Engaging frontline staff in quality improvement

Dr Ashley McKimm, Head of BMJ Quality

Why quality? Why now?D

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Immunisation1768

Penicillin1928

Sanitation1840s

Anaesthesia1840s

Why quality? Why now?D

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Why quality? Why now?M

1. BMJ archive searches patient safety, quality and experience reports 1900-2000; Medical error citations collated by the National Patient Safety Foundation for the period 1939-98. Adapted from slide by Pat Croskerry.

Medical error reports – England and Wales 1939-98

Cita

tions

7,300 patients per year per hospital suffer an adverse event

Nearly 2 bus loads per week per hospital

Why now?

1. Balas EA, Boren SA. Managing clinical knowledge for health care improvement In: Bemmel J, McCray AT, editors. Yearbook of Medical Informatics 2000

On average it takes 17 years for new clinical knowledge to become routine practice

The challenge

1. Help identify area for improvement

2. Find out how others have solved it – and what didn’t work

3. Support step-by-step through the improvement process

4. Get advice from mentors, experts and the global community

5. Publish and share your work

Five challenges

1. IDENTIFY AND SHARE

• Aims to become the world’s largest repository of quality improvement evidence

• Standardised SQUIRE guideline template to aid sharing projects and allow comparison

• Making it searchable to help clinicians find what works and doesn’t work before they start

Recent projects submitted

Recently completed projects -

•Improved surgical handover which increased the discharge of suitable patients at weekends from 5% to 20%•An educational programme which improved correct prescribing for Parkinson’s disease from 43% to 82%•Developed a new calculation tool which led to a three-fold increase in accurate dosage of gentamicin

Read more projects in BMJ Quality Improvement Reports at qir.bmj.com 

Lahore, Pakistan

Chain of improvement Pakistan Toronto and Malawi

2. MAKE IMPROVEMENT

SIMPLE

give us the tools to learn

Understanding the basics Problem identification Relevant background Introduction to measurement Baseline measurement Getting to grips Learning to change Making the change Empowering yourself Learning to improve Steps to success Crunching those numbers Learning Final thoughts

Learning modules Improvement tools

By October 2014

• Over 2,000 completed projects by frontline staff

• Global directory of active improvement projects

• 100+ communities of interest

• Patients actively involved with teams in improvement

Join our collaborative

• Develop an improvement programme in your organisation for frontline staff

• Encourage them and give permission to share their work

• Connect and collaborate with organisations doing similar improvement work globally

Web: quality.bmj.comEmail: quality@bmj.com

Twitter: bmjquality