Do you have two jobs?

By Andrew Moore (@maidenturret)

We’re living in complex, fast-moving times. Our beloved health and social care systems are facing unsustainable pressures. Despite a number of reforms over the last 20 years aimed at addressing the challenges of demographics, inequality and decreasing resources, the delivery of sustainable models of health and social care services is still work in progress. Transformational change is never easy and I have often reflected on what we can learn from successful organisations that have lasted the test of time.

A recent World Economic Forum report highlighted that the average life span of a publically traded company is 10 years. Yes, a number of these entities are acquired, merged or split up into smaller companies. Many of them, however, are relegated to the graveyard of failed companies. In many cases, when companies perish, one of the major contributing factors is that management clung stubbornly to the status quo. Sustainable organisations demonstrate a willingness to constantly change, to innovate and not simply rest on their current success. I recently watched a documentary about the Mini production plant in Oxford, in which the three elements of sustainable and successful organisations was abundantly evident. Every employee interviewed clearly articulated with enthusiasm that they had two jobs, producing Minis and improving the quality of the processes/product. Their passion for improvement was palpable.

Within the NHS ‘quality’ is now firmly on most people’s radar through enablers such as the Quality Strategy, Scottish Patient Safety Programme and the considerable investment in growing quality improvement capacity and capability. I have been hugely impressed by the impact of the National Delivery Plan for AHP’s which has delivered a whole range of sustainable improvements across health and social care.

How do we make further progress towards quality being everyone’s business? If you ask a staff nurse on a busy ward or a hard pressed physiotherapy assistant what is their role from a ‘quality’ perspective, what would their answer be? Probably their answer would be couched in terms of delivering a quality service to patients. Given the service pressures it can sometimes feel impossible to think about quality improvement when there are no beds or you are under pressure to hit waiting time targets (As a nurse I do have sympathy for my AHP colleagues who have been dis-proportionally affected by the shrinking resource envelope).

However, I think we are in a good place on which to build. There are lots of examples from within my own organisation where clinical leaders and their teams ‘carve’ out the time to progress quality improvement activities and also reflect on what ‘quality’ means to them as a team. It is often said that quality improvement is a team sport and these successful teams have demonstrated the positive impact of taking time to engage, reflect and re-charge the enthusiasm/empathy batteries.

To encourage others to get involved, colleagues in the Emergency Department at University Crosshouse Hospital (led by @claireGilroy6) are going to test a campaign called ‘30 minutes per day for quality and safety for 30 days’ aimed at getting the whole multidisciplinary team involved in quality improvement. The focus is on all members of the team taking a small amount of time per day to think about and progress improvements, using an action focused approach. We aim to build on the work in ED (using the quality improvement is infectious principle and a touch of competitiveness!) to build momentum across my organisation. Follow progress on twitter using the hashtag  #ED3030.

AHP colleagues are clearly leading the way in delivering a whole range of improvements (the AHP blog is a fabulous showcase) and are well placed to influence others to get involved in quality improvement.

I have ‘two jobs’….do you?



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