Quality Improvement in Hunter New England Health

Principles of Quality Improvement and Clinical Practice Improvement

The focus on quality improvement in health care is now recognised as a core part of good patient care and service delivery. The concepts and methodology of quality improvement had its antecedents in the work of W. Edwards Deming in the 1950s, which emphasised the pivotal role of process redesign in improving quality of service in non-clinical settings.  The application of this methodology in the context of the clinical work undertaken by experienced medical, nursing and allied health professionals is now well-accepted, and has led to the routine implementation of continuous practice improvement programs and initiatives across all of health care delivery.

Principles that underpin quality improvement include:

• Health care delivery is a complex system
• Individuals who work in the system are highly motivated to do the best they can and have extensive knowledge of their area of expertise
• Health service quality and adverse events usually include factors relating to systems and processes
• Improving quality requires decisions based on data, teamwork, change management and creative thinking techniques

In 1999, NSW Health published  A Framework for Managing the Quality of Health Services in New South Wales which provided a foundation for the implementation of effective quality improvement programs in NSW Health, and describes six dimensions and the principles underpinning quality improvement. This document was a major milestone that provided a meaningful framework in both the clinical and administrative contexts of health service delivery.