Quality improvement in action
Kate Nash and Anna Garratt discuss how quality improvement can make an impact on practice and summarise the key approaches to this process
Recent policy emphasises the importance of midwives having the opportunity to be involved with innovation and the creation of opportunities to make grassroot level changes that improve their working environment and the quality of care provision to women and babies (NHS England, 2016; no date; Jabbal and Lewis, 2018). The NHS (2021) staff survey has captured data relating to the opportunities staff have to make improvements within their workplace, with 55.2% responding that they are able to make improvements happen. This article provides an introduction to quality improvement and signposts midwives to some simple but effective quality improvement tools.
Within the NHS, resources such as time and workforce availability are a precious commodity. Frequent change can contribute to the burden felt by team members, creating a perception of change fatigue where staff may become resistant to or feel overwhelmed by change that they perceive they have little control over (Gifford et al, 2012). It can be hard to create opportunities for innovation and improvement when faced with staff shortages and chronic excessive workload (Bailey and West, 2021). While quality improvement might easily be dismissed as something that somebody else does, having the opportunity to create simple changes and initiatives in practice can have a significant impact on the clinical working lives of midwives and care provision. An example of this is ‘the Spark’, which was an initiative undertaken by professional midwifery advocate Anna Garratt in response to low morale and feedback from midwives within a clinical ward area in practice. It was a bi-weekly forum for midwives and support staff created to help improve staff morale, teamwork and reignite the passion that individuals had all felt at some stage for their role in women's care. Its objective was to provide an inclusive forum for team members to celebrate their work and to share personal experiences. While the forum was set up and facilitated by clinical practice facilitator and professional midwifery advocate Anna Garratt, different midwives contribute each week and subjects have included the ‘brilliance of women’ and the ‘impact of the sum of our own experiences in the birthing room’, as well as stories from those who have worked outside of the UK.
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