Quality improvement frameworks for veterinary practice: getting started
Abstract
Quality improvement is a continuous process aimed at improving care and outcomes for patients. It is also about encouraging team members to learn from everything that happens – good or bad. Before setting out to improve quality, it is useful to see what quality healthcare is made up of and how these areas are interdependant. To be successful, quality improvement has to be a whole team activity, so getting the team on board from the start is vital. Encouraging the team to discuss what their personal concerns are and prioritising areas for improvement are important. Implementing quality improvement in practice involves good communication; it is vital that the team are aware of and involved in quality improvement activities in the practice. This article covers setting the groundwork for quality improvement to be successful. Once these foundations are established, the team understand quality and safety, and is communicating effectively, then quality improvement tools and systems can be used. The second part of this article will cover how to successfully implement quality improvement tools and systems (such as clinical audit, checklists, care bundles, significant event audit and root cause analysis), how to consider human factors and systems thinking when implementing quality improvement projects and how to learn from everything that happens in practice.
Quality improvement is a popular theme in veterinary practice – but what does it really mean? What do practices actually need to do to achieve it? Batalden and Davidoff (2007) defined quality improvement as ‘the combined and unceasing efforts of everyone to make the changes that will lead to better patient outcomes (health), better system performance (care) and better professional development (learning)’. This definition is important as it emphasises both the continuous nature of quality improvement and the fact that, in order to work, it must involve the whole team.
Constantly reviewing the way care is delivered to patients and clients, what outcomes are obtained and learning from everything have always been the main drivers of veterinary practice. Quality improvement formalises these activities so that it is a well-thought out, continuous process. In the UK, all veterinary professionals who are regulated by the Royal College of Veterinary Surgeons (RCVS) are expected to ensure that clinical governance forms part of their professional activities (RCVS, 2024).
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