QI Blog May 2019.

Quality improvement to me means that we all work together on projects which aim to make healthcare safe, effective, efficient and most importantly patient centred. At the end of the day no matter what role we play in the health board we are all here to give our patients the best care and experience possible. However in order for us to improve the quality of our service we must first reflect on and evaluate our current practice to see what areas if any we could improve. By using the resources available to us anyone of us can make our ideas into a quality improvement project. Often the majority of projects can be carried out without needing any financial support and can bring benefits to our practice and patient care. The key factor in sustaining our improvements and providing quality to our practice is our amazing staff that work for BCU. Without everyone’s hard work and positive attitudes towards quality improvement projects we would not have achieved the change in culture that we currently have.

It is important to remember that in order to affect outcomes, we have to affect structures and processes. In order to do this I apply the theory of profound knowledge. This has four major components of: system thinking, psychology of change, theory of knowledge and variation. In every quality improvement project I do I always start by identifying the issue and dividing it into sub processes. I complete a driver diagram to help create a clear picture of the situation. I will then share my vision with my clinical lead, managers and staff in order to gain their support and allow team members to contribute in order to reach a common goal. In order to test the theories of changing components or processes I always use PDSA cycles. Often the cycle of Plan, Do, Study, Act needs to be repeated several times throughout the project before you get the process you are happy with, which will help affect the outcome in a positive way. However it is important to remember that all systems are developed to create outcomes and these outcomes will have a natural variation. In order for our work to become highly reliable we need the following three components: leadership, a culture of safety and a robust process of improvement such as Lean or Six Sigma. An excellent example of this in practice is when I did a quality improvement project in order to increase our compliance in completing the thromboprophylaxis risk assessment.

Christine Welburn.

Thromboprophylaxis Specialist Nurse YGC.

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