NHS Modernisation Agency's way to improve health care
http://www.100md.com
《英国医生杂志》
EDITOR—As leaders in the NHS Modernisation Agency, we were delighted to see the paper by Young et al summarising three key approaches to improving manufacturing systems.1 Improvement programmes in the agency have been adapting these approaches successfully to NHS healthcare systems for several years.2
We now refer to this body of knowledge as "clinical systems improvement." At its heart is the graphical presentation of data and their analysis using statistical process control. Key measures are monitored to see whether changes to the system have made a notable impact and determine whether improvement has occurred before the change is rolled out. Data are presented in a format that is easily understood and statistically valid, which appeals particularly to doctors.
We have had success in applying these methods to improve emergency flows,3 and reducing journey times in cancer care. Now we are learning to apply these methods across entire organisations. For example, in Nottingham City Trust elective admission rates have increased by 8% and cancelled admissions for surgery have been cut in half by improving the emergency pathway and reducing medical outliers.
The improvement partnership for hospitals is accumulating knowledge and experience from Modernisation Agency programmes (www.modern.nhs/iph).4 We offer an ambitious learning programme to NHS trusts, support senior managers, and clinicians in reforming their local healthcare delivery systems.
Publication of our methods and results in journals such as the BMJ will help to spread awareness, encourage clinicians to be more involved in improving their own services, and stimulate fruitful discussion. Our vision is that staff in all healthcare organisations will have the capacity continuously to improve their own services on the basis of the priorities of their patients and that together we will improve the quality of healthcare in the NHS.
Hugh Rogers, medical director, Improvement Partnership for Hospitals
hugh.rogers@npat.nhs.uk, NHS Modernisation Agency, London WC1V 7PW
Kate Silvester, associate director, innovation and knowledge group
NHS Modernisation Agency, London WC1V 7PW
Jill Copeland, programme director, Improvement Partnership for Hospitals
NHS Modernisation Agency, London WC1V 7PW
Competing interests: None declared.
References
Young T, Brailsford S, Connell C, Davies R, Harper P, Klein J. Using industrial processes to improve patient healthcare. BMJ 2004;328: 162-4. (17 January.)
Silvester K. Chaos the enemy of quality. Clinician in Management 1997;6: 9-13.
Walley P. Designing the accident and emergency system: lessons from manufacturing. Emergency Medical Journal 2003:20; 126-30
White C. Improvement initiative rolled out for acute trusts in England. BMJ 2003:327; 768.
We now refer to this body of knowledge as "clinical systems improvement." At its heart is the graphical presentation of data and their analysis using statistical process control. Key measures are monitored to see whether changes to the system have made a notable impact and determine whether improvement has occurred before the change is rolled out. Data are presented in a format that is easily understood and statistically valid, which appeals particularly to doctors.
We have had success in applying these methods to improve emergency flows,3 and reducing journey times in cancer care. Now we are learning to apply these methods across entire organisations. For example, in Nottingham City Trust elective admission rates have increased by 8% and cancelled admissions for surgery have been cut in half by improving the emergency pathway and reducing medical outliers.
The improvement partnership for hospitals is accumulating knowledge and experience from Modernisation Agency programmes (www.modern.nhs/iph).4 We offer an ambitious learning programme to NHS trusts, support senior managers, and clinicians in reforming their local healthcare delivery systems.
Publication of our methods and results in journals such as the BMJ will help to spread awareness, encourage clinicians to be more involved in improving their own services, and stimulate fruitful discussion. Our vision is that staff in all healthcare organisations will have the capacity continuously to improve their own services on the basis of the priorities of their patients and that together we will improve the quality of healthcare in the NHS.
Hugh Rogers, medical director, Improvement Partnership for Hospitals
hugh.rogers@npat.nhs.uk, NHS Modernisation Agency, London WC1V 7PW
Kate Silvester, associate director, innovation and knowledge group
NHS Modernisation Agency, London WC1V 7PW
Jill Copeland, programme director, Improvement Partnership for Hospitals
NHS Modernisation Agency, London WC1V 7PW
Competing interests: None declared.
References
Young T, Brailsford S, Connell C, Davies R, Harper P, Klein J. Using industrial processes to improve patient healthcare. BMJ 2004;328: 162-4. (17 January.)
Silvester K. Chaos the enemy of quality. Clinician in Management 1997;6: 9-13.
Walley P. Designing the accident and emergency system: lessons from manufacturing. Emergency Medical Journal 2003:20; 126-30
White C. Improvement initiative rolled out for acute trusts in England. BMJ 2003:327; 768.