RT Journal Article
SR Electronic
T1 Value improvement at the point of care: engaging and empowering front-line teams with a new quality improvement methodology
JF BMJ Open Quality
JO BMJ Open Qual
FD British Medical Journal Publishing Group
SP e001233
DO 10.1136/bmjoq-2020-001233
VO 10
IS 2
A1 Poonam Gupta
A1 Gracy Chacko
A1 Paul Mavin
A1 Ian McDonald
A1 Mawahib El Hassan
A1 Emad Omari
A1 Azhar Ali
A1 Raana Siddiqui
A1 Needa Khan
A1 Lisa McKenzie
A1 Tricia Bolender
A1 William Andrews
YR 2021
UL http://bmjopenquality.bmj.com/content/10/2/e001233.abstract
AB Background Healthcare organisations require systems to consistently meet the needs of their patients while providing excellent quality of care. The value improvement (VI) approach was developed by the Institute for healthcare improvement and successfully piloted at Raigmore Hospital, Scotland. It showed positive results in improving outcomes and reducing costs. Our multidisciplinary team from a tertiary care cardiac hospital in Doha, Qatar wanted to see if we could improve value in a clinically and geographically distinct context. We sought to understand the effectiveness of this approach as an integrative management philosophy that aims for continuous improvement in the quality of services by increasing efficiency and reducing waste.Methods This study evaluates the outcomes achieved from applying the VI methodology. The method is rooted in a framework that emphasises standardisation, continuous process improvement and rightsizing capacity to demand. The main tools include a data box score, a visual management board and weekly communication huddles.Results As a result of the VI methodology, our team achieved improvements across performance, staff capacity and cost domains. Compared with the 4–8 weeks baseline data collection period, these improvements included an increase in discharges before 13:00 hour by 61%, a reduction in the number of blood samples per patient per day by 20%, an increase in nursing time spent in direct patient care by 18%, and an increase in staff satisfaction to 40%.Conclusions We found that the VI approach offered a systematic method for continuously improving the quality of care by focusing attention each week on safety, efficiency and patient experience. The team improved numerous processes and outcomes resulting in a positive impact on patients and families and increased the engagement of staff in continuous improvement. In this way, we improved our capacity to undertake and complete quality projects.All data relevant to the study are included in the article or uploaded as supplementary information.