Development of a respiratory quality improvement faculty in an acute hospital using QI methodology.

Abstract

National Health Service (NHS) clinical staff are required to demonstrate involvement in quality improvement (QI) and patient safety. Clinicians are often best placed to identify problems and design solutions for their own clinical environments, yet the rotational nature of training can impact on the design, implementation and sustainability of projects.The In-hospital Quality Improvement for Respiratory team was created in August 2020 within a busy respiratory department to inspire a culture of continuous improvement and provide a sustainable infrastructure to support and progress QI projects (QIPs).The trust uses the LifeQI platform which provides a change score from 0.5 (intention to participate) to 5.0 (outstanding sustainable results) as a representation of a QIP's progress.We aimed to increase the number of QIPs in the respiratory department registered on the LifeQI platform from 1 to at least 10 projects by September 2021.A QI framework was used to identify and address four primary improvement drivers: (1) QI understanding/training, (2) QI faculty communication, (3) QI participation, and (4) QIP completion using multiple Plan-Do-Study-Act cycles. Data were collected on the number of active respiratory projects registered within the LifeQI platform, mean LifeQI change score and the number of projects with a change score ≤1.Twenty-four new QIPs were initiated in the first 12 months, with a number of projects leading to sustainable change. The largest improvements were seen in autumn 2020 as the faculty's multidisciplinary membership expanded.We achieved our aim of increasing the number of registered QIPs, sustaining the QI faculty throughout the COVID-19 pandemic. Our multidisciplinary membership continues to increase and the faculty has improved access, organisation and project progression across a large department with an established process for rotating staff to join existing QIPs. Our model has the potential to be replicated in other clinical departments within NHS organisations.