The BMJ and the Health Foundation are launching a joint series of papers exploring how to improve the quality of healthcare delivery.
Posted on: 18 May 2018 06:41
Dr Fiona Godlee: "This series offers new ideas and skills so doctors can feel empowered to change the system."
The series will discuss the evidence for systematic quality improvement, provide knowledge and support to clinicians, and ultimately help to improve care for patients.
Commenting on the launch of the series, Dr Jennifer Dixon, chief executive of the Health Foundation said: “Stories of a disordered system abound in health care. If this is to change then more clinicians need to view their role as bigger than just treating the patient in front of them.”
In an editorial to launch the series, Dr Dixon and colleagues from the Health Foundation outline their belief that just as doctors learn to assess, diagnose and treat clinical conditions, “they also need to learn how to design improvements to services, including communicating and negotiating better within and beyond their teams on the best way forward.”
They stress that the task ahead is not to turn doctors into managers, but the first step must be to give legitimacy to the role of the clinician to improve the quality of services and “to equip doctors and other clinicians with formal skills to do it.” But they argue that medical training “still does not help enough doctors to develop these skills.”
They acknowledge that there has been progress. Some UK Royal Colleges for example are introducing postgraduates to quality improvement. But they point out that “many places of work either do not recognise the need, or offer no support.”
Yet there is plenty of evidence that systematic quality improvement makes a difference, not just for patients but for staff too, they write. “And despite everything many doctors in the wider NHS are motivated to reach beyond the boundaries of traditional medicine, and improve care.”
Explaining why quality improvement is a priority now, Dr Dixon added: “Because of past efforts and the obvious current level of interest, this agenda of developing quality improvement activity has now reached tipping point in the UK.
“There is a huge opportunity now to embed it into the NHS as part of everyday work, an opportunity which should be grasped now especially if there is a ten-year settlement for the NHS in the offing, as announced recently by the Prime Minister.”
In a linked editorial, BMJ patient partners Anya De Iongh and Sibylle Erdmann give a patient perspective on what better healthcare looks like.
They say quality improvement in healthcare “is a team effort and most effective when it includes people using services and their carers, families and advocates.” But they stress that the invitation to patients to get involved “needs to be both timely and respectful.”
They point to the expansion of boundaries of the traditional patient-doctor relationship, but say “we still have some way to go before all clinicians welcome every patient contribution either during consultations or service improvement discussions."
Living through illness gives individuals a unique insight of enormous value to quality improvement efforts on both a personal and organisational level, they write. “These efforts must recognise the qualitative nature of patient experience, and give it equal priority with the experience of healthcare professionals providing clinical services.”
Dr Fiona Godlee, Editor in chief at The BMJ said: “Doctors have always worked to improve the quality of the care they give. But their focus and training has been on managing individual patients. This series offers new ideas and skills so doctors can feel empowered to change the system in which they work, to build effective teams, and to work with patients to deliver better, safer care.”
Links / further reading: www.bmj.com/quality-improvement
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