Improving Quality in Healthcare

Questioning the Work for Effective Change

Inbunden, Engelska, 2024

AvMurray Anderson-Wallace,Nick Downham

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This book is for anyone who is interested in improving quality in healthcare. It will appeal to those who are traditionally responsible for quality matters, as well as practicing clinicians and leaders. Unusually, it will also be as relevant to those who have the keenest interest in the quality of care - interested citizens.

It is a deliberate antidote to the anti-intellectual, QI tool driven, mechanistic approach that still dominates much of healthcare quality improvement work. The authors - both of whom have extensive experience of working in and around quality issues in healthcare at a national, regional and local level - challenge such approaches, which they believe fail to take account of patient and organisational context and invite reductionism, cherry picking, atomisation of complex issues, leading ultimately to simplistic and unsustainable outcomes.

Key features of the book:

· An exploration of some of the often-overlooked and misunderstood core concepts of quality; their history and meaning in a contemporary context.

· A framework to “question the work" using four interconnected conceptual domains as a valuable framework to consider improving quality and reducing failure demand.

· Critical re-examination of the dominant approaches to change that are frequently adopted in “quality” work, many of which have been rooted in scientific management that have failed to live up to their promise – particularly transformational.

· Exploring how an inter-disciplinary perspective can reframe aspects of quality thinking.

Produktinformation

Utgivningsdatum2024-01-01
Mått170 x 242 x 17 mm
Vikt550 g
FormatInbunden
SpråkEngelska
Antal sidor224
Upplaga1
FörlagSAGE Publications
ISBN9781529733068

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Murray has a clinical background in mental health services and psychological therapy and is trained in systemic approaches to counselling, consultation and supervision. He is a qualified groupwork practitioner, registered with the Institute of Group Analysis. Murray has an enduring interest in the social dynamics of organising and has spent much of his career tackling complex socio-cultural and ethical issues, including leading several large-scale independent reviews of care. Murray has provided strategic support to a wide range of national quality programmes and networks in the UK and abroad. He has taught at postgraduate level internationally and is a visiting professor at the Health Systems Innovation Lab at London South Bank University. Murray’s practice also includes work as an independent editor, writer and broadcaster, producing media to stimulate debate about complex professional and ethical issues in healthcare. He is co-author of Networks in Healthcare: Managing Complex Relationships (Emerald) with Professor Becky Malby.Nick is a healthcare quality, systems thinking and organisational development specialist. He is committed to helping clinicians, other professionals and communities be their most impactful in helping people live good lives. He has a quality and industrial engineering background and has spent most of his career working in health and social care. Nick has shaped, and continues to shape, some of the largest and most enduring quality improvement programs in the NHS. He is visiting teaching faculty at the Health Systems Innovation Lab at London South Bank University and works with front line teams, and their leaders at all levels, in healthcare services across primary and secondary care domestically and internationally.

Chapter 1: ContextChapter 2: The History of Quality in HealthcareChapter 3: Cultures of QualityChapter 4: Understanding Variation – Tensions and DilemmasChapter 5: Demand, Capacity and UtilisationChapter 6: Understanding Failure DemandChapter 7: Principles to Avoid Failure DemandChapter 8: Defragmenting to IntegrateChapter 9: Understanding the Specialist, Generalist and Citizen MuddleChapter 10: Supporting the Human System of WorkChapter 11: Understanding NeedChapter 12: Conclusion

True to form Murray & Nick invite a critical re-examination of the dominant approaches used in a great deal of improvement work in healthcare. Based on their extensive experience of working in the field over the last 25 years, they argue that many of the current approaches fail to take proper account of organisational and patient context; invite reductionism and the atomisation of complex issues, and ultimately create only an illusion of progress. They promote the use of a framework to "questioning the work", and discuss four interconnected domains to help guide inquiry.I was particularly drawn towards the chapters on "Cultures of Quality" and "Supporting the Human System at Work" in which they discuss a wide range of issues that impact on safety. They cite a lot of the great work done by Prof Mary Dixon-Woods (often referred to in this newsletter) and the Harmed Patient Alliance work on "compounded harm". Although the book is unashamedly an academic text, it’s also pretty accessible, and offers a thoughtful analysis of how to understand some complex issues with case study examples to illustrate their points.