Background There is little written about embedding quality improvement in hospices and less still in the UK (Marchant. A quality improvement project embedding quality improvement in a hospice setting. Master’s dissertation report, 2021), but much about quality improvement in healthcare generally. ‘For 30 years, the Institute for Healthcare Improvement (IHI) has used improvement science to advance and sustain better outcomes in health and health care across the world’ (Institute for Healthcare Improvement. How to improve. [Internet] 2023). Havens Hospices is an all age palliative care provider in Essex. There was interest in finding ways to improve the use of quality improvement across the organisation to bring about meaningful positive change.
Aims To increase:
The number of quality improvement ideas suggested.
The number of these seen through to a project and presented.
Awareness, skills and knowledge around quality improvement tools.
Methods The IHI model of quality improvement was used and changes implemented one at a time using plan do study act (PDSA) cycles. The main changes have been:
Introduction of a simple teams form to suggest QI ideas.
Process for rating these ideas and providing feedback on each one.
Training for staff and a QI guide to aid with ongoing training and project completion.
Quality improvement awards introduced and then incorporated into our main staff award system.
Rating process moved to sit with senior leadership team to allow definitive decision making promptly.
Results Significant sustained increases in QI ideas into the process. Many of these are now ongoing projects. In the first year we had five projects presented externally and this year we have a further four abstracts submitted on quality improvement work.
Conclusion We have successfully implemented a process for getting ideas, reviewing them, and then providing the necessary level of support for change to happen. Awards and education have supported these increases. There is still work needed to make sure all projects are seen through to a conclusion and learning shared both internally and externally.
Acknowledgement University of Cardiff for support with initial project as part of Master’s dissertation referenced above.