Strategies for sustaining a quality improvement collaborative and its patient safety gains

Abstract

This study has presented what principle programme coordinators across 20 NHS organizations considered to be the key strategies to sustain their own improvement programme and its successes, during the supported phase of the programme and 1 year on. Recommendations are to consider these practical strategies in order to improve chances of maintaining changes and continuing a quality improvement programme beyond the formal cessation of the intervention.

Collaboratively Improving Diabetes Care in Sweden Using a National Quality Register

“…Considering the widespread use of QICs, deeper investigation is warranted to clarify what aspects of QICs work for whom, and why, in different contexts 13,19,[38][39][40] and to ensure sustainability. 41,42 A more profound understanding could enhance improvement work that employs quality registers in Sweden and elsewhere.…”

Sustained improvement in nutritional outcomes at two paediatric cystic fibrosis centres after quality improvement collaboratives

“…In a qualitative analysis of a collaborative,7 Parand et al 7 reported that programme improvement methodology is one key in sustaining improvement, bringing attention to the need for improvement in patient outcomes while introducing process improvement techniques 8. QI methodologies within collaboratives most predictive of long-term success include the early adoption of QI such as rapid cycles of change, implementation and adherence to clinical practice guidelines in a systematic manner, and the learning of new ideas 8 9 18 19.…”

“…1 7–9 19 Data display provides motivating feedback while giving improvement a high profile 7. The CFF data registry has proven to be an essential data tool for both a benchmark with other CF centres and an external requirement for target performance goals for key patient outcomes such as BMI percentile.…”

“…This change in culture has been reported in the literature as essential to maintain improvement. 7 8 Although at the outset of the collaboratives, neither programme had a history of a strong culture of improvement, both teams have been able to effect a change in programme culture. The most important methods that each programme used to change culture were to recruit staff to support QI, having a leader serve as a champion and coach, patient and family involvement, and managing up.…”

“…Results of specific collaboratives in other populations of patients with conditions other than CF have led to improvement 7. However, most collaboratives only showed improvement in the short term and there is no significant evidence of long-term benefit 7–9.…”