For Quality Improvement tools and toolkits visit the Improvement tools webpage.

Quality Improvement Publications

TitleDescriptionPublication Date
How do hospital boards govern for quality improvement? A mixed methods study of 15 organisations in England This study contributes to a deeper understanding of how boards govern for QI. 20 November 2017
Making the case for quality improvement: lessons for NHS boards and leaders This briefing outlines 10 lessons for NHS leaders and provides a starting point for leaders seeking to embed quality improvement in their work. 11 October 2017
Embedding quality improvement skills These guides are for NHS organisations seeking to begin or build on their improvement capacity and capability. 11 September 2017
Leading Large Scale Change: A Practical Guide This is a refresh of the 2011 guide and provides a vital and comprehensive round-up of all the latest thinking and practical approaches and tools that can be used in advancing large scale change programmes. 11 September 2017
Evaluating Complex Health Interventions: A Guide to Rigorous Research Designs This guide provides a framework to inform decision-making around appropriate designs to evaluate public health and other service interventions. 26 June 2017
What we know about designing an effective improvement intervention A recent BMJ Quality & Safety article discussing the challenges of designing an effective improvement intervention. 16 June 2017 (online)
Information governance in local quality improvement This document will support commissioners and others adhere to legal standards, key legislation and principles when requesting patient data. 14 June 2017
Using clinical audit in commissioning A brand new HQIP guide outlining how clinical audit can be used by commissioners to assure both quality and drive continuous improvement in patient care. 13 June 2017
Guide to managing ethical issues in quality improvement or clinical audit projects This guide is intended to help those responsible to review and develop arrangements for the effective ethics oversight of QI and clinical audit activities. 8 February 2017
Rapid Improvement Guide to: Optimising medicines discharge to improve patient flow NHS Improvement - 5 key principles of optimising medicines discharge with illustrative case studies. 2017
Considering chance in quality and safety performance measures: an analysis of performance reports by boards in English NHS trusts An analysis of performance reports used by Trust Boards. 14 December 2016
The problem with red, amber, green: the need to avoid distraction by random variation in organisational performance measures ‘The Problem with…’ series covers controversial topics related to efforts to improve healthcare quality, including widely recommended but deceptively difficult strategies for improvement and pervasive problems that seem to resist solution. 14 December 2016
A guide to HQIP resources This is a summary guide to the Healthcare Quality Improvement Partnership clinical audit and quality improvement resources available for free from their website. 5 December 2016
Optimising the community-based approach to healthcare improvement: Comparative case studies of the clinical community model in practice Academic publication contrasting USA and UK based clinical communities. 2016
Does quality improvement improve quality? This insightful article suggests four ways to improve quality improvement. 2016
A guide to patient and public involvement in quality improvement This is a comprehensive updated guide to the benefits of PPI in quality improvement projects and how to implement effectively. 8 April 2016
5 Tips for Making Good Use of Patient Experience Data A blog written by IHI Improvement Advisor Kevin Little, PhD, recommends ways to make meaningful improvements in care. 27 August 2015
Using communications approaches to spread improvement A practical guide to help you effectively communicate and spread your improvement work. Summer 2015
Evaluation: what to consider Commonly asked questions about how to approach evaluation of quality improvement in health care. March 2015
First steps towards quality improvement: a simple guide to improving services If you are involved at any level in improving health or social care, this resource will provide the information you need for your first steps towards making quality improvements, giving your improvement project the best possible chance of success. May 2014
Systematic review of the application of the plan–do–study–act method to improve quality in healthcare Learn more about PDSA. 17 March 2014
Skilled for improvement?

Learning communities and the skills needed to improve care: an evaluative service development.

The Health Foundation Report provides a graphic and illuminating description of the difficulties and barriers which arise in improvement work.

March 2014
Quality improvement made simple What everyone should know about health care quality improvement This guide looks in particular at what are known as organisational or industrial approaches to quality improvement. These aim to bring about a measurable improvement by applying specific methods within a healthcare setting. August 2013
How to spread good ideas A systematic review of the literature on diffusion, dissemination and sustainability of innovations in health service delivery and organisation.  A related article can be found here. April 2004

Patient Safety Publications:

Title DescriptionPublication Date
Improving quality and safety in healthcare Case studies from providers that have been rated ‘good’ for safety by the Care Quality Commission. They offer practical guidance to developing and spreading good practice on assessing and responding to patient risks, medicines management and safety culture. 2 June 2017
Root-cause analysis: swatting at mosquitoes versus draining the swamp An article highlighting the need to enhance the effectiveness of RCAs 18 April 2017
Our current approach to root cause analysis: is it contributing to our failure to improve patient safety? A study examining the types of solutions proposed in RCAs 18 April 2017
Six Resolutions to Reboot Patient Safety Patient safety has always been at the heart of the movement to improve quality in health care.  This article looks at six ways to reboot patient safety 17 February 2017
Exploring the roots of unintended safety threats associated with the introduction of hospital ePrescribing systems and candidate avoidance and/or mitigation strategies: a qualitative study

An article examining the risks associated with the introduction of hospital ePrescribing systems

7 February 2017
A Framework for Safe, Reliable, and Effective Care This white paper from IHI provides clarity and direction to health care organizations on the key strategic, clinical, and operational components involved in achieving safe and reliable operational excellence 2017
At a crossroads? Key challenges and future opportunities for patient involvement in patient safety Find out about key challenges and future opportunities for patient involvement in patient safety. 2016

In this paper, recommended by the Health Foundation November 2015 Research Scan, researchers found that it is uncertain whether high-risk prescribing in primary care is driven by individual GPs or by practices having higher or lower risk prescribing cultures.

Researchers from Scotland examined data about more than 26,000 patients and 398 GPs from 38 general practices. They found more variation in high-risk prescribing between GPs than between practices so only targeting practices with higher than average rates for interventions would miss most high-risk prescribing.

6 November 2015
The problem with root cause analysis Exploration of root cause analysis in healthcare: opportunities and limits. 2016
Safer Healthcare: Strategies for the Real World A new book by Charles Vincent (Health Foundation Professorial Fellow and Professor of Psychology at the University of Oxford) and René Amalberti (Professor of Medicine at Haute Autorité de Santé). 2016
Continuous improvement of patient safety

This report synthesises the lessons from the Health Foundation’s work on improving patient safety.

Part I illustrates why improving safety is so difficult and complex, and why current approaches need to change.

Part II looks at some of the work being done to improve safety and offers examples and insights to support practical improvements in patient safety.

In Part III, the report explains why the system needs to think differently about safety, giving policymakers an insight into how their actions can create an environment where continuous safety improvement will flourish, as well as how they can help to tackle system-wide problems that hinder local improvement.

November 2015
Safer Clinical Systems: evaluation findings

This Health Foundation report presents the findings of the independent evaluation of the second phase of the Safer Clinical Systems improvement programme.

The evaluation and our summary analysis argues that small scale locally led improvement work has an important role to play in improving patient safety. However action also needs to be taken at an organisational and system level, to address problems beyond the control of clinical teams. Without it, there will be a limit to the level of improvement that can be achieved at the frontline.

December 2014

Other Publications

TitleDescriptionPublication Date
The challenge and potential of whole system flow A report looking at improving flow across whole health and care systems December 2016
The practice of system leadership: Being comfortable with chaos

This report, by the King's Fund draws on the experiences of 10 senior leaders to look in depth at the skills needed to be a system leader. The 10 individuals are from different backgrounds and work in different contexts, and give some very candid reflections on their successes and failures. But they share a track record of having tried to bring about change (not always successfully) through using ‘soft’ power, enabling others to see and deliver the changes that are needed.

20 May 2015
Bringing Lean to life "Bringing Lean to Life" provides a basic introduction and overview of Lean; the culture, principles and tools to understand, tackle and resolve issues within healthcare. It is not intended as a complete guide to implementing Lean as a management system. May 2014

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