has become central to its organisational policy and goals for which it has received national and international attention.Design/methodology/approachThis piece reflects on the Trust's transformation and its approach. It provides many examples and discusses several of the associated challenges in building and sustaining QI momentum. It is the result of a range of perspectives from staff involved in planning and building large-scale QI capability. It contextualises QI's current status in UK mental healthcare.FindingsSeveral key factors were identified: board-led commitment to organisational transformation; investment in training and resources to support staff motivation; clear and realistic project goals in line with the service's over-arching strategic direction; support for service users and staff at all levels to get involved to address issues that matter to them; and, finally, placement of a high value on service user and staff qualitative feedback.Practical implicationsBuilding QI capability represents a significant challenge faced by all large healthcare providers. Sharing experiences of change can assist other organisations achieve the necessary buy-in and support the planning process.Originality/valueAchieving and sustaining lasting organisational change in healthcare is challenging. This article provides a background on QI at ELFT and reflects on the pathway to its present position at the forefront of the application of QI within healthcare.

Identifying and understanding benefits associated with return-on-investment from large-scale healthcare Quality Improvement programmes: an integrative systematic literature review

“…Sustainability of outcomes was therefore also seen as an important achievement by most authors. This was supported by some of the literature which also indicated that successful QI built legacies mainly through spreading, embedding, and sustaining improvements [78,93,[101][102][103][104][105][106]. This finding was confirmed by impact studies, extensive QI programme evaluations and discussions of overall QI impacts [69, 85, 87, 93, 103-106, 108, 115, 116, 119, 121, 124-126].…”

“…There was a shared view that quality and patient safety should be more central to QI and investment goals than financial outcomes [72,88,[90][91][92][93][94][95]. This view had not changed over time.…”

“…Systems efficiency helped improve staff efficiency, effectiveness, productivity, and experience, which benefited patients [84,99,100]. Improved systems enabled improved organisational capacity, capability, and resilience [93,[101][102][103][104][105][106].…”

“…Williams et al [100] focused on both staff and patient outcomes. QI was also used to operationalise organisations' strategies [93,108]. Staines et al [108] found that a positive QI reputation allowed recruitment of a suitable CEO.…”

Health governance: reponses to and effects of COVID-19

“…ELFT provides care to socially diverse and socio-economically deprived catchment area, and achieving sustainable change has proved challenging. The Trust has invested in new training and resources to foster staff motivation, to establish clear and realistic project goals and to promote inclusivity (O'Sullivan et al, 2021).…”