Abstract

Quality improvement: balancing a systems approach and the human factor

• My experience in applying engineering approaches to improve health and social care, and the barriers encountered • My reflections on how engineering approaches can help achieve and sustain quality improvement locally and across a system

Quality improvement has been a common thread throughout my experience within the health and social care systems. I will describe my experiences in service and system redesign in both Canada and the UK, and what I have learned. Transformation programmes tend to encounter barriers, both human and structural, and I will discuss strategies to address them using engineering approaches. My employing organisation for the last 9 years, NELFT NHS Foundation Trust, has embraced the QI programme and concepts as a form of Organisation Development, and to address gaps in quality. I will describe how that came about and why, and the challenges the programme is currently facing. My recent programme of transformation work has involved broader change across the system (currently implementing an “Integrated Care System” or ICS in Thurrock) and I will reflect on how engineering approaches, in conjunction with addressing the human factor, are assisting in achieving the vision.