How hospital trusts are embedding Quality Improvement to deliver high quality and sustainable patient care

Published: 11 September 2018 Page last updated: 12 May 2022

Today (Wednesday 12 September) we publish a report that explores how a number of high performing hospital trusts have used a systematic approach to quality improvement (QI) to ensure better patient outcomes and performance.

'Quality improvement in hospital trusts' shares learning from acute, community and mental health trusts adopting and embedding QI across their organisation, and highlights the experiences of staff and patients involved.

The report is based on interviews with trust staff from all levels, local QI teams and patient groups as well as visits to six trusts to see their QI in action. We also spoke to members of the CQC hospital inspection team and reviewed inspection reports, published trust board papers and local QI publications.

While the approach taken by trusts to embed QI across their organisation varied, we found some common themes. Commitment from the board and senior leadership was crucial to ensuring success, with senior leaders acknowledging from the outset that QI would be a long-term journey and that everyone in the trust would need to make a commitment to it.

We saw that putting in place a model of improvement requires leaders of all backgrounds and frontline staff to work together, and can break down barriers between both managers and clinicians, and providers and patients, so there is a shared purpose to deliver better care to patients.

The report describes the various steps involved, from identifying a need for a QI approach, through to building the right skills and culture among staff and then applying specific QI techniques. It also highlights what trusts told us about the importance of involving patients in this work, with examples of where trusts have worked directly with patients and the local community to make beneficial changes.

Professor Ted Baker, CQC's Chief Inspector of Hospitals said:

"In many trusts we have rated as outstanding, we have found a culture of quality improvement embedded throughout the organisation. When QI is used well, staff are engaged, they are focused on the quality of patient care, and they are confident in their ability to improve.

"This report highlights what trusts have told us about their experiences of using QI as a systematic approach to improving service quality, efficiency and morale. It is not a ‘how-to guide', but rather, uses the words of hospital staff and case studies of successful initiatives to share learning with other trusts and inspire those who may be considering adopting a QI approach."

"CQC carried out this work as we wanted to hear and share trusts' experiences of QI – not just as a mechanism to problem solve in failing parts of the organisation, but as a way of expanding improvement beyond organisational or functional boundaries, so that impact is possible across the wider health and social care system."

"We recognise that our hospital trusts are working under significant pressure with increased workload and staffing shortages creating difficult challenges. Our inspections have shown that trusts with the right leadership and an embedded QI approach are better able to manage these pressures and continue to deliver high quality care.

"We know this is not easy - it's a challenging task that involves changing behaviour in complex organisations, but it can be done and as this report shows, it can have a real impact on improving patient care."

This report highlights what trusts have told us about their experiences of using QI as a systematic approach to improving service quality, efficiency and morale

Professor Ted Baker, Chief Inspector of Hospitals