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Open Access
Article
Publication date: 7 September 2021

Thomas W. Wainwright and David McDonald

Health services continue to face economic and capacity challenges. Quality improvement (QI) methods that can improve clinical care processes are therefore needed. However, the…

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Abstract

Purpose

Health services continue to face economic and capacity challenges. Quality improvement (QI) methods that can improve clinical care processes are therefore needed. However, the successful use of current QI methods within hospital settings remains a challenge. There is considerable scope for improvement of elective clinical pathways, such as hip and knee replacement, and so the use and study of QI methods in such settings is warranted.

Design/methodology/approach

A model to manage variability was adapted for use as a QI method and deployed to improve a hip and knee replacement surgical pathway. A prospective observational study, with a mixed-methods sequential explanatory design (quantitative emphasised) that consisted of two distinct phases, was used to assess its effectiveness.

Findings

Following the use of the novel QI method and the subsequent changes to care processes, the length of hospital stay was reduced by 18%. However, the interventions to improve care process highlighted by the QI method were not fully implemented. The qualitative data revealed that staff thought the new QI method (the model to manage variability) was simple, effective, offered advantages over other QI methods and had highlighted the correct changes to make. However, they felt that contextual factors around leadership, staffing and organisational issues had prevented changes being implemented and a greater improvement being made.

Originality/value

The quality of QI reporting in surgery has previously been highlighted as poor and lacking in prospective and comprehensively reported mixed-methods evaluations. This study therefore not only describes and presents the results of using a novel QI method but also provides new insights in regard to important contextual factors that may influence the success of QI methods and efforts.

Details

The TQM Journal, vol. 33 no. 7
Type: Research Article
ISSN: 1754-2731

Keywords

Content available
Book part
Publication date: 24 October 2017

Abstract

Details

Corruption, Accountability and Discretion
Type: Book
ISBN: 978-1-78743-556-8

Content available
Book part
Publication date: 12 October 2015

Abstract

Details

Inquiry-Based Learning for Science, Technology, Engineering, and Math (Stem) Programs: A Conceptual and Practical Resource for Educators
Type: Book
ISBN: 978-1-78441-850-2

Content available
Book part
Publication date: 21 May 2019

John N. Moye

Abstract

Details

Learning Differentiated Curriculum Design in Higher Education
Type: Book
ISBN: 978-1-83867-117-4

Content available
Book part
Publication date: 7 December 2017

Eva Tutchell and John Edmonds

Abstract

Details

The Stalled Revolution: Is Equality for Women an Impossible Dream?
Type: Book
ISBN: 978-1-78714-602-0

Content available
Book part
Publication date: 1 July 2017

Peter K. Ross, Susan Ressia and Elizabeth J. Sander

Abstract

Details

Work in the 21st Century
Type: Book
ISBN: 978-1-78714-578-8

Content available
Book part
Publication date: 21 May 2020

Ann Gallagher

Abstract

Details

Slow Ethics and the Art of Care
Type: Book
ISBN: 978-1-83909-195-7

Content available
Book part
Publication date: 8 November 2011

Abstract

Details

The Third Sector
Type: Book
ISBN: 978-1-78052-281-4

Content available
207

Abstract

Details

European Business Review, vol. 15 no. 3
Type: Research Article
ISSN: 0955-534X

Keywords

Content available
Article
Publication date: 23 August 2013

David Weir

648

Abstract

Details

Journal of Organizational Ethnography, vol. 2 no. 2
Type: Research Article
ISSN: 2046-6749

Keywords

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