Overcoming the 'self-limiting nature of QI: can we improve the quality of patient care while caring for staff?

In this month’s edition, Mandel and Cady draw on organisational change theories to argue that quality improvement (QI), as currently deployed, is self-limiting.1 In other words, if left untamed it will fail to produce valuable change and may have a raft of negative consequences, including stress, reduced engagement and burnout among healthcare staff. While acknowledging that some improvement methods (eg, appreciative inquiry, positive deviance) do address the emotional experience of staff as well as their performance, and focus on socio-behavioural (teamwork, cultures, etc) as well as process-technical design elements, Mandel and Cady call for these to be explicit elements of all healthcare QI initiatives. We argue here that this article represents a theoretical framing for messages that ring loud throughout the QI and safety literature. These linked messages are (1) additive change means asking staff to do more and more, potentially creating safety clutter, and (2) improvement...

Source: BMJ Quality and Safety - November 17, 2022 Category: General Medicine Authors: Lawton, R., Thomas, E. J. Tags: Editorials Source Type: research