In my job as clinical editor I see the latest trends in quality improvement as hospitals quickly implement the latest policy or idea but I often wonder what happens in the long term when the initial fuss has died down? How often do we see a five or ten year follow-up of a nursing innovation?
Take for example productive ward. Last year the NHS Institute which spearheaded the productive ward initiative closed and many nurses wondered what would happen to the valuable knowledge, experience and support they offered. A few weeks ago I can across an interesting paper which identified an apparent declining interest in the initiative in the UK with fewer evaluations being published.
Does this mean that productive ward has hit the buffers or are trusts continuing to implement the philosophy that underpins this patient-focused innovation but are not publishing the outcomes? I wonder if I walked on a ward today and asked about productive ward would health care professionals describe it as something they did a few years ago when they tidied the cupboards? Would they be able to tell me how it is has continued to develop over time? Or would I just get blank looks?
“The problem is we never really find out what works or why it works”
The same question could be asked about intentional rounding. This initiative was given official backing a few years ago from the prime minister and considerable effort went into its implementation but did it make a difference? Is it still happening?
Considerable investment of time and emotion go into making ideas a reality in busy nursing teams. I am not surprise when nurses become cynical about change when no sooner have they implemented one new idea when policy makers move onto the next thing.
The problem is we never really find out what works or why it works.
What nurses want is change that is going to help them improve care and give them stability. Perhaps it is time to take stock of all the recent quality improvement initiatives in the UK and invest in looking at the long term outcomes because without this information we will continue to go round in circles. If you have been around the health service as long as I have you will know what I mean.