Resources

Over the past three decades, many health systems have sought to enhance care delivery. Despite various approaches such as quality improvement and lean management these efforts can fall short. Failures are often attributed to leaders and workers not doing the right things. This article argues that the real quality problems lie in the underlying systems staff work with. It says that human service organisations will be more successful if they focus on designing systems that support the delivery of high-quality care, rather than trying to fix the people working within them.

‘Safety culture is like a garden: to bloom, it must be planned, planted and  tended.’ This is a key message from a systematic review of safety culture and an excellent reminder that culture is never ‘set and forget’.

There are many benefits of enhancing consumer and staff satisfaction in human services, but something we don’t often discuss is the potential financial advantage. Creating a great experience for both consumers and staff can be viewed as a professional and ethical imperative; and also as a strategic business investment.

We frequently discuss the importance of a ‘safety culture’ in human services – but what are the key ingredients? This scoping review synthesises evidence from multiple studies to identify key factors contributing to patient safety culture. Although the review focused on hospitals, the findings are relevant for all human service leaders seeking to build or strengthen their culture of safety.

The inter-dependency of clinician wellbeing and patient safety is well accepted. Staff burnout is a widespread problem and patient safety improvement appears to have stalled. This survey of 2187 physicians and 6643 nurses practising in 64 hospitals in six European countries investigated the well-being of physicians and nurses in hospital practice in Europe, and identified interventions that hold promise for reducing adverse clinician outcomes and improving patient safety.

Investment in digital health is advancing rapidly. In 2020, the total global funding for digital health was the highest recorded at US $26.5 billion. A global appetite for digital health, fuelled by the COVID-19 pandemic and the associated rapid adoption of point-of-care technological solutions, including telehealth, has driven the digital disruption of health care.

Negotiation is part of everyday life, and never more so than in health and human services. People in quality and clinical governance roles in particular, often don’t have a lot of formal power and rely heavily on relationships and influence to achieve their objectives.

Dignity in healthcare, and particularly in the care of the elderly, is seen as a basic human right, as is the right not to be harmed in the course of care. But are these rights counteracting each other?

This article explores the relationship between the management of clinical risk and the provision of dignified care to older people on acute hospital wards in the NHS. It shows that the care relationship between staff and their patients can be negatively affected by risk management practices that seek to eliminate the inherent uncertainties of clinical care. Ironically, it seems the management of clinical risk can pose a challenge to maintaining dignified care for older people.  

People in quality and clinical governance roles are often viewed as a ‘spare pair of hands’ and end up doing tasks that they are not responsible for. This leads to dissatisfaction, burnout, and not getting the important jobs done. Mind Tools describes a four stage process for setting firmer boundaries that may be useful for those who want a more focused and effective role in 2024.

Three short videos from Dr Cathy Balding about how to be a more effective quality improvement professional.