Improving Quality in Healthcare: Questioning the Work for Effective Change

This book is for anyone who is interested in improving quality in healthcare. It will appeal to those who are traditionally responsible for quality matters, as well as practicing clinicians and leaders. Unusually, it will also be as relevant to those who have the keenest interest in the quality of care - interested citizens.

It is a deliberate antidote to the anti-intellectual, QI tool driven, mechanistic approach that still dominates much of healthcare quality improvement work. The authors - both of whom have extensive experience of working in and around quality issues in healthcare at a national, regional and local level - challenge such approaches, which they believe fail to take account of patient and organisational context and invite reductionism, cherry picking, atomisation of complex issues, leading ultimately to simplistic and unsustainable outcomes.

Key features of the book:

·       An exploration of some of the often-overlooked and misunderstood core concepts of quality; their history and meaning in a contemporary context.

·       A framework to "question the work" using four interconnected conceptual domains as a valuable framework to consider improving quality and reducing failure demand.

·       Critical re-examination of the dominant approaches to change that are frequently adopted in "quality" work, many of which have been rooted in scientific management that have failed to live up to their promise – particularly transformational.

·       Exploring how an inter-disciplinary perspective can reframe aspects of quality thinking.

Murray has a clinical background in mental health services and psychological therapy and is trained in systemic approaches to counselling, consultation and supervision. He is a qualified groupwork practitioner, registered with the Institute of Group Analysis. Murray has an enduring interest in the social dynamics of organising and has spent much of his career tackling complex socio-cultural and ethical issues, including leading several large-scale independent reviews of care. Murray has provided strategic support to a wide range of national quality programmes and networks in the UK and abroad. He has taught at postgraduate level internationally and is a visiting professor at the Health Systems Innovation Lab at London South Bank University. Murray’s practice also includes work as an independent editor, writer and broadcaster, producing media to stimulate debate about complex professional and ethical issues in healthcare. He is co-author of Networks in Healthcare: Managing Complex Relationships (Emerald) with Professor Becky Malby.

Nick is a healthcare quality, systems thinking and organisational development specialist. He is committed to helping clinicians, other professionals and communities be their most impactful in helping people live good lives. He has a quality and industrial engineering background and has spent most of his career working in health and social care. Nick has shaped, and continues to shape, some of the largest and most enduring quality improvement programs in the NHS. He is visiting teaching faculty at the Health Systems Innovation Lab at London South Bank University and works with front line teams, and their leaders at all levels, in healthcare services across primary and secondary care domestically and internationally.