Quality improvement

Collaboratively creating an approach to measure improvement culture at a large acute hospital

Continuously improving and changing the way that healthcare is delivered is an important but difficult task. Culture – the values, beliefs and norms of an organisation – can support or hinder people’s ability to make changes and improvements.

Fostering a culture that champions and empowers improvement has been a long-standing goal within the UK’s National Health Service. Across the UK, hospitals strive for a culture where staff feel empowered and able to make improvements as part of their daily work (ie, ‘improvement culture’).

However, there are no ‘gold-standard’ or agreed upon approaches to measuring or assessing cultures that empower improvement. It is essential to have a way of measuring improvement culture, otherwise it is impossible to know whether an organisation has or is fostering such a culture.

Project aims

In this project, KIS improvement science specialists aim to create an evidence-based plan and guidance for how improvement culture could be measured at a large acute London hospital, King’s College Hospital NHS Foundation Trust.

Working closely with the hospital’s quality improvement (QI) team, we hope this will enable the QI team to effectively measure and monitor improvement culture at the hospital.

Key objectives

The following objectives will be addressed in the project:

Identify the core domains and/or characteristics of an improvement culture and whether the data already available to the quality improvement team adequately captures these domains/characteristics
Identify the already available measures for improvement culture and the acceptability, feasibility, validity and/or reliability of these measures

How the project will be conducted

We will work closely with the hospital’s quality improvement team, hospital staff and patient and public contributors to develop the measurement plan and guidance. We will do this iteratively over eight key steps:

Convene a project working group of improvement specialists, hospital staff members and patient and public members
Create a working definition of improvement culture
Gather views of the working group on the general approach for the project
Rapid literature review of measures for improvement culture
Gather views of the working group on potential approaches to measuring improvement culture at the hospital
Map the quality improvement teams existing data to the domains of improvement culture
Test/apply the improvement culture domains to key articles in the field
Create the draft plan for measuring improvement culture at the hospital.

We will use a mainly qualitative approach across the different stages to identify key themes for measuring improvement culture.

Our collaborators at KCH

We will be working closely with Andrea Cortés, Improvement Deputy Director; Agnese Lazzari, Senior Improvement Manager; Rebecca Tulk, Assistant Improvement Manager; and other colleagues at King’s College Hospital.