My Quality Improvement journey - an introduction
Monday March 6, 2017
I’m a mental health nurse and I always want to feel that I am delivering the best care to service users and I am able to support nurses in the best way. Over the years I have tried to change practices through imposing changes, using research findings, auditing, educating staff and rather undignified pleading and begging. Some attempts have been successful, most have not been.
Over the last couple of years I have used a Quality Improvement approach and have been surprised that this has had the greatest impact to change practice. I am definitely still a novice but the first thing I have learnt is that Quality Improvement is referred to as QI. This is important as when learning something new the jargon can sometimes feel like a barrier however with QI that is as complicated as it gets. This improvement approach is accessible for everyone to use and the jargon comes with time and practice.
I became involved in QI after attending an HPFT presentation of Continuous Improvement a few years ago. Eddie Short’s positivity was really inspiring and it was exciting to learn that you do not need ‘permission’ to do this work. I thought this was bold and progressive of the Trust to take this approach.
So with lots of ideas and motivation I decided to give it a go but wasn’t sure on how to precede. I completed the FREE on-line course Improvement FUNdamentals and learnt the fundamentals of QI, how to use the model of improvement, measuring for improvement and sustaining and spreading improvements. The reward for this study was that I was awarded with my HIKER (Health Improvement Knowledge & Experience Resource) Badge during an on-line graduation ceremony. Not bad for a technophobe!
So now it was time to do something. I decided to focus on community nursing medication errors. I was obviously concerned about the impact on service users but I was really worried to learn that following an incident nurses can exhibit symptoms of PTSD some months later. I formed a project team which included carers, service users, community nurses and a pharmacist. I presented my idea but crucially no solutions and through a brain storming exercise determined the cause and effect of medication errors. The group agreed an aspirational vision that there would be no medication errors. The starting point was to openly discuss with the nurses why they should report a medication error and how to do this. This plan is now being put into action.
If you are interested in QI you can use this website and the ‘Start an Improvement Project’ section gives you lots of support around the tools you can use.
I plan to share monthly updates on my QI work detailing the successes and the mistakes, sorry learning opportunities, so keep looking in on the website and hopefully you can gain some insights from my reflections to give you the confidence to take forward your own QI efforts.