Quality improvement paper included in list of top papers for 2019

Research by Dr Lorelei Jones, Lecturer in Healthcare Science, Bangor University, and colleagues at UCL, Kings and Imperial, has been included in BMJ Quality and Safety’s list of top papers for 2019. 

The paper discusses how healthcare organisations respond to quality improvement .

A priority for health-care systems world-wide is improving the quality of care provided by hospitals. This study was part of an evaluation of an initiative in 6 hospitals in England to support the senior leadership teams to improve the quality of care provided by the organisation. The aim of the study was to explain the effects of the initiative, and to identify lessons for the design of future initiatives.

It found that for organisations to benefit from a quality improvement initiative they need to have some ‘slack’ – described by the participants as ‘thinking space’ and ‘someone to do the doing’.  The organisations that benefited from the intervention also had stable leadership and a shared vision for the improving quality. The implications of our research for regulators concerned with strengthening the improvement capability of hospitals is that they need to take slack seriously, and reduce accordingly the number of demands on organisations. Organisations considering engaging in this type of initiative might first consider what they could ‘stop doing’ to enable sufficient slack. Our study suggests that simply adding one more initiative to an already overburdened organisation will not produce the desired results. The design of board-level interventions should be adapted to the context, for example, by focusing on strengthening the building blocks of healthy board functioning in organisations where this is weak.

Funder: National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care North Thames

Research Team: Dr Lorelei Jones, School of Health Sciences, University of Bangor.

Linda Pomeroy, Department of Applied Health Research, UCL

Glenn Robert, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King’s College London

Susan Burnett, Department of Surgery and Cancer, Imperial College London

Janet Anderson, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King’s College London

Steve Morris, Department of Applied Health Research, UCL

Estela Capelas Barbosa, Department of Applied Health Research, UCL

Naomi Fulop, Department of Applied Health Research, UCL (Principal Investigator)

Congratulations to all involved!