Quality improvement for hospices and palliative care organisations

Empowering a strong and dynamic hospice sector is an essential goal in our strategy to bring quality hospice care to everyone in need.

Quality improvement

This is why we are developing a series of resources to enable the uptake of a systematic quality improvement approach that will be of benefit not just to hospices, but all palliative care organisations.

What is quality improvement? 

Quality improvement "seeks to improve the patient experience and outcomes through changing provider behaviour and that of the organisation through using a systematic change method and strategies."
Quality Improvement Made Simple, The Health Foundation 2016.

How does quality improvement complement the quality assurance work hospices are engaged in?

Quality assurance is any systematic process of checking to see if the service provided is meeting specified requirements. Mechanisms that offer assurance include reviewing complaints, auditing and benchmarking. 

While quality assurance focusses on ensuring the care of an individual meets the necessary standards, quality improvement looks at developing processes and systems and is about operational delivery as a whole. Though the two are different processes, the standards developed for and outcomes of quality assurance can help to inform the quality improvements required.

What can a quality improvement approach offer hospice, palliative and end of life care providers? 

  1. A clear definition of quality that reflects your philosophy of care, your regulatory framework and other similar drivers.
  2. A practical, systematic approach to making change happen in practice.
  3. A way to ensure a strong strategy that embeds quality assurance and quality improvement approaches across your entire organisation on an ongoing basis, with input from the whole workforce.
  4. Increasingly skilled teams who have confidence in the quality of the data they collect and benchmark, particularly in relation to patient safety, along with an understanding of the practical tools and techniques needed to support change.
  5. Greater knowledge on the part of quality managers (or similar) regarding the science of quality improvement and how this is most effectively implemented in a palliative care context.
  6. A way to understand the needs of your local population and your organisation’s capacity to meet those needs. Armed with this knowledge, you will be better able to design your services accordingly.
  7. Reinforcement of the value of research, ensuring that your plans for service improvement are evidence-based.

What is Hospice UK doing to support quality improvement in palliative care settings?

  1. We have established a Quality Improvement Advisory Group (link) who can advise us and ensure that the direction of the QI programme meets the needs of our members, subscribers and other interested parties.
  2. We are developing a four-level programme to support quality improvement in hospice and palliative care organisations.
  3. We are supporting the development of new communities of practice, focussed on implementing quality improvement initiatives at a local level.
  4. We will enable these communities to engage with peers through a quality improvement forum. This will provide opportunities to share tools and resources, and ask questions.
  5. There is a bank of case studies being prepared from our Building on the Best programme, aimed at improving end of life care in hospitals across the UK. We expect they which will be a rich source of learning.
  6. We worked in partnership with NHS Improvement on a 12-month Emergency Care Improvement programme to improve the quality of care in hospitals for patients in their last three months of life. Following the programme’s success, we have moved on to the second phase and are continuing the programme in eight sites across England.
  7. We are continuing to seek out quality improvement case studies, as well as strategic national partnerships, to inform our work from wider bodies interested in quality improvement.

Useful Resources

Patient experience improvement framework: An evidence-based framework centred around Care Quality Commission key themes to enable board and senior teams in providers to continuously improve the experience of patients.

Driver Diagrams: an excellent website  to illustrate the value of a driver diagram and how  to formulate one.

The Handbook of Quality and Service Improvement Tools: an excellent resource for an introduction and overview to Quality Improvement.

Briefing: Partnerships for improvement: ingredients for success Robin Miller, Ross Millar, Tim Gardner, Will Warburton

Using communications approaches to spread improvement. A practical guide to help you effectively communicate and spread your improvement work

The habits of an improver, Thinking about learning for improvement in health care Bill Lucas with Hadjer Nacer

Spreading change: A guide to enabling the spread of person- and community-centred approaches for health and wellbeing

Context for successful quality improvement Naomi Fulop, Glenn Robert

Get in touch

Contact our Clinical Support team if you would like to learn more about our work in quality improvement.

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