Resources

Sustaining and scaling system improvement is an ongoing challenge in the complexity of human services. Efforts to address common care problems are constantly reinvented, as lessons learned in one organisation are not routinely transferred to others. This article describes an approach to long term spread and scale from the beginning of small-scale improvement. 

In this episode of ‘Listen to THIS’,  podcast from the THIS Institute at Cambridge University, the hosts discuss learning from failure as essential for improvement,  to better understand what doesn’t work and why. 

Unleashing the Potential of our Health Workforce, led by Professor Mark Cormack, looked at the available evidence about health professionals’ ability to deliver on their full scope of practice in primary care. The review identified opportunities to remove the barriers stopping health professionals from working to their full scope of practice. It also drew on examples of multi-disciplinary teams where members are working to their full scope of practice to deliver best-practice primary care. Here, Mark presented some barriers and opportunities for health professionals to work at their full scope of practice.

Building a clinical governance framework is challenging, especially for health services that are used or provided across more than one state or territory. This webinar discussed some key components for building a practical clinical governance framework to enhance uptake amongst users of the system. 

In 2024, Kelly decided she wanted to dive deeper into quality improvement so she could help her clients make a real difference in care quality. What she learned there completely changed how she thinks and works with organisations to improve care. We can’t all attend Oxford, but we can benefit from Kelly’s new knowledge and how she’s applied it, particularly from this one lightbulb moment.

Spreading, scaling up, and sustaining improvements in human services is a complex challenge that many countries, including the UK, USA, and Australia, have been tackling. Despite significant efforts, the sustainability of scaling up local improvements remains low. One reason for this is the traditional, linear approach to spreading improvements, which often overlooks the complexity and evolving nature of healthcare systems.

The Institute for Healthcare Improvement (IHI) has introduced the concept of Quality Improvement (QI) ‘dosing’, where different staff roles receive tailored levels of improvement science (SOI) training based on their responsibilities. 

Implementation is often a weak link in improvement efforts to meet targets. Yet the success and sustainability of change depends on it. The Implementation Playbook is a quick reference guide developed by the World Health Organization (WHO) to facilitate effective health-related implementation efforts.

Trying to improve care in human services can be overwhelming. We start out with great aspirations to fix a care quality issue. But as we get closer to the problem it appears to loom ever larger, and we wonder what we’ve got ourselves into. Most care quality issues are entrenched and multifaceted and can’t be solved by a single solution or big-bang change. Often our initial enthusiasm wanes and we default to revising the procedure and running training because everything else seems too hard. Essentially, we’ve wasted time and effort on maintaining the problem, rather than finding the solution.

Engagement surveys show a never-before-seen level of fatigue and burn-out. The last results of the National Health Service (NHS) national staff survey showed 46.8% of staff have felt unwell as a result of work-related stress in the previous 12 months. Attrition and turnover are at near all-time highs.