THE HEALTH FOUNDATION
6
Evidence scan: Quality improvement training for healthcare professionals
For hundreds of years, clinicians have sought to make healthcare more efective and accessible. Recently, health professionals have
begun to learn about formal methods to improve quality. his evidence scan summarises research about the types of training
available and its impacts.
1.1 Purpo se
‘Not all changes are improvements but all improvement involves change. Changing
the systems that deliver care has thus become the cornerstone of the movement
that is now referred to as medical quality improvement.’
1
he focus on improving the quality of healthcare is not new. In 1517 the founding charter of the Royal
College of Physicians emphasised the need for members to set and maintain standards of practice
‘for their own honour and the public beneit’.
2
However, over the past 20 years improving the quality and safety of healthcare has taken on new
importance in the UK.
Health services are now facing signiicant challenges. here are constant medical and technological
advances to keep pace with, the population is growing in size, people are living longer but oten in
poor health and the demand for healthcare outstrips the staing and inancial resources available.
3,4
he focus on patient-centred care, holistic practice and providing value for money means that there is
a greater need to ensure that health professionals, allied teams and managers have the knowledge and
skills to improve and develop healthcare services.
A wide range of techniques have been used to improve healthcare including improvement
cycles, clinical audit, guidelines, evidence-based medicine, healthcare report cards, patient-held
records, targets, national service frameworks, the Quality and Outcomes Framework, performance
management approaches, continuous quality improvement, inancial incentives, leadership,
choice and competition. All of these initiatives require health professionals and managers to
learn and apply new skills. he Health Foundation believes that training can be an efective lever for
improving the quality of healthcare. Yet education and training initiatives are not always prioritised by
policy makers or practitioners.
5,6
‘While healthcare organisations are initiating a number of strategies to
improve care and respond to changing regulatory and policy requirements, many
clinicians practicing in them have not received training on quality and safety as
a part of their formal education.’
7
Research suggests that a lack of knowledge and skills among clinicians and managers is a signiicant
barrier to improving quality in healthcare.
8–10
For example, an evaluation of improvement projects
in England found that managers and practitioners oten lacked basic skills and knowledge in how
to assess evidence, plan improvements, manage projects and analyse data.
11
Training health professionals in quality improvement has the potential to impact positively
on attitudes, knowledge and behaviours.
12
In fact, some suggest that training professionals may be just
as efective as inancial incentives for improving the quality of healthcare.
13
Yet little is known about the most efective ways to train health professionals in quality improvement.
his evidence scan explores the following questions: – What types of training about formal quality
improvement techniques are available for health professionals?
– What evidence is there about the most efective methods for training clinicians in quality
improvement?
THE HEALTH FOUNDATION
7
Evidence scan: Quality improvement training for healthcare professionals
his section briely describes the scope and methods of the scan. Section 2 outlines some of
the content and teaching methods used in quality improvement training. Section 3 explores the
efectiveness of various types of training.
1.2 Deining quality
