Requires Improvement

How did we get here, and how can we move on?

To some, the news comes as no surprise, to some it’s a shock, and to others it shocking. Whatever your perspective, action is clearly required.

We know that those at the top are sometimes left wondering..

quality improvement clinic post - requires improvement by nikki davey
quality improvment clinic article - requires improvement
But as I go about my work I hear people say things like ‘managers don’t really care about patient safety – they just care about ‘ticking the box’. And whilst blaming managers might provide a route to vent frustration, I don’t think blame is a helpful road to travel.

Instead, I am more inclined to believe that it is the system we require people to work in that causes them to unwittingly shift their priorities – directing their work effort towards compliance and tidy and timely reporting – and away from the prize of supporting and delivering good patient care.

It’s a tricky one and, if you’re an organisation that has recently received a ‘requires improvement’ notice from the CQC for patient safety – the pressure bears down. So how do you decide on the approach you and your organisation will adopt to get your ‘status’ changed?

As ever, there are choices: some are more palatable than others and some require more courage and resilience. So I’ve listed some below that I’ve come across in the past year.

Choice 1: Fix things by requiring staff be more vigilant at ticking the boxes  – choose this if you are happy to ignore that fact that as humans they will tire from time to time. 

Choice 2: Believe that the people you have can deliver a different result using the same skills they’ve applied before – just trying a bit harder this time around – choose this if you really believe that your staff are not trying, that telling them to try harder will enable them to suddenly understand what kind of trying will create better results and that they will be able to do it 

Choice 3: Reassure people and hope you’ll have a chance to sort it out once you have reached the ‘bigger goal’ of achieving financial security – choose this if you are happy with a goal that is forever moving and never achievable in a publicly funded organisation  

Choice 4: Acquire a deep understanding of the fundamental problems that have led to patient safety and address them systematically using real time, real life data to inform your work effort – choose this when you really believe in your staff and are committed to long-term efforts

At the Quality Improvement Clinic we think our approach works best with Choice 4 – so if you want to know more about how we can support you in making this work for your team – we’re always happy to share what we do 🙂.