Continuous quality improvement: educating towards a culture of clinical governance

Developing Quality Improvement capacity and capability across the Children in Fife partnership

A Project Manager from the Fife Early Years Collaborative facilitated a large-scale Quality Improvement (herein QI) project to build organisational capacity and capability across the Children in Fife partnership through three separate, eight month training cohorts. This 18 month QI project enabled 32 practitioners to increase their skills, knowledge, and experiences in a variety of QI tools including the Model for Improvement which then supported the delivery of high quality improvement projects and improved outcomes for children and families. Essentially growing the confidence and capability of practitioners to deliver sustainable QI. 27 respective improvement projects were delivered, some leading to service redesign, reduced waiting times, increased uptake of health entitlements, and improved accessibility to front-line health services. 13 improvement projects spread or scaled beyond the initial site and informal QI mentoring took place with peers in respective agencies. Multiple PDSA cycles were conducted testing the most efficient and effective support mechanisms during and post training, maintaining regular contact, and utilising social media to share progress and achievements.

Attitudes toward quality improvement among healthcare professionals

Purpose

– The purpose of this article is to describe how the training of healthcare professionals in improvement work can be performed, and evaluate potential changes in attitude as a result of the initiative.

Design/methodology/approach

– The study was carried out at a University Hospital in Sweden. There were 443 participants in the study. The response rate before the intervention was 55 per cent (242 respondents) and six months later, it was 43 per cent (190 respondents). A two-day training program about quality improvement was performed on seven different occasions and after the training had been concluded, participants were encouraged to translate their newly acquired knowledge into improvement projects. Surveys on attitudes toward improvement work were completed by the participants right before the training and six months afterwards. The results were analyzed using a Mann-Whitney test.

Findings

– The analysis showed some statistically significant changes in attitude among the participants. There were also differences between groups of participants based on their profession and the number of years in their current position.

Research limitations/implications

– A limitation of the study is that it was solely based on attitudes expressed during the survey and did not include any observed changes in behavior. Another limitation is that attitudes after the intervention were only measured once.

Originality/value

– It is possible to use training to change attitudes toward improvement work. The result differs among groups of participants, which raises the question as to whether training should be tailored to better suit the needs of different groups to create positive change. Further research is needed regarding how to reach and fully implement a quality improvement mindset.

Teaching and continuing professional development: an Italian experience

Continuing Professional Development (CPD) is a key factor for effective implementation of Clinical Governance. The development of a quality system is, in fact, strictly related to the development of competencies of healthcare professionals. Lifelong learning has emerged as a new paradigm that underlines the need to maintain and continuously improve knowledge, competencies and attitudes in the changing scenario of healthcare systems. CPD accreditation is another fundamental issue and a variety of voluntary and compulsory approaches can be recognised at an international level. The experience of the University Hospital of Padova may be useful to demonstrate that CPD can be addressed to implement a Clinical Governance project.

Specialist registrar training: what still needs to be improved?

It is 6 years since specialist training in the UK was radically reformed. Is educational quality still improving or have early improvements slipped as the novelty has worn off? What further improvements are needed to ensure the production of specialists who are properly prepared to be the consultants of the future? The authors address these questions from the perspective of one postgraduate deanery.