28 October 2021
Visit our eLearning platform this month and find out the latest in quality improvement (QI). Here, we speak to Dr Iona Thorne, a consultant acute/obstetric physician and rheumatologist at Chelsea and Westminster Hospital NHS Trust.
Dr Thorne is one of the founding members of BSR's QI special interest group. She spent a year at the Care Quality Commission (CQC) visiting organisations with an embedded QI programme.
How would you describe QI?
It’s a systematic and coordinated approach to improvement that uses an evidence-based methodology to improve quality. It uses specific QI tools with the aim of bringing about measurable, sustainable and continuous improvement in quality.
What are the benefits of QI?
There’s robust data that demonstrates that when a systematic programme of QI is embedded and used effectively, it delivers better patient satisfaction, better clinical outcomes and improvement in operational and financial performance. It also helps staff satisfaction and retention. It’s been identified in the NHS Long Term Plan as a mechanism by which national improvement in quality of care will be delivered, while reducing the costs of healthcare.
When did you first get involved in QI?
I came into QI wanting to be equipped to drive forward the services I worked in. As a trainee the annual requirements shifted from an audit project to a QI project. The first project I did using QI methodology looked at implementing safety screening tests before escalating immunosuppression in rheumatology.
I also developed a local process for day case prostaglandin treatment for patients with severe symptoms of secondary Raynaud’s. It was a project that came out of patient feedback around their frustration with the way the service was organised. Part of that involved collaboratively developing regional guidelines to standardise the process.
What was a key takeaway from your time at the CQC?
Early in my time there I discovered that only a handful of hospitals trusts had been rated outstanding overall. Those that did had the common feature of an organisational focus on QI that was culturally embedded throughout the staff. They were truly patient-centred, and staff were very engaged. I spent my time at the CQC understanding what that journey looks like and the key elements.
What are the benefits to individuals of implementing QI?
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Satisfaction – working in an environment that cherishes every team member’s individuality and harnesses each members ingenuity
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Upskilling – QI relies on using tools and skills. In organisations that are committed to QI, the trusts are upskilling all members of the team
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Quality – QI focuses on a shared view of what quality looks like. This is a complete shift from the medical model that we’ve been trained in.
What is BSR currently doing with QI?
There’s plenty of opportunity for members to get involved. This month’s focus on the eLearning platform is QI, where you’ll find resources and tools that will really help you upskill and be inspired in this area.
BSR also has a QI special interest group, which is always welcoming new members, come and find us at conference, our QI course or get in touch if you are interested in hearing more. As well as coordinating the courses and conference sessions, we’re moving towards being a supportive network for QI in the rheumatology community.
What are your top tips for members for making a start with QI?
You don’t need to start from scratch. Connect with people already working in this area and resources that will help you. There needs to be leadership but there’s no model of leadership that says it must be a medic or someone in a formal leadership position.
Start a conversation in your team about what high-quality care looks like. Ideally this should involve everyone involved in patient care across the MDT. Patient involvement is also powerful.
Create time and space for discussing this shared view and set priorities. QI activity flows out of this. Identify some quick wins, build confidence with the process and drive momentum. Find opportunities to share and celebrate your success.
Improve your knowledge and skills around QI by visiting our eLearning platform. This month you’ll benefit from resources including practical tips on how to undertake QI and some rheumatology examples. All members can access eLearning as a member benefit. If you have any problems accessing, please email events@rheumatology.org.uk.