Barrier | Rationale | Solution |
---|---|---|
Time and clinical commitments | ‘In addition to a supportive educational environment, clinicians require time to learn, within an environment that allows space and time for learning’.18 | Although difficult to achieve with tight rotas, educational supervisors have developed solutions such as dedicated quality improvement (QI) study days or regular afternoon project workshops using study leave allocations, departmental meeting slots or weekend staffing. Teamwork on a project not only ensures individual clinicians have capacity to complete projects but also motivates, improves interpersonal skills and builds interprofessional working relationships. |
Resources | ‘To provide sustainable benefits, QI activities should, where possible, be aligned with the mainstream allocation of resources in healthcare, supported through professional training, and through commissioning and regulation, and be integrated into the management of services’.18 | Organisations that support QI do dedicate resources to QI education programmes. Few resources are in fact required if faculty is found within the organisation. Clinicians themselves should look to people within the organisation, such as data analysts, administrators and project managers, who can provide project support. Patients are an invaluable resource, and it can be hugely rewarding and beneficial to engage patient groups in QI projects. |
Transitions to new roles | Junior healthcare professionals require support and confidence to participate in improvement work, particularly when they are transitioning to new roles.18 | QI supervisors need to mentor and support projects, emphasising the importance of learning from everyone, however junior. Doctors in postgraduate training (DrPGT) can bring fresh ideas for improvement from other organisations where they have previously worked. |
Project supervision | Inertia to getting projects ‘off the ground’ and to ensure project progress and completion.18 | ‘QI activities typically require a change from routine practice and must overcome inertia to get started. Successful projects require leadership capable of sparking enthusiasm and maintaining momentum....Patient voices can be an important support in this.18’ Regular feedback and project mentorship is important to ensure progress of projects. |
Education on QI methodology | Although clinicians are motivated and understand what improvements are required, they require support in understanding and applying QI methodology.18 | Faculty development initiatives, such as the Royal College of Paediatrics and Child Health (RCPCH) regional programme, are a response to the need to train the workforce in QI methodology, and support those with QI skills to educate and spread their learning within clinical networks. |
Organisational culture | Many healthcare workers who have ideas for improvement feel that it is not their place to make these changes or feel that the organisation is not working to support them.18 | Support from ‘senior clinicians and leaders who make it clear that quality improvement is important and an organisational culture that values improvement and supports change’ is key to promote participation in QI.18 |