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7. Continuous Improvement in Healthcare
| What this will mean for you |
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- A wait of no more than 18 weeks from GP referral to treatment
- Fast track access to diagnostics and treatment services when these are required
- An assurance that NHSScotland is focussed on improving quality, addressing excessive variation in practice, and ensuring the highest standards of patient safety
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Our Approach
NHSScotland must be characterised by a culture of continuous improvement and the relentless pursuit of quality. One aspect of this will be a continuing focus on cutting waiting times, through the introduction of an 18 week "whole journey" time. This builds on the good progress that has been made in hitting targets for inpatient and day-case treatment, outpatients, heart bypass surgery and angioplasty, key diagnostic tests and accident and emergency services and the additional targeted support we have provided to help NHS Boards achieve the 62-day waiting time target for cancer by December 2007.
Although access to services remains a key issue, we also believe that it is in the interest of our patients that we consider the six dimensions of quality: safety, effectiveness, patient-centredness, timeliness, efficiency, equity. We want to build an organisational culture of patient safety across NHSScotland, supported by high clinical standards defined by NHS Quality Improvement Scotland and enable all NHS Boards to identify and close unacceptable variations in clinical practice.
Framework for Discussion
This discussion offers us an opportunity to shape the way in which we:
- Develop a programme of action to reduce the time from GP referral to treatment to 18 weeks and introduce individual waiting time guarantees
- Continue to invest in staff skills, training and competencies to drive all aspects of service improvement
- Introduce a new approach to the measurement of waiting times that is clearer, more consistent and fairer to patients, including the abolition of Availability Status Codes
- Ensure that services respond to the individual needs and circumstances of people's lives, including age, disability, gender, race, ethnicity, religion or belief and sexual orientation
- Design and deliver services on the basis of the best available scientific evidence
- Work through the Scottish Patient Safety Alliance to build and sustain an organisational culture of safety across NHSScotland, underpinned by high quality clinical standards defined by NHS Quality Improvement Scotland
- Introduce new measures to tackle Healthcare Associated Infection ( HAI) including examining the case for pre-admittance screening for MRSA across Scotland, targeting skin and soft tissue infections, reducing blood stream infections, and ensuring that additional surveillance data are put to use in the areas of general medicine and care of the elderly
- Support collaborative improvement programmes to drive continuous quality improvement across NHSScotland and introduce a new collaborative to improve the quality of services for people with long term conditions
- Develop more local diagnostic facilities and make tests available at an earlier stage in the patient's pathway of care
- Develop a new strategy for eHealth by Spring 2008, that provides a shared vision for staff and patients of how we can make the most of new technology in improving patient care
| Issues to consider |
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- How could the approach described above be developed further to deliver improvements in the quality, efficiency and sustainability of services?
- Which aspects of the overall quality agenda would you prioritise?
- What specific actions should NHSScotland take at a national, regional and local level to better embed a culture of safety, quality and continuous improvement?
- What further opportunities do you see for taking this agenda forward through cooperation and collaboration between NHSScotland and its partners?
- Have you had any recent personal experiences that might help us shape and inform future actions across Scotland?
- Which key performance targets would best focus NHSScotland on the key issues of continuous improvement and quality and how should the new waiting time target be defined in order to maximise its potential for improving the quality of patient care?
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