Why is a QI culture important?
Why is a QI culture important?
Core to quality is the development of a quality culture, or a mindset which should permeate the pharmacy. You must learn to nurture and develop the right enabling patterns of behaviour to develop a quality culture. This is often overlooked; many organisations spend a lot of time on the application of methods and tools, but not on the culture in which these tools are implemented.
Executing a series of quality improvement initiatives does not build an effective culture of continuous improvement. It’s a good place to start, but more needs to be done to drive excellence over the longer term and embed continuous improvement within your practice.
Some of the common challenges include:
- Implementing quality initiatives, but not monitoring the improvements effectively
- Employees are trained, but are not empowered to apply their expertise
- Quality improvement initiatives are side-tracked by more pressing or competing priorities
- Expertise is lost through staff turnover.
The benefits of doing this right are manifold. First and foremost, it contributes to safer care and a better patient experience. It also enhances teamwork, embeds clinical processes and makes it easier to achieve QI goals you may wish to set in the future.
When a quality culture is embedded, all employees, from senior leadership to frontline staff, have embedded QI into the way they work every day. Employees continuously consider how processes can be improved, and QI is no longer seen as an additional task but a frame of mind in which the application of QI is second nature. The basics of QI are so ingrained in staff that they seek out the root cause of problems.2
Remember that it’s people – not toolkits, policies or SOPs – that will determine your success. Figure 1 outlines the key features present in a QI culture.
| Figure 1: A picture of QI culture | |
| Feature | Explanation |
|
Patient centredness |
Patients are at the centre of everything your team does and are considered important partners in their care. Staff continually strive to see things through the eyes of the patient |
|
Belief in human potential |
An improvement culture values people and encourages their professional and personal development. Employees are involved in decision making because those at the frontline often have the best and most intimate knowledge of problems |
|
Improvement and innovation encouraged |
The saying ‘if it ain’t broke, don’t fix it’ does not apply. People are encouraged and enabled to improve services, and experimentation and flexibility are valued |
|
Recognition of the value of learning |
People are encouraged to be proactive problem solvers and learners. Evidence from a variety of sources is used to guide clinical practice. Knowledge is shared throughout the team |
|
Effective team working |
No individual or profession dominates quality improvement approaches. People work together for the benefit of patients |
|
Communication |
People are kept in the loop on important decisions. How these decisions have been made is clearly communicated to everyone |
|
Honesty and trust |
Activities to support quality improvement will be appreciated and valued by colleagues and managers. In turn, managers must be able to trust that employees will make best use of the time, space and resources given to them. Without trust, no improvement can take place. |
Case study: How QI training empowers pharmacists
A study published in 20213 looked at the experiences of 13 community pharmacists enrolled on a newly developed postgraduate QI module, with focus groups held before and after they completed the module – a six-month virtual course provided by Leicester School of Pharmacy, with tutor support and three face-to-face sessions.
Discussions honed in on the Healthy Living Pharmacy (HLP) scheme in particular, in light of perceptions that HLP’s public health role is being “delivered sub-optimally” due to factors like organisational infrastructure and lack of staff training.
Prior to the QI training, there was a consensus among the pharmacists that HLP suffers from “poor patient awareness”, said the authors. Focus groups held at the end of the module identified that participants were using QI “to undertake a more proactive and investigatory approach to practice”.
In the words of one participant: “I enjoyed discovering the new tools… that I had no idea about. I like the fact that I’ve gained skills for my CV… I’ve become a better leader because I’m looking at deeper issues than I was before.”
According to the authors: “Quality improvement forms an important part of the NHS quality and safety agenda. However, community pharmacists may not currently have adequate knowledge of QI principles.
“The postgraduate educational intervention showed promising results in pharmacists’ knowledge, organisational culture and application in practice.”