What is Quality Improvement (QI)?

The best way to ensure that our services are safe, responsive and provide quality care is by continually making improvements.

"Quality improvement is about giving the people closest to issues affecting care quality the time, permission, skills and resources they need to solve them. It involves a systematic and coordinated approach to solving a problem using specific methods and tools with the aim of bringing about a measurable improvement."

(The Health Foundation 2021)

About QI at SHSC

The use of QI in healthcare has been accelerated over the last couple of decades starting from the US and more recently in the UK. Unlike some trusts, quality improvement training has been available in SHSC for over a decade.

Our approach at SHSC is to use the Model for Improvement as our main framework.

The Model of Improvement is a fundamental aspect of most QI training. Our staff have access to a wide variety of training across the NHS and beyond. We have staff within our Trust that have completed some of these courses including microsystems, QSIR, Improvement Academy Training and IHI training.

We also provide our own in-house training both online and face to face.

Across the trust we are trying to utilise the wealth of QI knowledge to improve our care for our service users and our staff. This includes:

  • National improvement programmes e.g. Patient Safety Incident Response Framework (PSIRF)
  • System wide programmes e.g. Primary and Community Mental Health Transformation (PCMHT)
  • Trust wide improvement programmes e.g. Learning Disabilities
  • Frontline QI projects e.g. Early Intervention Service (EIS)

Our commitment to quality improvement is set out in our Quality Strategy. This sits as an enabling strategy within our Clinical and Social Care Strategy.

Our approach to QI

The Model for Improvement is the framework that we are using to drive continuous improvement. Here at SHSC we use an adapted version of the Model for Improvement to include coproduction and codesign.

SHSC staff have access to a variety of training including:

  • Microsystems
  • Improvement Academy Training
  • Institute for Healthcare Improvement
  • In-house introduction to QI training
  • Leading with an improvement mindset

All of this training has the Model for Improvement as its core element.

Model for Improvement

The Model for Improvement includes the use of the Plan - Do - Study - Act (PDSA) cycle but we also need to be able to answer the following questions when we are doing any quality improvement work:

  • What are we trying to accomplish?
  • How will we know that a change is an improvement?
  • What change can we make that will result in an improvement?
  • Who do we need to involve and when?

Some of the things we are focusing on

National programmes

Learning from deaths

Sexual Safety

Patient Safety Incident Response Framework (PSIRF)


System and Trust-wide programmes

Primary and Community Mental Health Transformation (PCMHT)

Community Mental Health Transformation (CMHT)

Restrictive Practice

Learning Disabilities


QI projects


Early Intervention Service (EIS)

Learning Disabilities

Not all of these programmes are supported by the QI team but we have staff leading these programmes that are trained in using QI tools.

Our quality framework

This framework can be found in our quality strategy but has been developed further based on feedback from our staff.

The quality improvement team is part of a wider quality framework including quality planning, quality control and quality assurance.

Quality planning

  • Understanding the needs of our service users to ensure that they have safe care
  • Using available evidence to plan how our systems and services lead to the best possible outcomes

Quality control

  • To use a set of measures to help monitor effectiveness chosen by the team and tracked in real time
  • Visual management system
  • Regular team huddles around data

Quality improvement

  • A systematic approach to improve performance and quality based on the 'science of improvement' and experience
  • Deep involvement from those closest to the issues with support from Trust leaders
  • Tackling what matters most

Quality assurance

  • Occasional checks that we are providing good care and meeting standards
  • Identifying gaps, developing action plans and re-checking to ensure compliance
  • Visible data to show good care provided

How you can get involved

The quality improvement team is always looking for service users, carers, families and members of the public to get involved in quality improvement projects.

If you would like to find out more about getting involved in quality improvement work, please email improvement@shsc.nhs.uk and one of the team will get back to you as soon as possible.

If you want to log a QI project or request support from the QI team please fill in our Quality Improvement Project Form (QIP).

This approach has been very beneficial to me. I often have ideas and thoughts but have not always felt confident or able to share them. This approach has helped me to bring forward ideas and feel valued. People always allow time for me to explain my thoughts and are respectful.

Being involved in improvement work has enabled me to feel part of a team and given me a sense of value that allows me to see that I have a voice worth listening to and something positive to contribute to the world. This is from a person who can go weeks and weeks without publicly speaking to anyone.

Quotes from service users/carers/staff who have been involved in quality improvement work

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