LEADERSHIP ACADEMY

'Quality assurance is not a tick box'

23 September, 2011 | By Dickon Weir-Hughes

Patients will be more confident in your services if you can show their quality.

Quality standards are generally determined by the intended users of a service or those that commission or regulate it.

Quality assurance is normally sought through a set of activities that are intended to ensure that services satisfy customer needs and requirements in a systematic and reliable manner.

Information can be collected through patient surveys, regulators’ audits and by seeking the views of others, via user groups, for example.

Other tools can pick up quality standards. These include key performance indicators and benchmarking.

All these methods will lead to a level of quality assurance that should allow users to have confidence in their care providers and their leaders.

Not all users are the same, so you need to ensure you hear everyone’s opinion and take all viewpoints and needs into consideration.

Traditionally, certain groups have not been heard, such as those with learning disabilities or mental health problems, ethnic minorities and lesbian, gay, bisexual and transgender people. As a leader, you are responsible for seeking out and working with their opinions.

Quality standards are set at many levels, including within organisations and departments. Internal quality assurance needs to involve more inward-looking processes to assess individual practices and to determine how you and your team are performing against your and their expectations.

As a leader, it is your responsibility to be knowledgeable of the quality assurance levels expected within your team and your organisation as a whole.

Listen to those using your service, and apply improved quality assurance measures to meet their requirements.

Having listened and defined quality standards, lead on their delivery. Meeting targets, such as reducing waiting times or improving GP access, will not happen without a proactive lead implementing strategies.

How to implement and improve quality assurance

Review and critique the quality specifications relevant to your area of practice, discipline or organisation. What one thing could you do to increase compliance?
Develop your thoughts, depending on your job role, now and in the future, on how you will better engage with those whose voices are heard less.
Ensure a high quality of work is everyone’s responsibility. Define your specific responsibilities and include these in your objectives.

For some, quality assurance exists only to chase government targets or to please senior management.

It is your job to educate your team about the need for quality assurance and motivate them to embrace it.

Having involved your team and implemented quality assurance strategies, it is vital to monitor performance so you are aware of the steps you have made and those you still need to make towards improving or maintaining quality within your organisation.

This is an excerpt from Clinical Leadership from A to Z by Dickon Weir-Hughes. Available from Amazon.co.uk

Dickon Weir-Hughes is chief executive and registrar of the Nursing and Midwifery Council. Before his appointment in 2009, Professor Weir-Hughes held senior roles at Barking, Havering and Redbridge, The Royal Marsden Hospital and Chelsea and Westminster hospitals.

Readers' comments (8)

mike | 25-Sep-2011 12:43 pm
You should take some of your own advice Dickon if you want Nurses to regain a little respect for the NMC, show us some quality for a change.
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Anonymous | 25-Sep-2011 5:22 pm
The problem is - of course - that people soon concentrate on the quality markers rather than quality in general. A bit like when an assignment is needed to pass a course and all that people are interested in from the first day is finding out how to pass the assignment.
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Roger Hodgson | 26-Sep-2011 8:48 am
Quality Assurance??? More like League Table information gathering.

Put more hands on staff in the work place, (the real workplace, on the wards not human resources and unqualified management sitting behind computers) and patient satisfaction along with quality of care and assurance will automatically follow.

There is no real need to write books on the subject of quality assurance and how to attain it... Given a practice based leadership and the opportunity and time to use appropriate interpersonal skills, Nurses will reverse the present conveyeror belt system of care to one where quality need not be measured by tick boxes
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Anonymous | 26-Sep-2011 6:14 pm
Well said Roger. I don't know what is happening in my trust but there is an explosion of madness in terms of quality markers. I feel my nursing care has suffered as a result. One almost wants to say to the patient - "I am not interested in you I have all these papers to fill in and committees to attend".
Where will it all end?
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DH Agent - as if ! | 27-Sep-2011 11:09 am
Far too many words, because this part is a correct description of the principles involved:

'Quality standards are generally determined by the intended users of a service or those that commission or regulate it.

Quality assurance is normally sought through a set of activities that are intended to ensure that services satisfy customer needs and requirements in a systematic and reliable manner.

Information can be collected through patient surveys, regulators’ audits and by seeking the views of others, via user groups, for example.'

but he follows it with the root of most problems in this area:

'Other tools can pick up quality standards. These include key performance indicators and benchmarking'

BENCHMARKING should be used to work out if your own behaviour compares favourably with that of others: MANAGERS have an innate tendency to concentrate on the benchmark tables, and to forget the primary objective, which is expressed by those 3 sentences describing the principles.

The point of the exercise,' ensuring that services satisfy customer needs', usually sinks without much trace beneath a mountain of detailed 'tick this box, tick that box' instructions !
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DH Agent - as if ! | 27-Sep-2011 2:59 pm
The fundamental problem is that if you need to read a book about this:

This is an excerpt from Clinical Leadership from A to Z by Dickon Weir-Hughes. Available from Amazon.co.uk

then you probaly won't understand what the book is getting at.

There are basically 2 types of readers of guidance: people who are trying to learn things by reading it, and people who read it thinking 'that bit is plainly misleading/wrong'.

And the second lot - the 'that bit is plainly wrong' tend to disagree amongst themselves about what would be correct.

The first lot - the people who need the guidance - often struggle to grasp it, because the writers tend to try and cover everything by laying down sets of rules (which is not how the writers themselves think, because they almost always think in terms of fundamental principles).

A bit of a rant - dsicussing the defects of NHS guidance sets me off !

PS That applies to this type of guidance - much less to some sorts of clincial guidance (such as 'the rules' for working out if someone has measles, which are much more directly-led by actual observations).
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Anonymous | 28-Sep-2011 9:16 am
Our patients regularily report that we do not have enough staff. Our visitors regularily report that we do not have enough staff. The nurses regularily report that we do not have enough staff. Management report that we will not get anymore staff. Quality can only be delivered with sufficient hands on staff. I rest my case.
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DH Agent - as if ! | 28-Sep-2011 11:32 am
Anonymous | 28-Sep-2011 9:16 am

I think everyone understands that. The point is, that politicians hardly ever admit that spending less money will result in a worse service. I have just sent an e-mail to some people I discuss Eolc with, regarding a court ruling due out today, and I ended with this:

'And, there is also this ‘we can refuse to treat you if we cannot justify the resource allocation’ issue, which is something which needs to be more clearly stated for EoLC issues: if I were a clinician, I would not tolerate being blamed by patients for political decisions.'

Accept responsibilty for your own decisions, make it clear that others are responsible for their decisions !
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