So I’ve always had passion for improving quality of services, especially patient care.
Personally as a new trainee joining the scheme, I wasn’t too sure how I could go about making
changes within the NHS, and whilst the opportunity came along to join Improvement FUNdamentals,
I was able to learn a lot about how I can effect change, and how to ensure that we can
implement sustainable change within the NHS, which was very useful for me, very helpful
as a new trainee starting the scheme.
I really enjoyed the course. It was quite interesting learning about the giants within
quality improvement. For me personally being able to understand how we can use different
models to gather information and possibly changes that need to be made, it’s been
very useful.
During my placement at Leicester University Hospital last year, we noticed that we kept
having an increase in our diagnostic referrals, five per cent year on year. It was unsustainable.
Our capacity wasn’t viable in terms of meeting our demands. In terms of patient care, it
was impacting on our diagnostic waits, it was impacting on the quality of care we was
able to give our patients who required diagnostic services from our departments. So it was decided
that we needed to make some changes in terms of how we can reduce our referrals, and this
is where I decided to use some of the things I’ve learned from doing this programme to
implement change.
I decided to explore our data, so reviewing our historical data looking at three years’
data, trying to ensure that we’ve actually…what we’ve predicted in terms of increase in
our demand is, was actually viable and was accurate. So after analysing the data I realised
there’s about six to seven per cent increase year on year. And then I realised we needed
to engage with our stakeholders. The majority of our referrals come in internally from our
CMGs, and that’s the clinical management groups, that’s our divisions, and also we
had referrals coming in externally from our GP practices. So it was crucial for us to
try to, I guess, engage with our stakeholders.
Firstly we changed culture, and that was very crucial in terms of our patients being referred
to our services. Most times we realised that there was a lack of understanding of what
patient needs to be referred for, so patient referred for multiple diagnostic services,
which wasn’t necessary, but at the same time was a lack of understanding of what the
patient needed, in order to diagnose what the condition might have been. So changing
culture was crucial, internally and externally, and it was just engagement, and it was due
to trying to work in partnership with a lot of our stakeholders.
There was a five per cent reduction within the first two months. This could have been
coincidental, but at the same time it was encouraging for us. This showed that our engagement
with our stakeholders, internally and externally, was having an impact, and patients were being
seen much more quicker. We was able to reduce our six week wait, and at the same time, there
was an improvement in terms of patient experience, which was very crucial for our organisation.
The MOOC helped me to understand how crucial it is to engage with our stakeholders, you
can’t make change and sustainable without involving your stakeholders, and it’s not
just about taking a punitive approach, but just being able to work in partnership, ensuring
that it’s a collaborative effort to reduce variations within our services and within
any quality improvement process you might be doing.
I would certainly encourage anyone interested in quality improvement within health care
to definitely participate in Improvement FUNdamentals. For me personally, joining the NHS, it was
quite nerve wracking coming into a new organisation, coming into a new environment, and for me,
Improvement FUNdamentals gave me the right skills, the right tools required to be able
to make some changes and it’s really helped me and I believe it can help anyone regardless
of your post and your position within your organisation. You know you shouldn’t have
to be at the highest level for you to be able to effect change, you know it takes just one
person to be passionate and willing to make change, and know exactly what to do in order
to make those changes, and Improvement FUNdamentals gives the right skills, the right tools, and
ability to go back to make those changes.