More information about text formats
Response to The secret sauce: secrets of high performing neonatal intensive care units
Soghier and Short highlight the importance of local contextual factors in determining the success of improvement initiatives in neonatal units. They draw attention to a number of qualitatively assessed factors, many of which are prefixed by the adjectives “effective”, “active” and, “strong” reflecting the importance of leadership and team culture in effective organisations.
Whilst contextual factor surveys might have a place in identifying the readiness of teams to undertake active improvement, they do little to assist organisations in improving their own readiness. The features of good healthcare leadership and team culture are not readily measured, and healthcare professionals in the UK have little or no training in the attitudes and skills necessary for leadership in quality improvement.
The Institute for Healthcare Improvement has attempted to describe the features of a high quality healthcare organisation in some detail (1). The British Association of Perinatal Medicine has recently produced Quality Indicators relating to structures and processes relevant to Quality and Patient Safety in the context of current neonatal care in the UK (2), which it is hoped will create a basis for units to develop “quality-readiness”.
There is reason to believe that collaboration across centres might add momentum to quality improvement (3). The UK, which has good access to...
There is reason to believe that collaboration across centres might add momentum to quality improvement (3). The UK, which has good access to national neonatal data and a mature benchmarking system, is well set up for collaborative neonatal quality improvement. Professional organisations now need to actively promote collaboration by bringing together clinical leaders focused on excellence, encouraging neonatal units to work together, and facilitating a national community of learning. This might be the missing link to producing a step change in the quality of neonatal care.
1. Frankel A, Haraden C, Federico F, Safe LJAF, White EC. A Framework for Safe, Reliable, and Effective Care. Cambridge, MA; 2017.
2. The British Association of Perinatal Medicine. Neonatal Service Quality Indicators. London; 2017. https://www.bapm.org/NSQI
3. ØVretveit J, Bate P, Cleary P, Cretin S, Gustafson D, McInnes K, et al. Quality collaboratives: lessons from research. Qual Saf Health Care [Internet]. 2002;11(4):345–51. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12468695%5Cnhttp://www.pubmedcentral....