An introduction to Quality

(for Improvement)

Dr. Damian Roland@damian_roland

Have YOU experienced Quality Care?

What does the Hippocratic Oath say about quality Improvement?

What is Quality?

OUTCOME

VARIATION

From: NHS QIPP Right Care. NHS Atlas of Variation in Healthcare for Children and Young People March 2012. 2012; London.

EXCELLENCE

Six Dimensions/Definitions

SAFE EFFECTIVEPERSON

CENTERED

TIMELY EFFECIENT EQUITABLE

United States Institute of Medicine (IoM)

Or…

No Needless Deaths

No Needless Pain or

Suffering

No Helplessness in those served or serving

No Unwanted

WaitingNo Waste

No one left out

US Institute for Healthcare Improvement

Where have we gone wrong?

Where have we gone wrong?

Roland D, Haden S, Pryde K and Lachman P. Paediatric trainees and the Quality Improvement Agenda: don't just do another audit. J R Soc Med 2011; 104:344-345

Assessing the impact of your last audit

What change resulted from the audit?

Have these changes been sustained?

Has the audit been repeated since the changes?

If not, is there a review date set for repeat audit?

Klaber R and Roland D. Delivering quality improvement: the need to believe it is necessary. Arch Dis Child 2014;99:175-179

PDSA

Measurement

Think of something you would like to improve?

http://bit.ly/lonenut

Does that video change your approach?

http://bit.ly/bronzeagechange

And now….?

Impossible to do alone

The Reality…

How do we use Quality Improvement to change outcomes

We ACT

We MEASURE

We IMPROVE

Thank you for your time

Dr. Damian roland@damian_roland

rolobotrambles.com