Culture Of Quality Improvement Research Articles

What's the CATCH? A Participatory Learning Model for Case Review Rounds to Support a Culture of Safety and Quality Improvement in Pediatric Hospital Medicine

To evaluate the effectiveness of a new model, Case Analysis and Translation to Care in Hospital (CATCH), for the review of pediatric inpatient cases when an adverse event or "close call" had occurred. The curricular intervention consisted of an introductory podcast/workshop, mentorship of presenters, and monthly CATCH rounds over sixteen months. The study was conducted with 22 pediatricians at a single tertiary care center. Intervention assessment occurred using participant surveys at multiple intervals: pre/post the intervention, presenter experience (post), physicians-involved and mentors experience (post), and after each CATCH session. Paired t-tests and thematic analysis were used to analyze data. Time required to support the CATCH process was used to assess feasibility. Our overall experience and data revealed a strong preference for the CATCH model, high levels of engagement and satisfaction with CATCH sessions, and positive presenter as well as physicians-involved and mentor experiences. Participants reported that the CATCH model is feasible, engages physicians, promotes a safe learning environment, facilitates awareness of tools for case analysis, and provides opportunities to create "CATCH of the Day" recommendations to support translation of learning to clinical practice. The CATCH model has significant potential to strengthen clinical case rounds in pediatric hospital medicine. Future research is needed to assess the effectiveness of the model at additional sites and across medical specialities.

The utility of performance review systems: A total quality management perspective

AbstractScholars and practitioners alike have argued that performance review is prone to destructive effects and negative outcomes in progressive work organizations with a total quality management (TQM) orientation. Despite its pervasive use and significant consequences at individual, team, and organizational levels across contemporary workplaces, it has remained inadequately explored for its current operational systems and their role in helping employees achieve job mastery and enabling organizations to attain desired quality outcomes. To address this lacuna, this study aims to explore how performance review systems can align with continuous quality improvement in contemporary workplaces that espouse a culture of continuous learning and quality improvement. Given the exploratory and broad scope of the research, it adopts a multiple case study design which offers benefits both in terms of process and outcomes. The findings are indicative of two different performance review systems with very different implications for managing employees and achieving quality outcomes in line with TQM: tactical system with a focus on employee obedience to rigid top‐down control system for achieving conformance quality measures, and a dynamic system with a focus on employee ownership of the quality process for achieving desired quality.

What can nurses learn from patient's needs and wishes when developing an evidence-based quality improvement learning culture? A qualitative study.

Patient participation is fundamental in nursing care and has yielded benefits for patient outcomes. However, despite their compassionate care approach, nurses do not always incorporate patients' needs and wish into evidence-based practice, quality improvement or learning activities. Therefore, a shift to continuous quality improvement based on evidence-based practice is necessary to enhance the quality of care. The patient's opinion is an essential part of this process. To establish a more sustainable learning culture for evidence-based quality improvement, it is crucial that nurses learn alongside their patients. However, to promote this, nurses require a deeper understanding of patients' care preferences. To explore patients' needs and wishes towards being involved in care processes that nurses can use in developing an evidence-based quality improvement learning culture. A qualitative study was conducted in two hospital departments and one community care team. In total, 18 patients were purposefully selected for individual semi-structured interviews with an average of 15 min. A framework analysis based on the fundamental of care framework was utilised to analyse the data deductively. In addition, inductive codes were added to patients' experiences beyond the framework. For reporting this study, the SRQR guideline was used. Participants needed a compassionate nurse who established and sustained a trusting relationship. They wanted nurses to be present and actively involved during the care delivery. Shared decision-making improved when nurses offered fair, clear and tailored information. Mistrust or a disrupted nurse-patient relationship was found to be time-consuming and challenging to restore. Results confirmed the importance of a durable nurse-patient relationship and showed the consequences of nurses' communication on shared decision-making. Insights into patients' care preferences are essential to stimulate the development of an evidence-based quality improvement learning culture within nursing teams and for successful implementation processes.

Learning from the End of the Public-Private Partnership for Lesotho's National Referral Hospital Network.

Public-private partnerships (PPP) are one strategy to finance and deliver healthcare in lower-resourced settings. Lesotho's Queen 'Mamohato Memorial Hospital Integrated Network (QMMH-IN) was sub-Saharan Africa's first and largest integrated healthcare PPP. We assessed successes and challenges to performance of the QMMH-IN PPP. We conducted 26 semi-structured interviews among QMMH-IN executive leadership and staff in early 2020. Questions were guided by the WHO Health System Building Blocks Framework. We conducted a thematic analysis. Facilitators of performance included: 1) PPP leadership commitment to quality improvement supported by protocols, monitoring, and actions; 2) high levels of accountability and discipline; and 3) well-functioning infrastructure, core systems, workflows, and internal referral network. Barriers to performance included: 1) human resource management challenges and 2) broader health system and referral network limitations. Respondents anticipated the collapse of the PPP and suggested better investing in training incoming managerial staff, improving staffing, and expanding QMMH-IN's role as a training facility. The PPP contract was terminated approximately five years before its anticipated end date; in mid-2021 the government of Lesotho assumed management of QMMH-IN. Going forward, the Lesotho government and others making strategic planning decisions should consider fostering a culture of quality improvement and accountability; ensuring sustained investments in human resource management; and allocating resources in a way that recognizes the interdependency of healthcare facilities and overall system strengthening. Contracts for integrated healthcare PPPs should be flexible to respond to changing external conditions and include provisions to invest in people as substantively as infrastructure, equipment, and core systems over the full length of the PPP. Healthcare PPPs, especially in lower-resource settings, should be developed with a strong understanding of their role in the broader health system and be implemented in conjunction with efforts to ensure and sustain adequate capacity and resources throughout the health system.

From database to practice: the MBSAQIP in the surgical literature

BackgroundThe Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) has been a game changer for metabolic and bariatric (MBS) surgeons, with continuous improvements in safety and outcomes throughout the years of its usage. It allows in-depth evaluations of MBS procedures, presenting practitioners and researchers with unparalleled opportunities for quality assessment, research and clinical advancement. ObjectivesTo offer an updated overview of MBSAQIP-related publications. SettingUnited States. MethodsPubMed was queried using keywords “MBSAQIP” and “Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program.” Letters to editors, duplicates, commentaries, and retracted articles were excluded. Studies that mentioned MBSAQIP but did not use the data within were also excluded. ResultsA total of 400 search items were returned as of August 2023. After exclusions, 289 studies were reviewed. Articles were published in a total of 28 unique journals, the majority of which were featured in Surgery for Obesity and Related Diseases (SOARD), with 114 articles (39.4%). Sixty-one articles were focused on creating predictive models or risk calculators, 58 on investigating the safety of procedures, and 52 on exploring complications. Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) were the 2 most commonly discussed procedures, at 80.3% and 80% respectively. Forty-three studies included patients who underwent robotic-assisted MBS. ConclusionsThe MBSAQIP is a valuable resource that has generated a wealth of studies in the literature. It has allowed for intense analysis of clinical issues and fostered a culture of safety and quality improvement. Participating surgeons must pledge commitment to extended follow-up periods to maximize its effectiveness.

Using Patient Navigation to Reduce Time to Diagnosis of Breast Cancer in Uganda

PurposeThe Ugandan Ministry of Health adopted BI-RADS as standard of care in 2016. The authors performed a medical audit of breast ultrasound practices at four tertiary-level hospitals to assess interpretive performance. The authors also determined the effect of a low-cost navigation program linking breast imaging and pathology on the percentage of patients completing diagnostic care. MethodsThe authors retrieved 966 consecutive diagnostic breast ultrasound reports, with complete data, for studies performed on women aged >18 years presenting with symptoms of breast cancer between 2018 and 2020 from participating hospitals. Ultrasound results were linked to tumor registries and patient follow-up. A medical audit was performed according to the ACR’s BI-RADS Atlas, fifth edition, and results were compared with those of a prior audit performed in 2013. At Mulago Hospital, an intervention was piloted on the basis of patient navigation, cost sharing, and same-day imaging, tissue sampling, and pathology. ResultsIn total, 888 breast ultrasound examinations (91.9%) were eligible for inclusion. Compared with 2013, the postintervention cancer detection rate increased from 38 to 148.7 cancers per 1,000 examinations, positive predictive value 2 from 29.6% to 48.9%, and positive predictive value 3 from 62.7% to 79.9%. Specificity decreased from 90.5% to 87.7% and sensitivity from 92.3% to 81.1%. The mean time from tissue sampling to receipt of a diagnosis decreased from 60 to 7 days. The intervention increased the percentage of patients completing diagnostic care from 0% to 100%. ConclusionsEfforts to establish a culture of continuous quality improvement in breast ultrasound require robust data collection that links imaging results to pathology and patient follow-up. Interpretive performance met BI-RADS benchmarks for palpable masses, except sensitivity. This resource-appropriate strategy linking imaging, tissue sampling, and pathology interpretation decreased time to diagnosis and rates of loss to follow-up and improved the precision of the audit.

Review of AI Maturity Models in Automotive SME Manufacturing

This study reviews studies on Artificial Intelligence (AI) maturity models (MM) in automotive manufacturing. To stay competitive, SMEs in the automotive industry need to embrace digitalization. SMEs employ a large segment of the USA's workforce. The benefits of operational efficiency, quality improvement, cost reduction, and innovative culture have made SMEs more aggressive about digitalization. Digitalizing operations with Artificial Intelligence are on the rise. In this paper, AI applications in SMEs are examined through the lens of an AI maturity model.

The Role of the Elements of Total Quality Management in Improving Banking Services) Applied Study at Khaleeji Commercial Bank)

The research aims to demonstrate the importance of adopting the philosophy of total quality management in improving banking services and identifying the dimensions of total quality management in banking institutions. As for its importance, it is manifested through the knowledge, understanding and application of total quality management by providing the requirements for the application of this philosophy in banking institutions according to recent developments in information technology in order to be able to improve their performance. The analytical study approach was adopted in the research and the use of the questionnaire tool in the study curriculum was adopted to analyze the opinions of the research sample that were applied in al Khaleeji Commercial Bank regarding the elements of total quality management available in the organization in question. Through the use of some statistical methods in the analysis, which are the extraction of frequencies, arithmetic mean and standard deviation normative as well as materiality. The research hypotheses were tested by using the correlation coefficient and simple regression model. The most important conclusions that the research reached is the importance of applying total quality in any organization because it can achieve an increase in competitive capabilities and support for a culture of quality and continuous improvement. To take advantage of the opportunities available to the organization through the application of scientific methods and tools that contribute to identifying problems and finding appropriate treatments for them. As well as the existence of a moral, linear relationship between the elements of total quality management and the improvement of banking services. The research came out with recommendations, including that organizations should work to promote and disseminate the culture and concepts of quality in all aspects of their work and to enhance and develop the capabilities of individuals working in this regard. The research came out with recommendations, including that organizations should work to promote and disseminate the culture and concepts of quality in all aspects of their work. Enhancing and developing the capabilities of individuals working on this can help for the continuous development and improvement of banking services provided to customers.

Implementation of the Acute Care for Elders Strategy to Improve the Quality of Care Transitions in Quebec and Ontario: a Retrospective Multiple Case Study.

In 2016, two Canadian hospitals participated in a quality improvement (QI) program, the International Acute Care for Elders (ACE) Collaborative, and sought to adapt and implement a transition coach intervention (TCI). Both hospitals were challenged to provide optimal continuity of care for an increasing number of older adults. The two hospitals received initial funding, coaching, educational materials, and tools to adapt the TCI to their local contexts, but the QI project teams achieved different results. We aimed to compare the implementation of the ACE TCI in these two Canadian hospitals to identify the factors influencing the adaptation of the intervention to the local contexts and to understand their different results. We conducted a retrospective multiple case study, including documentary analysis, 21 semi-structured individual interviews, and two focus groups. We performed thematic analysis using a hybrid inductive-deductive approach. Both hospitals met initial organizational goals to varying degrees. Our qualitative analysis highlighted certain factors that were critical to the effective implementation and achievement of the QI project goals: the magnitude of changes and adaptations to the initial intervention; the organizational approaches to the QI project implementation, management, and monitoring; the organizational context; the change management strategies; the ongoing health system reform and organizational restructuring. Our study also identified other key factors for successful care transition QI projects: minimal adaptation to the original evidence-based intervention; use of a collaborative, bottom-up approach; use of a theoretical model to support sustainability; support from clinical and organizational leadership; a strong organizational culture for QI; access to timely quality measures; financial support; use of a knowledge management platform; and involvement of an integrated research team and expert guidance. Many of the lessons learned and strategies identified from our analysis will help clinicians, managers, and policymakers better address the issues and challenges of adapting evidence-based innovations in care transitions for older adults to local contexts.

A cross-stakeholder approach to improving out-of-hospital cardiac arrest survival

Out-of-hospital cardiac arrest (OHCA) affects over 300,000 individuals per year in the United States with poor survival rates overall. A remarkable 5-fold difference in survival-to-hospital discharge rates exist across United States communities. We conducted a study using qualitative research methods comparing the system of care across sites in Michigan communities with varying OHCA survival outcomes, as measured by return to spontaneous circulation with pulse upon emergency department arrival. Major themes distinguishing higher performing sites were (1) working as a team, (2) devoting resources to coordination across agencies, and (3) developing a continuous quality improvement culture. These themes spanned the chain of survival framework for OHCA. By examining the unique processes, procedures, and characteristics of higher- relative to lower-performing sites, we gleaned lessons learned that appear to distinguish higher performers. The higher performing sites reported being the most collaborative, due in part to facilitation of system integration by progressive leadership that is willing to build bridges among stakeholders. Based on the distinguishing features of higher performing sites, we provide recommendations for toolkit development to improve survival in prehospital systems of care for OHCA.

Lessons learned from the EACTS-MSTCVS quality fellowship: a call to action for continuous improvement of cardiothoracic surgery outcomes in Europe.

The Michigan Society of Thoracic and Cardiovascular Surgeons (MSTCVS), a pioneer in initiating and nurturing quality improvement strategies in statewide cardiothoracic surgery, has been running the Quality Collaborative (MSTCVS-QC) program since 2001. This initiative has significantly grown over the years, facilitating at least 4 in-person meetings annually. It actively engages cardiac and general thoracic surgeons, data managers and researchers from all 32 non-federally funded cardiothoracic surgery sites across Michigan. Broadening its influence on joint learning and clinical outcomes, the MSTCVS-QC formed a strategic partnership with Blue Cross Blue Shield of Michigan, the state's largest private insurer, to further promote its initiatives. The MSTCVS-QC, operating from a dedicated QC centre employs an STS-associated database with additional aspects for data collection and analysis. The QC centre also organizes audits, facilitates collaborative meetings, disseminates surgical outcomes and champions the development and implementation of quality improvement initiatives related to cardiothoracic surgery in Michigan. Recognizing the MSTCVS-QC's successful efforts in advancing quality improvement, the European Association for Cardiothoracic Surgery (EACTS) introduced a fellowship program in 2018, facilitated through the EACTS Francis Fontan Fund (FFF). This program allows early-career academic physicians to spend 4-6 months with the MSTCVS-QC team in Ann Arbor. This article chronicles the evolution and functionality of the MSTCVS-QC, enriched by the experiences of the inaugural 4 EACTS/FFF fellows. Our objective is to emphasize the critical importance of fostering a culture of quality improvement and patient safety in the field of cardiothoracic surgery with open discussion of audited, high-quality data points. This principle, while implemented locally, has implications and value extending far beyond Europe, resonating globally.

1044-P: Advancing Quality Improvement Culture among 27 Pediatric and Adult Diabetes Centers

Background: The T1D Exchange Quality Improvement Collaborative (T1DX-QI) is a learning health system of over fifty endocrinology centers working to improve diabetes outcomes through Quality Improvement (QI). Centers join T1DX-QI with varying levels of QI culture and are assigned a QI Coach to support practice transformation. This study summarizes the results of 27 endocrinology centers involved in the T1DX-QI for over 12 months. Method: Centers completed a 20-question self-assessment survey to measure QI culture over time in four evidence-based areas: QI Team Structure (team roles); QI Foundation (data collection and training); QI Capacity (use of QI tools); and QI Success (scaling up small tests). Data was collected in 2021 and 2022 for the same centers. The overall difference in QI Capacity was calculated using a Chi-Square test. Results: Overall, QI Culture increased from 67% to 75% from 2021 to 2022 (p-value = 0.005). Figure 1 demonstrates that improvements were seen in three of the four evidence-based areas for both pediatric and adult centers in this time. Conclusion: Even with as little as one year of involvement with the T1DX-QI, centers experience an improvement in their QI Capacity. Disclosure A.Mungmode: None. L.Chao: None. J.Ilkowitz: None. O.Ebekozien: Advisory Panel; Medtronic, Research Support; Eli Lilly and Company, Dexcom, Inc. T1dx-qi collaborative: n/a. O.Odugbesan: None. V.Elisha: None. D.W.Steenkamp: Research Support; Abbott Diabetes, Novo Nordisk. M.K.Kamboj: None. D.Desalvo: Consultant; Dexcom, Inc., Research Support; Insulet Corporation. R.Y.Sonabend: None. A.Neyman: None. P.M.Mathias: None. Funding The Leona M. and Harry B. Helmsley Charitable Trust

Qualitative study of international key informants’ perspectives on the current and future state of healthcare quality measurement and feedback

ObjectivesThe aim of this study is to explore the current and future state of quality measurement and feedback and identify factors influencing measurement feedback systems, including the barriers and enablers...

Collaborating to DrEaM bigger and better: the challenges in using digital data to drive quality improvement in clinical practice

Background: Supporting patients to Drink, Eat and Mobilise (DrEaMing) within 24 h of major surgery is associated with reduced length of hospital stay and late complications.1 This quality metric was assigned a financial incentive in the 2022 NHS England CQUIN scheme with a compliance target of 60–70% for specific surgical patient cohorts. Beyond the CQUIN, we wanted to deliver DrEaMing to all surgical patients and embed a culture change by reinvigorating core concepts of enhanced recovery pathways. Optimal use of our electronic healthcare record, EPIC, was key to our strategy, aiming to provide surgical teams with sustainable real-time data to drive quality improvement (QI) through electronic extraction of CQUIN metrics. Methods: CQUIN specialty data were extracted from EPIC quarterly. Anaesthetic registrars worked as DrEaMing champions alongside clinical nurse specialists (CNS) to facilitate collaborative working within the perioperative team. Key stakeholders were educated on how to record DrEaMing instructions and provision allowing electronic audit of CQUIN compliance with accurate time stamps. A total of 26 ward staff involved in DrEaMing provision on postoperative surgical wards were surveyed on barriers to DrEaMing. Results: EPIC data from 2022–23 showed varying CQUIN compliance rates across surgical specialties. Gynae-oncology documentation of postoperative DrEaMing instructions increased from 0% in April to 100% by January, however, postoperative DrEaMing provision plateaued around 60–70%. Overall CQUIN attainment across the year was <50%. Colorectal CQUIN compliance was limited by poor documentation of postoperative eating instructions and subsequent poor ward eating provision (Fig. 6), reflecting the heterogenous nature of colorectal procedures undertaken and varied recovery approach by teams. Surveys of ward staff across women’s health and colorectal surgery revealed burden of documentation, lack of access to means to document and unclear surgical postoperative instructions were important barriers to ward documentation of DrEaMing provision. Conclusion: DrEaMing compliance using EPIC data extraction at UCLH remains poor, despite motivated staff and a culture of QI, but was significantly higher with manual review of the notes trawl highlighting disparity between clinical practice and use of new EPIC builds. Our aim to make DrEaMing data easily accessible for QI requires further buy-in from surgical teams and engagement with ward staff. Permanent CNS act as pivotal change champions, through education and raising awareness. 1.Oliver CM, Warnakulasuriya S, McGuckin D, et al. Br J Anaesth 2022; 129: 114–26

Culture of Safety Quality Improvement Project: Longitudinal AHRQ Survey Results From a Family Medicine Residency Program.

This project analyzed the culture of safety quality improvement at the Family Medicine Center (FMC). The Agency for Healthcare Research and Quality (AHRQ) Culture of Safety Survey was used as a benchmark for internal and external comparison. The AHRQ Culture of Safety Survey was administered to health care staff in 2015, 2017, and 2019, respectively, at the Family Medicine Center. Baseline perceptions of safety and quality were established using the data from the AHRQ Culture of Safety Survey in 2015. We performed multiple large-scope quality improvement projects that focused on identified deficiencies. The changes in perception were monitored over time every 2 years. We analyzed the results using the Kruskal-Wallace test (P=.05). The AHRQ Culture of Safety Survey showed statistically significant improvement in patient centeredness, effectiveness, timeliness, efficiency, equitableness, and overall patient safety from 2015 to 2019. Some inconsistencies were seen between different sections of responses, likely due to wording interpretations by the participants. Overall, the AHRQ Culture of Safety Survey is an effective way to help monitor employee perception of multiple domains that lead to a safe and effective clinical environment as compared to other practices across the country. Clinic-wide implementation of quality and patient care strategies resulted in significant improvements in nearly every category of the survey.

Factors influencing family physician engagement in practice-based quality improvement: Qualitative study.

To explore the experiences of family physicians leading quality improvement (QI) efforts and to better understand facilitators and barriers related to advancing QI in family practice. Qualitative descriptive study. The Department of Family and Community Medicine at the University of Toronto in Ontario. The department launched a quality and innovation program in 2011 with the dual goals of teaching QI skills to learners and supporting faculty in leading QI efforts in practice. Family physician faculty who held QI leadership roles at any of the department's 14 teaching units between 2011 and 2018. Fifteen semistructured telephone interviews were conducted over 3 months in 2018. Analysis was informed by a qualitative descriptive approach. Consistency of responses across the interviews was suggestive of thematic saturation. Substantial variation was found in the level of engagement with QI in practice settings despite the common training, forms of support, and curriculum the department provided. Four factors influenced the uptake of QI. First, committed leadership across the organization was fundamental to developing an effective QI culture. Second, external drivers such as mandatory QI plans sometimes motivated engagement in QI but sometimes were barriers, particularly when internal priorities conflicted with external demands. Third, at many practices, QI was widely perceived as extra work rather than as a way to enable better patient care. Finally, physicians described lack of time and resources as a challenge, particularly in community practices, and advocated for practice facilitation as a mechanism to support QI efforts. Advancing QI in primary care practice will require committed leaders, a clear understanding among physicians of the potential benefits of QI, alignment of external demands with internal drivers for improvement, and dedicated time for QI work along with support such as practice facilitation.

Quality and safety in residential aged care: an evaluation of a national quality indicator programme.

In Australia, 243 000 individuals live in approximately 2700 residential aged care facilities yearly. In 2019, a National Aged Care Mandatory Quality Indicator programme (QI programme) was implemented to monitor the quality and safety of care in facilities. To examine the validity of the QI programme indicators using explicit measure review criteria. The QI programme manual and reports were reviewed. A modified American College of Physicians Measure Review Criteria was employed to examine the QI programme's eight indicators. Five authors rated each indicator on importance, appropriateness, clinical evidence, specifications and feasibility using a nine-point scale. A median score of 1-3 was considered to not meet criteria, 4-6 to meet some criteria and 7-9 to meet criteria. All indicators, except polypharmacy, met criteria (median scores=7-9) for importance, appropriateness and clinical evidence. Polypharmacy met some criteria for importance (median=6, range 2-8), appropriateness (median=5, range 2-8) and clinical evidence (median=6, range 3-8). Pressure injury, physical restraints, significant unplanned weight loss, consecutive unplanned weight loss, falls and polypharmacy indicators met some criteria for specifications validity (all median scores=5) and feasibility and applicability (median scores=4 to 6). Antipsychotic use and falls resulting in major injury met some criteria for specifications (median=6-7, range 4-8) and met criteria for feasibility and applicability (median=7, range 4-8). Australia's National QI programme is a major stride towards a culture of quality promotion, improvement and transparency. Measures' specifications, feasibility and applicability could be improved to ensure the programme delivers on its intended purposes.

New approach to undergraduate quality improvement.

While quality improvement (QI) is an essential component to modern day clinical practice, some foundation doctors fail to engage. This is compounded by a lack of formalised undergraduate QI teaching. We trial an undergraduate active learning workshop and evaluate it using a concurrent triangulation mixed methods design. We constructed a 2-hour interactive QI workshop utilising near-peer educators for third year undergraduate medical students. Our workshop demonstrated an exemplary project and a template featuring evidenced-based QI tools to grasp key concepts. Informal support was provided for student QI projects, undertaken in small peer groups. Utility was assessed using linked pre-and-post event questionnaires with Likert scales, free text thematic analysis and project completion rates. We recruited 74 students to attend our workshops delivered over 3 months. We achieved high event satisfaction and significant improvements on baseline confidence. Free text comments suggested students perceive QI as an important part of the undergraduate curriculum, described barriers to engagement and the value they place on project autonomy. The workshop eased student feelings of anxiety and intimidation regarding change ideas. Nine projects were completed with one winning a poster prize at a regional conference. We demonstrate a popular resource light model that can be scaled up to a variety of centres. Targeting QI teaching at the undergraduate level may be instrumental in developing QI culture in health care systems and address barriers to postgraduate involvement. Our study furthers the understanding of undergraduate students' perspectives of QI and demand for further sessions.

Literature review: Improvement patient safety during the pandemic covid-19

Patient safety has been a major challenge for patient safety and healthcare systems over the past 20 years. In 1999 To Err Is Human by the Institute of Medicines raised public awareness about patient safety and described the potential for significant harm to patients. Evidence shows that despite concerted efforts to make health care safer unintentional harm by health care providers that seriously harms patients is still common. A 2016 study estimated that 140.400 deaths were caused by medical error in the United States making medical error the third leading cause of death in the United States and further emphasizing the need for improved patient safety. Healthcare systems around the world continue to take a treatable toll on patients. It is a preventable complication of care that accounts for 3.6% of acute hospital deaths in England. There are financial implications of poor care and negative outcomes. For example the UK Health Foundation says: Careful care is expensive. Unstable production systems; And costs can be reduced by providing reliable care. This review examines the goals of health reform and national efforts to create a culture of quality improvement and patient safety principles. And show how these principles can be applied to patient care and health care practice.

Identifying and prioritising the key components of a Quality Improvement Network for allied health professionals and psychological therapists: a group concept mapping project

IntroductionDespite growing enthusiasm for quality improvement (QI), the complexities of modern healthcare continue to create gaps in our ability to consistently deliver the most effective and efficient care for patients,...