Quality improvement, the continual change of services through testing, measuring, reviewing and refining, is becoming increasingly common in NHS organisations. But the report finds while mental health providers are increasingly adopting this approach in individual teams or services, more need to do this across their organisations.
The report finds that quality improvement can lead to improvements in both quality and efficiency of care. This includes reducing lengths of stay, waiting times, bed numbers and bed occupancy. It can also reduce staff absence, violent incidents involving staff and first appointment non-attendance.
If quality improvement is done systematically by engaged frontline teams, it can lead to sustained improvements that are shared across the organisation. The report also noted that mental health providers have a long history of involving service users in service design, making them particularly well-placed to using quality improvement to support innovation.
The report warns that successfully adopting quality improvement across the organisation takes time. It is also important to engage and empower frontline teams to develop solutions rather than imposing them from the top of the organisation.
Shilpa Ross, Senior Researcher at The King’s Fund and one of the report authors, said:
“As the Care Quality Commission highlights in its new report, pressures on mental health services in England are rising and access to timely support at times of crises remains a long-standing issue. Some mental health providers have reported impressive improvements in patient care by making quality improvement a part of the way the organisation does things. It has the added benefit of improving the organisational culture, something which many providers struggle to do and which has a positive impact on both employees and the experience of people being cared for. It is important that mental health providers look at how they can adopt quality improvement to meet the pressing need to improve services.”
Mental health leaders play a vital role in creating the right conditions for quality improvement. Leaders should:
- Gain board-level commitment to quality improvement
- engage and empower frontline teams to develop solutions rather than imposing them from the top of the organisation.
- build an appropriate infrastructure, including a robust support structure for frontline teams and mechanisms to spread learning across the organisation.
- commit to one quality improvement methodology long-term to sustain and adopt quality improvement in how the organisation works and its culture.