Supporting colleagues to improve care: educating for quality improvement

Runnacles, Jane; Roueché, Alice

doi:10.1136/archdischild-2014-306106

Cited by 4 publications

(5 citation statements)

References 13 publications

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“…Although unlikely, given that the GCH is the only trauma centre and hospital within a 48-km radius, a patient could have sought treatment in an ED outside of our healthcare system after the initial evaluation. The likelihood of a missed ciTBI using the PECARN guidelines, as demonstrated in a number of subsequently published studies, is extremely low 39–41. We identified only two ciTBI cases in the preintervention data and none following our intervention.…”

Section: Discussionmentioning

confidence: 68%

Reduction of paediatric head CT utilisation at a rural general hospital emergency department

et al. 2020

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BackgroundBlunt head injury is a common pediatric injury and often evaluated in general emergency departments. It estimated that 50% of children will undergo a head computed tomography (CT), often unnecessarily exposing the child to ionizing radiation. Pediatric academic centers have shown quality improvement (QI) measures can reduce head CT rates within their emergency departments. We aimed to reduce head CT utilization at a rural community emergency department.MethodsChildren presenting with a complaint of blunt head injury and were evaluated with or without a head CT. Head CT rate was the primary outcome. We developed a series of interventions and presented these to the general emergency department over the duration of the study. The pre and intervention data was analysed with control charts.ResultsThe preintervention and intervention groups consisted of 576 children: 237 patients with a median age of 8.0 years and 339 patients with a median age of 9.00 years (p=0.54), respectively. The preintervention HCT rate was 41.8% (95% CI 35.6% to 48.1%) and the postintervention rate was 27.7% (95% CI 23.3% to 32.7%), a decrease of 14.1% (95% CI 6.2% to 21.9%, p=0.0004). During the intervention period, there was a decrease in HCT rate of one per month (OR 0.96, 95% CI 0.92 to 1.00, p=0.07). The initial series of interventions demonstrated an incremental decrease in HCT rates corresponding with a special cause variation.ConclusionThe series of interventions dispersed over the intervention period was an effective methodology and successfully reduced HCT utilisation among children with blunt head injury at a rural community emergency department.

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Section: Discussionmentioning

confidence: 68%

Reduction of paediatric head CT utilisation at a rural general hospital emergency department

et al. 2020

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“…Quality improvement is about unceasingly seeking excellence through the patient journey. 21 There are many approaches to quality improvement including: 24 1. structured educational programmes, eg workshops and seminars 2. experiential learning, eg regular short meetings, action learning sets, mentoring to ensure success via problem shooting 3. multi-professional learning, eg managers and clinicians working together to gain perspectives on each other's work in guiding quality improvement.…”

Section: Box 2 How To Define Quality and Enable Improvement?mentioning

confidence: 99%

“…15 Exposure to quality improvement educational approaches is inconsistent and awareness of quality improvement is variable. 24 The Health Foundation has identified barriers to success for clinical teams undertaking quality improvement. Issues, such as unrealistic goals, insufficient leadership and lack of dissemination because of ownership of a project, can inhibit sustainability and the effects of initiatives.…”

Section: Box 2 How To Define Quality and Enable Improvement?mentioning

confidence: 99%

“…36 The hub will aim to achieve this by supporting and mentoring teams undertaking quality improvement work in addition to focusing on the psychology of change, such as challenging the beliefs, values and assumptions of those working in the system. 24,36 The RCP is committed to ensuring 'the best possible health and healthcare for everyone' and emphasises the need to improve care for patients via 'quality and service improvement'. 37 The hub will aim to build on this by supporting clinicians to develop and establish sustainable quality improvement competencies and capability, and enabling capacity for improvement to be developed across the clinical team.…”

Section: The Purpose Of the Quality Improvement Hubmentioning

confidence: 99%

“…15,19,20 Box 2 summarises the scope of 'quality' with respect to patient care and the mix of approaches that will support physicians and their teams to improve whatever aspect of quality is in need of improvement. [21][22][23][24][25]…”

Section: Introductionmentioning

confidence: 99%

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The Royal College of Physician’s Quality Improvement Hub – how can it help physicians to improve patient care?

Choudry

Stewart

Woodhead

2016

Future Hospital Journal

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Doctors have a central role in managing patients across a multitude of clinical environments, which places them in the ideal position to identify systemic issues. Traditional medical training focuses on the knowledge and technical skills required; rarely are doctors trained in leadership, management or how to analyse and understand systems so as to design safer, better care. Quality improvement methodology is an approach that is known to enable improvement of the systems in which healthcare professionals work in order to provide safe, timely, evidence-based, equitable, efficient and patient-centred care. To address the current disparity, the Royal College of Physicians (RCP) has launched a Quality Improvement Hub, which will aim to support physicians to face the challenges of improving medical care, enabling them to navigate the tools with more confidence and share and implement the learning more swiftly.

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Clinician Engagement in Quality: A Literature Review

Dickinson

Duffield

Bichel-Findlay

et al. 2020

Quality Management in Health Care

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Background and Objectives: Defining quality in the health care context has proven difficult, with many organizations not able to clearly articulate their use of this term in a manner that is easily understood by their clinical staff. This review seeks to investigate the literature to explore clinician engagement in quality including where engagement has been problematic, and if the reasons for this have been identified. Methods: An integrative review of the literature was undertaken to determine whether evidence within the literature supports a hypothesis that there is a lack of understanding of and engagement in quality at an organizational level by health professionals. A search of the literature was conducted using EBSCO Academic Complete, CINAHL, and MEDLINE databases. Results: This article identified 18 studies where the understanding of quality by clinicians and their level of engagement with the process are investigated. We found that there has been no comprehensive study that explores the development of an agreed-upon definition and measurement of quality or clinician understanding and engagement in quality. The studies conducted have been small and discipline-specific. Conclusion: There is a growing body of evidence indicating that clinical and nonclinical staff interpret the meaning of quality and quality improvement differently. Quality and quality improvement are interpreted in relation to the clinician's individual work, professional, and learning and development experience. The literature suggests that clinician interpretation is influenced in part by their own personal beliefs and values, in addition to their interpretation of their individual work/professional responsibilities.

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Supporting colleagues to improve care: educating for quality improvement

Cited by 4 publications

References 13 publications

Reduction of paediatric head CT utilisation at a rural general hospital emergency department

Reduction of paediatric head CT utilisation at a rural general hospital emergency department

The Royal College of Physician’s Quality Improvement Hub – how can it help physicians to improve patient care?

Clinician Engagement in Quality: A Literature Review

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