Quality Improvement Curriculum Framework 03.10 …

1 Quality Improvement Curriculum Framework Supporting an NHSS cotland Workforce to deliver care that is: Safe Person-centred Effective Contents 1. The NHSS cotland Quality 2. Quality Improvement in 3. Introduction to the Quality Improvement Curriculum 4. Quality Improvement Workforce Development Model ..2 Board Level (Executive and Non Executive)..2 Foundation Level ..2 Practitioner Lead Practitioner Level ..4 5. Purpose of the 6. Key educational principles of the Framework ..5 7. Uses and applications of the Framework ..5 8. Learning Resources for Quality 9. Indicative mapping to Knowledge and Skills Framework (KSF) ..6 10. Indicative mapping to the Scottish Credit and Qualifications (SCQF) Framework ..6 11. Final Learning Outcomes ..6 12. Quality Improvement Curriculum Framework Model ..7 13. Final Learning Outcomes ..8 Board Members ..8 Foundation Level ..8 Practitioner Lead Practitioner Level.

2 8 14. Stage Learning Stage Learning Outcome Table ..10 15. Quality Improvement Glossary of Glossary ..14 Appendix I Indicative Mapping to KSF ..21 1 1. The NHSS cotland Quality Strategy The Quality Strategy is the NHSS cotland blueprint for improving the Quality of care that patients and carers receive from the NHS across Scotland. It sets out ambitions which acknowledge: Putting people at the heart of everything the health service does; A focus on providing the best possible care; Recognition that real Improvement in Quality of care involves all staff, both clinical and non clinical, working at all levels in all roles. In the NHSS cotland Quality Strategy, the ambition for healthcare that is person-centred, safe and effective is underpinned by the need to embed the mutual approach of shared rights and responsibilities into every interaction between patients, their families and those providing health services (pg 17, Quality Strategy).

3 This requires a renewed focus on building capacity and capability for all staff to ensure that they have the knowledge, skills and attitudes necessary to deliver high Quality services. 2. Quality Improvement in Healthcare The definition below seeks to describe what improving health services means and the part that we all play in continually improving the care provided. The combined and unceasing efforts of everyone healthcare professionals, patients and their families, researchers, payers, planners, administrators, educators to make changes that will lead to better patient outcome, better system performance, and better professional development. Batalden P, Davidoff F. Qual. Saf. Health Care 2007;16;2-3 To improve services effectively we need to be able to set clear aims, establish measures, test changes and implement these changes. There are many well-tested tools and techniques that support Improvement in designing services that provide maximum benefit to the patient in an effective and safe way.

4 3. Introduction to the Quality Improvement Curriculum Framework In the last number of years, NHS Boards have been developing expertise in applying Quality Improvement thinking and techniques to healthcare Improvement , through both locally driven projects and through national Improvement programmes, such as the 18 Weeks Referral to Treatment and the Scottish Patient Safety Programme. The Quality Improvement (QI) Curriculum Framework aims to provide ongoing support for the development of learning in Quality Improvement by describing the knowledge and skills needed to continuously improve services and enable the NHS workforce to access appropriate learning and development resources. The QI Curriculum Framework , Figure 1 page 7, aims to support staff across all of NHS Scotland to access learning in Quality Improvement thinking and techniques. The Framework has been developed and refined with a group of Quality Improvement leads from health boards who have subject matter expertise along with an understanding of how the Framework may support capacity building in practice.

5 The Framework reflects the priorities of the NHSS cotland Quality Strategy, and is intended to provide a scaffold for enabling structured and systematic professional and educational development in Quality 2 Improvement . It is designed to support capacity building for everyone in NHSS cotland in Improvement of person-centred care, continuing Improvement of patient safety and increase clinical effectiveness of care and treatment. It is intended that the Framework will enable staff with different roles in the organisation to identify the gaps between their current knowledge and skills and future requirements and to support them to plan their own learning and development. For all staff, the aim of the Framework is to: enable individuals to reach a broader and deeper understanding of their roles in Quality Improvement ; enable individuals to gain a broader and deeper understanding of the knowledge, skills and behaviours expected/required by their roles in Quality Improvement ; facilitate individuals to identify their professional development needs to effectively carry out their Quality Improvement role; provide benchmark statements against which individuals can gauge themselves.

6 4. Quality Improvement Workforce Development Model Figure 4 describes the NHSS cotland workforce development needs in building capacity and capability in Quality Improvement . FIGURE 4 Board Level (Executive and Non Executive) A focus on Quality and Improvement of the services delivered is at the heart of the role of NHS Boards. The focus on continuous Improvement is vital as evidence shows that even high performing healthcare organisations can improve their Quality of care by focussing on safety and efficiency and putting the patient at the centre of how we design our services. The final learning outcomes for NHS Boards on page 8 indicate the attributes NHS Board members may be expected to demonstrate in relation to Quality Improvement . Foundation Level All staff working in healthcare settings should be encouraged to take a reflective approach in their role.

7 This will be achieved by raising awareness of the principles that underpin Quality and ensuring that everybody involved (and this should include the patient and carer) has an appropriate level of understanding of the significance of Quality and its part in service delivery. In particular the Foundation learning will involve: recognising that everyone has a responsibility to enable Quality care and everybody has a voice; pursuing Quality at every opportunity, at every health intervention, by everybody; becoming familiar with the philosophies and aims of the most widely used approaches to Quality NHS STAFF (ALL)LEADPRACTITIONERNHS BOARDSNHS STAFF (ALL)LEADPRACTITIONERNHS BOARDS 3 Improvement in healthcare; recognising the relevance of healthcare systems and pathways; reflect on individual roles and responsibilities in delivering high Quality care. The Foundation level learning would provide opportunities for staff new to the workforce to learn about Quality Improvement and be included, for example, in induction programmes, practice development programmes or undergraduate courses.

8 The education could also inform the continued professional development (CPD) of staff currently employed and be integrated into existing opportunities for CPD. Practitioner Level This level is applicable to a wide range of staff with different roles whose work should be informed by a clear understanding of the principles and practice of continuous Improvement in healthcare. In particular the Practitioner level will involve: acting as a knowledgeable and informed practitioner of Quality Improvement within their local environment; actively pursuing increased understanding of Quality Improvement methodologies and approaches; leading change through Quality Improvement initiatives within their working environment; facilitating the understanding of Quality Improvement amongst their colleagues/team; acting as an implementation (project manager) lead at local level to embed Quality Improvement tools and approaches; working collaboratively to be identified as a cohort of Quality Improvement champions with relevant experience to promote Quality Improvement locally; encouraging the sharing of experience amongst their group of Quality Improvement practitioners; fostering cultural change within their employing organisation.

9 It is envisaged that: practitioners will approach the role with some knowledge of Quality Improvement techniques, but are unlikely to have wide and varied experience; individuals will be supported by Leads (acting as facilitator and mentor) and via structured learning interventions to acquire relevant wider knowledge, skills and behaviours as they undertake the role described above; they will be allowed bounded time and resources to increase their knowledge, skills and behaviours of Quality Improvement techniques within their local setting; Individuals will be encouraged to see their personal development as career progression, perhaps moving into the Lead level in time. The Practitioner level reflects a leadership role in Quality Improvement . Practitioners are seen as role models and should champion a culture of change and innovation within their own local environment. They can signpost others to learning resources and ensure that access to learning about Quality is available to their teams.

10 The Practitioner level will include staff working in clinical settings, for example charge nurses, as well as those working in support services, such as administration and finance. 4 Lead Practitioner Level The Lead Practitioner Group will represent an expert resource to promote Quality Improvement in healthcare settings, able to contribute to knowledge in the field and to lead, along with others, a culture of change and innovation throughout the healthcare organisation in which they work. In particular Lead Practitioners will be involved in: promoting Quality Improvement at strategic level within the organisation; representing the business case for Quality Improvement at regional and local levels in the range of ways that this may require; leading (along with others) and supporting the delivery of high Quality healthcare Improvement within their workplace; supporting the integration of Quality Improvement projects at all levels in the organisation; advancing innovative and new applications of healthcare Improvement science in the workplace; supporting the development of other practitioners in Quality Improvement science to enable them to deliver healthcare improvements or enable others to do so; supporting the advancement of knowledge related to improving the delivery of health services including enhancing access to Quality Improvement tools and techniques.