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Abstract
This article discusses the role of service improvement methodology in changing the quality of care delivered. It outlines the six-stage framework for quality improvement recommended by the NHS Institute for Innovation and Improvement. The reader is encouraged to complete a series of activities to plan and deliver a service improvement project. Potential challenges to the successful delivery of a service improvement project are also considered. The article concludes with an example of the use of the six-stage framework to improve the quality of urinary catheter care in one acute NHS trust.
Keywords
Change management, communication, leadership, quality improvement, service improvement
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Aims and intended learning outcomes
The aim of this article is to enable nurses at all levels to use service improvement methodology to lead and sustain change in their clinical practice, and so improve the quality of a service. The article includes an example of a structured framework that has driven service improvement at Imperial College Healthcare NHS Trust in London. After reading this article and completing the time out activities you should be able to:
* Understand the reasons why service improvement is important.
* Recognise the importance of effective leadership in delivering change.
* Use a six-stage framework to plan, deliver and sustain a service improvement project.
* Understand and manage some of the human dimensions of change.
Introduction
Janes and Mullan (2007) observed that 'if the NHS is to achieve the level of transformation required to ensure that it is fit for purpose in the 21st century, a culture of continuous improvement must be developed, in which every member of staffcan engage in new ways of working'. Quality improvement remains high on the political and professional agenda (Royal College of Nursing 2012), and should be seen in the context of recent failures in quality of care, such as those at Mid Staffordshire NHS Foundation Trust (Francis 2010). The independent inquiry, chaired by Robert Francis QC, into failings at the trust heard evidence that an inadequately risk-assessed reconfiguration of services resulted...