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Quality Improvement (QI)

We use Quality Improvement (QI) to help improve what we do and how we work to continue to provide outstanding care to our patients. 

In the following video, our Chief Executive Julian Emms talks about why QI is important to creating a culture where everyone has a voice, and our staff and patients can collaborate to improve the way we do things.

We have partnered with Catalysis to support our programme. They’re a global organisation focusing on transforming healthcare and creating value.

Visit the Catalysis website to find out more (opens new browser tab) 

Our Quality Improvement follows Lean methodology.

Lean methodology is an evidence-based approach that has been tried and tested throughout healthcare organisations for over 20 years.

It helps guide us in making substantial and lasting changes in patient safety, quality, and experience by reducing waste and maximising value.

Over time, improvement work can become part of business-as-usual activities for all staff.

This video explains our approach to QI.

Our QI team works closely with our Executive Directors and senior leadership team, to align the management system across all our services, and agree the prioritisation of work and projects that will help us meet our True North objectives.

Our annual plan on a page sets out what we are trying to achieve, share our vision and goals with our staff, patients, carers, and external stakeholders. 

Read about our Annual Plan on a Page (LINK)

Our True North Objectives set out our aspirations for the areas we would like to see improvement in. They help focus our attention and resources.

True North is categorised into four areas that will create the greatest benefits for our patients, care, staff, and partners. 

  • Harm Free Care: provide the safest services (reducing harm to patients and staff)
  • Supporting our staff: make this organisation a great place to work
  • Good Patient Experience: Improve the outcomes for all patients
  • Money Matters: Become a financially sustainable organisation 

Breakthrough Objectives

These are key areas that can be achieved with significant changes to the way we work. We hope to see an improvement in the following four areas:

  1. Reducing the number of falls on our inpatient wards
  2. Reducing the number of self-harm incidents
  3. Reducing the number of physical assaults on our staff
  4. Increasing the uptake of physical health checks for patients with serious mental illness. 

Alongside the breakthrough objectives there three additional elements that work together to drive continuous improvement at all levels.

Our QI team deliver training, coaching and ongoing support for all our teams.

The team is made up of a mixture of clinical and non-clinical staff, who all have a passion for continuous quality improvement.

We’re implementing QMIS to all teams.

QMIS is a set of lean management and improvement tools to help staff maximise value adding activities, while reducing or removing wasteful and inefficient processes.

When you visit us, you may see or hear about QMIS tools and practices in the day-to-activities of our hospitals, teams, and clinics.

We welcome ideas for how to improve our services so please share these with your care teams. 

We follow a structured problem-solving approach known as an ‘A3’ for our projects, which is widely used across many sectors, including healthcare.

If an issue is complex or is likely to affect wider services, they may become a QI project and use the A3.

We train our staff in QI methodology, known as Yellow and Green Belt. We’re accredited to deliver this through Cardiff university Lean competency scheme. These staff then lead projects in their areas. Many of these projects have achieved lasting benefits to staff and patients.

They will make sure it has the resources and support needed to bring real benefits to our staff and patients.

View a blank A3 guide (pdf)

Improvement projects

Our services and teams in the Trust use the A3 as a structured problem-solving approach to deliver improvement projects.

Read some examples of our improvement projects (opens new browser tab)