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Implementing large‐scale quality improvement: Lessons from The Productive Ward: Releasing Time to Care™

Elizabeth Morrow (National Nursing Research Unit, King's College London, London, UK)
Glenn Robert (National Nursing Research Unit, King's College London, London, UK)
Jill Maben (National Nursing Research Unit, King's College London, London, UK)
Peter Griffiths (School of Health Sciences, University of Southampton, Southampton, UK)

International Journal of Health Care Quality Assurance

ISSN: 0952-6862

Article publication date: 27 April 2012

2644

Abstract

Purpose

This paper aims to focus on facilitating large‐scale quality improvement in health care, and specifically understanding more about the known challenges associated with implementation of lean innovations: receptivity, the complexity of adoption processes, evidence of the innovation, and embedding change. Lessons are drawn from the implementation of The Productive Ward: Releasing Time to Care™ programme in English hospitals.

Design/methodology/approach

The study upon which the paper draws was a mixed‐method evaluation that aimed to capture the perceptions of three main stakeholder groups: national‐level policymakers (15 semi‐structured interviews); senior hospital managers (a national web‐based survey of 150 staff); and healthcare practitioners (case studies within five hospitals involving 58 members of staff). The views of these stakeholder groups were analysed using a diffusion of innovations theoretical framework to examine aspects of the innovation, the organisation, the wider context and linkages.

Findings

Although The Productive Ward was widely supported, stakeholders at different levels identified varying facilitators and challenges to implementation. Key issues for all stakeholders were staff time to work on the programme and showing evidence of the impact on staff, patients and ward environments.

Research limitations/implications

To support implementation, policymakers should focus on expressing what can be gained locally using success stories and guidance from “early adopters”. Service managers, clinical educators and professional bodies can help to spread good practice and encourage professional leadership and support. Further research could help to secure support for the programme by generating evidence about the innovation, and specifically its clinical effectiveness and broader links to public expectations and experiences of healthcare.

Originality/value

This paper draws lessons from the implementation of The Productive Ward programme in England, which can inform the implementation of other large‐scale programmes of quality improvement in health care.

Keywords

Citation

Morrow, E., Robert, G., Maben, J. and Griffiths, P. (2012), "Implementing large‐scale quality improvement: Lessons from The Productive Ward: Releasing Time to Care™", International Journal of Health Care Quality Assurance, Vol. 25 No. 4, pp. 237-253. https://doi.org/10.1108/09526861211221464

Publisher

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Emerald Group Publishing Limited

Copyright © 2012, Emerald Group Publishing Limited

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