Browsing by Author "Banerjee, J."

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    How Quality Improvement Collaboratives Work to Improve Healthcare in Care Homes: A Realist Evaluation
    (Oxford University Press, 2021-02-16) Hinsliff-Smith, K.; Devi, Reena; Gordon, Adam; Chadborn, Neil; Goodman, Claire; Meyer, Julienne; Dening, Tom; Housley, Gemma; Long, Annabelle; Lewis, Sarah; Banerjee, J.; Gladman, J.R.F.; Long, A.; Usman, A.; Housley, G.; Glover, M.; Gage, H.; Logan, P.A.; Martin, F.C.; Gordon, Adam Lee
    Background Quality Improvement Collaboratives (QICs) bring together multidisciplinary teams in a structured process to improve care quality. How QICs can be used to support healthcare improvement in care homes is not fully understood. Methods A realist evaluation to develop and test a programme theory of how QICs work to improve healthcare in care homes. A multiple case study design considered implementation across 4 sites and 29 care homes. Observations, interviews and focus groups captured contexts and mechanisms operating within QICs. Data analysis classified emerging themes using context-mechanism-outcome configurations to explain how NHS and care home staff work together to design and implement improvement. Results QICs will be able to implement and iterate improvements in care homes where they: have a broad and easily understandable remit; recruit staff with established partnership working between the NHS and care homes; use strategies to build relationships and minimise hierarchy; protect and pay for staff time; enable staff to implement improvements aligned with existing work; help members develop plans in manageable chunks through QI coaching; encourage QIC members to recruit multidisciplinary support through existing networks; facilitate meetings in care homes; and use shared learning events to build multidisciplinary interventions stepwise. Teams did not use measurement for change, citing difficulties integrating this into pre-existing and QI-related workload. Conclusions These findings outline what needs to be in place for health and social care staff to work together to effect change. Further research needs to consider ways to work alongside staff to incorporate measurement for change into QI.
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    Improving the quality of care in care homes using the Quality Improvement Collaborative approach: lessons learnt from six projects conducted in the UK and the Netherlands
    (MDPI, 2020) Hinsliff-Smith, K.; Devi, R.; Martin, G.; Banerjee, J.; Butler, L.; Pattison, T.; Cruickshank, L.; Maries-Tillott, C.; Wilson, Tracie; Damery, S.; Meyer, J.; Poot, A.; Chamberlaine, P.; Harvey, D.; Giebel, C.; Chadbourne, N.; Gordon, Adam Lee
    The Breakthrough Series Quality Improvement Collaborative (QIC) initiative is a well-developed and widely used approach but most of what we know about it has come from healthcare settings. In this article, those leading QICs to improve care in care homes provide detailed accounts of six QICs, and share their learning of applying the QIC approach in the care home sector. Overall, five care home specific lessons were learnt: i) plan for the resource needed to support collaborative teams with collecting, processing, and interpreting data ii) create encouraging and safe working environments to help collaborative team members feel valued, iii) recruit collaborative teams, QIC leads and facilitators who have established relationships with care homes, iv) regularly check project ideas are aligned with team members’ job roles, responsibility and priorities, and v) work flexibly and accept that planned activities may need adapting as the project progresses. These insights are targeted at teams delivering QICs in care homes. These insights demonstrate the need to consider the care home context when applying improvement tools and techniques in this setting.