Original Article
Clinical engagement: improving healthcare together
Scottish Medical Journal 2014, Vol. 59(1) 62–66 ! The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0036933013520117 scm.sagepub.com
E Riches1 and B Robson2
Abstract Clinical engagement can achieve lasting change in the delivery of healthcare. In October 2011, Healthcare Improvement Scotland formulated a clinical engagement strategy to ensure that a progressive and sustainable approach to engaging healthcare professionals is firmly embedded in its health improvement and public assurance activities. The strategy was developed using a 90-day process, combining an evidence base of best practice and feedback from semi-structured interviews and focus groups. The strategy aims to create a culture where clinicians view working with Healthcare Improvement Scotland as a worthwhile venture, which offers a number of positive benefits such as training, career development and research opportunities. The strategy works towards developing a respectful partnership between Healthcare Improvement Scotland, the clinical community and key stakeholders whereby clinicians’ contributions are recognised in a non-financial reward system. To do this, the organisation needs a sustainable infrastructure and an efficient, cost-effective approach to clinical engagement. There are a number of obstacles to achieving successful clinical engagement and these must be addressed as key drivers in its implementation. The implementation of the strategy is supported by an action and resource plan, and its impact will be monitored by a measurement plan to ensure the organisation reviews its approaches towards clinical engagement.
Keywords Clinical engagement, healthcare improvement, strategy
Introduction ‘We want to use our knowledge to make real improvements’. Key informant interviewee.
Healthcare Improvement Scotland is a national health body that was set up to improve the quality and safety of healthcare for people across Scotland. The organisation supports healthcare providers in Scotland by delivering evidence-based advice, supporting improvements in healthcare practice, and scrutinising services to provide public assurance about the safety and quality of care. The organisation includes a number of wellknown areas of work. Among these, the Healthcare Environment Inspectorate ensures that Scottish hospitals are safe and clean, the Scottish Intercollegiate Guidelines Network (SIGN) produces clinical guidelines and the Scottish Patient Safety Programme aims to improve the safety of hospital care across Scotland. The organisation also supports the Scottish
Medicines Consortium (SMC) and the Scottish Health Technologies Group, which support the introduction of new medicines and devices in Scotland, respectively. These various parts of Healthcare Improvement Scotland work together to put patients at the heart of their work. Visible, active clinical leadership across the organisation’s strategic strands–evidence, improvement and scrutiny–is central to achieving this purpose. This involves creating, securing and nurturing clinical connections at all levels across NHS Scotland and beyond, ranging from proactive support and dynamic participation, to successful leadership. Such clinical engagement has the potential to achieve lasting 1 2
Healthcare Improvement Scotland, Edinburgh, UK Healthcare Improvement Scotland, Glasgow, UK
Corresponding author: Emma Riches, Healthcare Improvement Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh EH12 9EB, UK. Email: [email protected]
Downloaded from scm.sagepub.com at University of Hawaii at Manoa Library on January 26, 2015
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change in the delivery of healthcare, enhance patient experience and improve treatment outcomes. Clinical communities have a wealth of knowledge in their own field of expertise and an understanding of the strengths and weaknesses of the NHS at frontline level.1 To draw on this knowledge, we need to actively involve clinicians (such as doctors, nurses, pharmacists, community health workers and allied health professionals) in our work on improving healthcare and have meaningful discussions about what makes a difference to patient care. Healthcare Improvement Scotland offers formal and informal opportunities for healthcare professionals to become involved in its work on quality improvement and public assurance. The aim of our clinical engagement strategy is to ensure that a progressive and sustainable approach to engaging healthcare professionals is firmly embedded in all of our activities, from strategic planning to implementation. In this article, we report on how this strategy was developed, highlight its key aims, describe the challenges we face in its delivery and outline priorities for its implementation.
Developing our strategy ‘Healthcare Improvement Scotland needs to define what it aims to achieve through clinical engagement’. Key informant interviewee.
Our clinical engagement strategy (http:// www.healthcareimprovementscotland.org/previous_ resources/policy_and_strategy/clinical_engagement_ strategy.aspx) was developed using a 90-day process based on the ‘innovation method’ used by Proctor and Gamble (which also inspired the 90-day research and development process used within the Institute for Healthcare Improvement).2 This process is designed to stimulate new and innovative thinking when considering challenging issues. During the first 30 days of the process, we searched for evidence of best practice and undertook 28 semistructured interviews of Healthcare Improvement Scotland staff and clinical advisors, Scottish Government colleagues and external clinicians. The second 30-day stage focused on what we learned from this evidence by convening internal and external focus groups to further distil our thinking and give a complete perspective. In the final stage, we drafted a strategy based on our learning, which was supported by an action and resource plan. When we conducted a literature search, much of the evidence identified related to engagement specifically with doctors. It suggested that clinical engagement was consistently considered to have a positive impact on quality improvement and scrutiny. Clinical engagement
is not satisfactory in isolation as other factors are concerned and thus makes clinician involvement difficult to achieve.1,3–5 Some of the key recommendations from the literature to achieve and sustain optimal strategic clinical engagement included: . allocating time and resources to secure clinician commitment, . establishing and maintaining a consistent vision to guide change programmes, . involving top-level leadership, . developing a continuous cycle of engagement which involves communication, refreshing formats and providing feedback to clinicians, . building capability and capacity to prepare for the change process and . developing and encouraging a supportive and receptive organisational culture.4,5 Interview responses also gave us insight into what practices were working well in Healthcare Improvement Scotland and where improvement was needed. The key messages were that there was: . confusion around the organisation’s role and how clinicians can contribute, . a previously unrecognised feeling of discontent among clinicians for a variety of reasons, . no operational definition of clinical engagement and how it is measured or evaluated, . a need to be creative in our approach to clinical engagement and breakdown of existing barriers and . a need for better use of tacit knowledge within the organisation gained through indirect engagement of clinicians. While there was consensus among staff at Healthcare Improvement Scotland that a unified and robust approach to clinical engagement from the outset of work programmes was lacking, there were many examples of projects in which clinical engagement has been successful. High profile examples include the work of SMC and SIGN which are recognised for providing timely and relevant guidance on the use of medicines and clinical best practice. Equally valuable has been the development of the surgical profiles work which engages clinicians in active dialogue about the use of surgical data within NHS boards and how these can guide improvements in patient care. Feedback from internal and external sessions highlighted that the following principles should underpin our approach to clinical engagement: . flexibility in our strategy,
Downloaded from scm.sagepub.com at University of Hawaii at Manoa Library on January 26, 2015
64 . . . . . .
Scottish Medical Journal 59(1) reciprocity of mutual benefits, respect, clarity around commitment, leadership, clear priorities and common purpose and capturing good practice.
Our strategy for clinical engagement ‘How we involve clinicians in our work and how we make that happen’. Healthcare Improvement Scotland Clinical Engagement Strategy.6
By listening to clinicians who have worked with us and based on research, we will create and maintain: . a culture where clinicians view working with Healthcare Improvement Scotland as a necessary, valuable and worthwhile endeavour, . a respectful partnership between Healthcare Improvement Scotland, the clinical community and key stakeholders, . a sustainable infrastructure, . an efficient and cost-effective approach to clinical engagement and . a continual review of our approaches. The strategy supports all the strategic aims of Healthcare Improvement Scotland and is pivotal to shaping and delivering our local delivery plan and work programme.6 It is important that we actively involve clinicians in all stages of planning and delivery of our work programme and maintain a flexible approach that fits different projects.
‘Value-based’ healthcare systems require safety, timeliness, equity, person-centredness, effectiveness and efficiency to be closely aligned in order to deliver a highquality service that achieves excellent outcomes. By protecting dedicated time for clinicians to participate in healthcare improvement activities and rewarding their involvement, it is hoped that financial and management barriers to clinical engagement can be minimised and the ‘value’ to the wider health service be recognised. Practical issues, such as a lack of information and communication systems and adequate support staff for clinicians while working with Healthcare Improvement Scotland, need to be overcome to facilitate clinical involvement in our work. We need to maximise information communication technology support to enable effective communication, clinical involvement and collaboration. The use of teleconferencing, video conferencing and webinars are all means of allowing continued engagement while minimising time away from clinical duties. We have also recently embraced social media. We are putting in place adequate project staff to support involving clinicians in our work so that they are not hindered by administrative activities and processes. Scepticism may stem from pressure from ‘management’, apathy that their involvement is not translated into ‘real’ change to services and patient care or an increase in an already cumbersome workload for little gain. We plan to change these attitudes by demonstrating the benefits of active involvement by working with managers and clinicians to identify and share what works for both managers and clinicians involved in national programmes.
Priorities for implementing our strategy Challenges we face ‘Time is tight and everyone is busy’. Key informant interviewee.
Within busy service delivery environments and a culture of targets, the barriers to clinical engagement are formidable. The burden of workload, scepticism, restrictions on professional autonomy, lack of time and lack of financial incentives are some of the challenges we face in achieving successful clinical engagement.7 It is important to recognise these obstacles and address them as part of the key drivers in our action plan. We recognise that clinicians have limited time outside their core clinical activities and, to avoid further pressure on financial resources in the NHS, we aim to embrace the ‘value-based’ healthcare system concept.
‘There is a lot of passion and commitment but it’s about harnessing all of that and agreeing the direction in going forward’. Key informant interviewee.
. Our compact The improving Healthcare Together Compact is a partnership agreement between Healthcare Improvement Scotland and clinicians who work with us. It is designed to facilitate a clearer understanding about what we can expect from each other, and to ensure meaningful and sustainable relationships with clinical communities. The concept of a ‘compact’ is based on the work of the Virginia Mason Institute where such a tool has been effective in identifying, promoting and supporting clinical engagement in providing high quality care.8,9
Downloaded from scm.sagepub.com at University of Hawaii at Manoa Library on January 26, 2015
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To stimulate clinicians’ enthusiasm for our work, we need to demonstrate that collaborating with us is a valuable endeavour. The working relationship should include a range of positive benefits, such as allowing stakeholder input to shape the business planning and the organisation’s outputs so that we produce advice and guidance that is fit for purpose for their day-to-day practice, and helps patients and healthcare teams. Rewarding the collaboration as part of career development and progression may also stimulate clinical interest by: . ensuring Healthcare Improvement Scotland activities provide appropriate continuous professional development accreditation, . providing supporting statements for appraisals and . supporting research and publications as part of an ongoing educational resource. Another selling point is access to training that is not offered to them in their current positions, such as quality improvement methods, measurement skills and communication opportunities. There may also be opportunities to engage on a national level and to work with the NHSScotland Quality Improvement Hub to build on capacity and capability in quality improvement. . Measuring our success Positive experiences of working with Healthcare Improvement Scotland will encourage other clinicians to participate in our work and improve the credibility of the organisation. Therefore as part of the activities we undertake, we need to measure how successful we are at clinical engagement. Implementation and impact will be monitored by a measurement plan to ensure we are achieving our aim. The measurement plan will incorporate clinical feedback, clinical ‘customer’ satisfaction, user experience measures and measures for communication and activity. This tool should enable us to review our practices. We also need to keep abreast of best practice elsewhere to help our strategy evolve. . Aiming to build a respectful partnership Successful partnerships are those with mutual benefits where each party feels valued. We aim to create and nurture our relationships with the clinical community and key stakeholders. We also aim to offer opportunities to support research, publication and professional activities for our clinical advisors.
Summary We cannot deliver the objectives of Healthcare Improvement Scotland without clinicians. The clinical community is our source of knowledge, our eyes at the coalface of the NHS and our ears to hear what is important to patients. Healthcare Improvement Scotland sets out to be a champion of clinical engagement; we are committed to involving clinicians and other healthcare professionals to ensure our work addresses the current challenges of the service and provides the best possible care for patients. Declaration of conflicting interests None declared.
Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
References 1. NHS Institute for Innovation and Improvement and Academy of Medical Royal Colleges. Engaging doctors: what can we learn from trusts with high levels of medical engagement? http://www.institute.nhs.uk/newa/ leadership/medical_leadership:_engaging_doctors_-_ learning_from_trusts_with_high_levels_of_engagement. html (2011, accessed 13 March 2012). 2. Institute for Healthcare Improvement. 90-day research and development process, http://qualityimprovement faculty.pbworks.com/f/IHI+90+Day+Research+and+ Development+ProcessApr09.pdf (2009, accessed 13 March 2012). 3. The Health Foundation. Evidence: how do you get clinicians involved in quality improvement? http:// www.health.org.uk/publications/how-do-you-get-clinicians-involved-in-quality-improvement/ (2011, accessed 13 March 2012). 4. Dickson H and Ham C. Engaging doctors in leadership: review of the literature, http://www.birmingham.ac.uk/ Documents/college-social-sciences/social-policy/HSMC/ research/leadership-literature-review.pdf (2008, accessed 13 March 2012). 5. National Leadership and Innovation Agency for Healthcare. Engaging clinicians in a quality agenda, http://www.wales.nhs.uk/sitesplus/documents/829/ EngagingCliniciansinaqualityagendaApril08.pdf (2008, accessed 13 March 2012). 6. Healthcare Improvement Scotland. Improving healthcare together. Clinical engagement strategy 2011-2014, http:// www.healthcareimprovementscotland.org/previous_ resources/policy_and_strategy/clinical_engagement_strategy.aspx (2011, accessed 13 March 2012).
Downloaded from scm.sagepub.com at University of Hawaii at Manoa Library on January 26, 2015
66
Scottish Medical Journal 59(1)
7. Siriwardena AN. Engaging clinicians in quality improvement initiatives: art or science? Qual Prim Care 2009; 17: 303–305. 8. Virginia Mason Institute Web site, http://www.virginiamasoninstitute.org (2014, accessed 8 January 2014).
9. Association of American Medical Colleges: Virginia Mason Medical Center. Applying LEAN methodology to lead quality and transfer healthcare, https://www. aamc.org/download/278946/data/virginiamasoncasestudy. pdf (Accessed 8 January 2014).
Downloaded from scm.sagepub.com at University of Hawaii at Manoa Library on January 26, 2015
Clinical engagement: improving healthcare together
Scottish Medical Journal 2014, Vol. 59(1) 62–66 ! The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0036933013520117 scm.sagepub.com
E Riches1 and B Robson2
Abstract Clinical engagement can achieve lasting change in the delivery of healthcare. In October 2011, Healthcare Improvement Scotland formulated a clinical engagement strategy to ensure that a progressive and sustainable approach to engaging healthcare professionals is firmly embedded in its health improvement and public assurance activities. The strategy was developed using a 90-day process, combining an evidence base of best practice and feedback from semi-structured interviews and focus groups. The strategy aims to create a culture where clinicians view working with Healthcare Improvement Scotland as a worthwhile venture, which offers a number of positive benefits such as training, career development and research opportunities. The strategy works towards developing a respectful partnership between Healthcare Improvement Scotland, the clinical community and key stakeholders whereby clinicians’ contributions are recognised in a non-financial reward system. To do this, the organisation needs a sustainable infrastructure and an efficient, cost-effective approach to clinical engagement. There are a number of obstacles to achieving successful clinical engagement and these must be addressed as key drivers in its implementation. The implementation of the strategy is supported by an action and resource plan, and its impact will be monitored by a measurement plan to ensure the organisation reviews its approaches towards clinical engagement.
Keywords Clinical engagement, healthcare improvement, strategy
Introduction ‘We want to use our knowledge to make real improvements’. Key informant interviewee.
Healthcare Improvement Scotland is a national health body that was set up to improve the quality and safety of healthcare for people across Scotland. The organisation supports healthcare providers in Scotland by delivering evidence-based advice, supporting improvements in healthcare practice, and scrutinising services to provide public assurance about the safety and quality of care. The organisation includes a number of wellknown areas of work. Among these, the Healthcare Environment Inspectorate ensures that Scottish hospitals are safe and clean, the Scottish Intercollegiate Guidelines Network (SIGN) produces clinical guidelines and the Scottish Patient Safety Programme aims to improve the safety of hospital care across Scotland. The organisation also supports the Scottish
Medicines Consortium (SMC) and the Scottish Health Technologies Group, which support the introduction of new medicines and devices in Scotland, respectively. These various parts of Healthcare Improvement Scotland work together to put patients at the heart of their work. Visible, active clinical leadership across the organisation’s strategic strands–evidence, improvement and scrutiny–is central to achieving this purpose. This involves creating, securing and nurturing clinical connections at all levels across NHS Scotland and beyond, ranging from proactive support and dynamic participation, to successful leadership. Such clinical engagement has the potential to achieve lasting 1 2
Healthcare Improvement Scotland, Edinburgh, UK Healthcare Improvement Scotland, Glasgow, UK
Corresponding author: Emma Riches, Healthcare Improvement Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh EH12 9EB, UK. Email: [email protected]
Downloaded from scm.sagepub.com at University of Hawaii at Manoa Library on January 26, 2015
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change in the delivery of healthcare, enhance patient experience and improve treatment outcomes. Clinical communities have a wealth of knowledge in their own field of expertise and an understanding of the strengths and weaknesses of the NHS at frontline level.1 To draw on this knowledge, we need to actively involve clinicians (such as doctors, nurses, pharmacists, community health workers and allied health professionals) in our work on improving healthcare and have meaningful discussions about what makes a difference to patient care. Healthcare Improvement Scotland offers formal and informal opportunities for healthcare professionals to become involved in its work on quality improvement and public assurance. The aim of our clinical engagement strategy is to ensure that a progressive and sustainable approach to engaging healthcare professionals is firmly embedded in all of our activities, from strategic planning to implementation. In this article, we report on how this strategy was developed, highlight its key aims, describe the challenges we face in its delivery and outline priorities for its implementation.
Developing our strategy ‘Healthcare Improvement Scotland needs to define what it aims to achieve through clinical engagement’. Key informant interviewee.
Our clinical engagement strategy (http:// www.healthcareimprovementscotland.org/previous_ resources/policy_and_strategy/clinical_engagement_ strategy.aspx) was developed using a 90-day process based on the ‘innovation method’ used by Proctor and Gamble (which also inspired the 90-day research and development process used within the Institute for Healthcare Improvement).2 This process is designed to stimulate new and innovative thinking when considering challenging issues. During the first 30 days of the process, we searched for evidence of best practice and undertook 28 semistructured interviews of Healthcare Improvement Scotland staff and clinical advisors, Scottish Government colleagues and external clinicians. The second 30-day stage focused on what we learned from this evidence by convening internal and external focus groups to further distil our thinking and give a complete perspective. In the final stage, we drafted a strategy based on our learning, which was supported by an action and resource plan. When we conducted a literature search, much of the evidence identified related to engagement specifically with doctors. It suggested that clinical engagement was consistently considered to have a positive impact on quality improvement and scrutiny. Clinical engagement
is not satisfactory in isolation as other factors are concerned and thus makes clinician involvement difficult to achieve.1,3–5 Some of the key recommendations from the literature to achieve and sustain optimal strategic clinical engagement included: . allocating time and resources to secure clinician commitment, . establishing and maintaining a consistent vision to guide change programmes, . involving top-level leadership, . developing a continuous cycle of engagement which involves communication, refreshing formats and providing feedback to clinicians, . building capability and capacity to prepare for the change process and . developing and encouraging a supportive and receptive organisational culture.4,5 Interview responses also gave us insight into what practices were working well in Healthcare Improvement Scotland and where improvement was needed. The key messages were that there was: . confusion around the organisation’s role and how clinicians can contribute, . a previously unrecognised feeling of discontent among clinicians for a variety of reasons, . no operational definition of clinical engagement and how it is measured or evaluated, . a need to be creative in our approach to clinical engagement and breakdown of existing barriers and . a need for better use of tacit knowledge within the organisation gained through indirect engagement of clinicians. While there was consensus among staff at Healthcare Improvement Scotland that a unified and robust approach to clinical engagement from the outset of work programmes was lacking, there were many examples of projects in which clinical engagement has been successful. High profile examples include the work of SMC and SIGN which are recognised for providing timely and relevant guidance on the use of medicines and clinical best practice. Equally valuable has been the development of the surgical profiles work which engages clinicians in active dialogue about the use of surgical data within NHS boards and how these can guide improvements in patient care. Feedback from internal and external sessions highlighted that the following principles should underpin our approach to clinical engagement: . flexibility in our strategy,
Downloaded from scm.sagepub.com at University of Hawaii at Manoa Library on January 26, 2015
64 . . . . . .
Scottish Medical Journal 59(1) reciprocity of mutual benefits, respect, clarity around commitment, leadership, clear priorities and common purpose and capturing good practice.
Our strategy for clinical engagement ‘How we involve clinicians in our work and how we make that happen’. Healthcare Improvement Scotland Clinical Engagement Strategy.6
By listening to clinicians who have worked with us and based on research, we will create and maintain: . a culture where clinicians view working with Healthcare Improvement Scotland as a necessary, valuable and worthwhile endeavour, . a respectful partnership between Healthcare Improvement Scotland, the clinical community and key stakeholders, . a sustainable infrastructure, . an efficient and cost-effective approach to clinical engagement and . a continual review of our approaches. The strategy supports all the strategic aims of Healthcare Improvement Scotland and is pivotal to shaping and delivering our local delivery plan and work programme.6 It is important that we actively involve clinicians in all stages of planning and delivery of our work programme and maintain a flexible approach that fits different projects.
‘Value-based’ healthcare systems require safety, timeliness, equity, person-centredness, effectiveness and efficiency to be closely aligned in order to deliver a highquality service that achieves excellent outcomes. By protecting dedicated time for clinicians to participate in healthcare improvement activities and rewarding their involvement, it is hoped that financial and management barriers to clinical engagement can be minimised and the ‘value’ to the wider health service be recognised. Practical issues, such as a lack of information and communication systems and adequate support staff for clinicians while working with Healthcare Improvement Scotland, need to be overcome to facilitate clinical involvement in our work. We need to maximise information communication technology support to enable effective communication, clinical involvement and collaboration. The use of teleconferencing, video conferencing and webinars are all means of allowing continued engagement while minimising time away from clinical duties. We have also recently embraced social media. We are putting in place adequate project staff to support involving clinicians in our work so that they are not hindered by administrative activities and processes. Scepticism may stem from pressure from ‘management’, apathy that their involvement is not translated into ‘real’ change to services and patient care or an increase in an already cumbersome workload for little gain. We plan to change these attitudes by demonstrating the benefits of active involvement by working with managers and clinicians to identify and share what works for both managers and clinicians involved in national programmes.
Priorities for implementing our strategy Challenges we face ‘Time is tight and everyone is busy’. Key informant interviewee.
Within busy service delivery environments and a culture of targets, the barriers to clinical engagement are formidable. The burden of workload, scepticism, restrictions on professional autonomy, lack of time and lack of financial incentives are some of the challenges we face in achieving successful clinical engagement.7 It is important to recognise these obstacles and address them as part of the key drivers in our action plan. We recognise that clinicians have limited time outside their core clinical activities and, to avoid further pressure on financial resources in the NHS, we aim to embrace the ‘value-based’ healthcare system concept.
‘There is a lot of passion and commitment but it’s about harnessing all of that and agreeing the direction in going forward’. Key informant interviewee.
. Our compact The improving Healthcare Together Compact is a partnership agreement between Healthcare Improvement Scotland and clinicians who work with us. It is designed to facilitate a clearer understanding about what we can expect from each other, and to ensure meaningful and sustainable relationships with clinical communities. The concept of a ‘compact’ is based on the work of the Virginia Mason Institute where such a tool has been effective in identifying, promoting and supporting clinical engagement in providing high quality care.8,9
Downloaded from scm.sagepub.com at University of Hawaii at Manoa Library on January 26, 2015
Riches and Robson
65
To stimulate clinicians’ enthusiasm for our work, we need to demonstrate that collaborating with us is a valuable endeavour. The working relationship should include a range of positive benefits, such as allowing stakeholder input to shape the business planning and the organisation’s outputs so that we produce advice and guidance that is fit for purpose for their day-to-day practice, and helps patients and healthcare teams. Rewarding the collaboration as part of career development and progression may also stimulate clinical interest by: . ensuring Healthcare Improvement Scotland activities provide appropriate continuous professional development accreditation, . providing supporting statements for appraisals and . supporting research and publications as part of an ongoing educational resource. Another selling point is access to training that is not offered to them in their current positions, such as quality improvement methods, measurement skills and communication opportunities. There may also be opportunities to engage on a national level and to work with the NHSScotland Quality Improvement Hub to build on capacity and capability in quality improvement. . Measuring our success Positive experiences of working with Healthcare Improvement Scotland will encourage other clinicians to participate in our work and improve the credibility of the organisation. Therefore as part of the activities we undertake, we need to measure how successful we are at clinical engagement. Implementation and impact will be monitored by a measurement plan to ensure we are achieving our aim. The measurement plan will incorporate clinical feedback, clinical ‘customer’ satisfaction, user experience measures and measures for communication and activity. This tool should enable us to review our practices. We also need to keep abreast of best practice elsewhere to help our strategy evolve. . Aiming to build a respectful partnership Successful partnerships are those with mutual benefits where each party feels valued. We aim to create and nurture our relationships with the clinical community and key stakeholders. We also aim to offer opportunities to support research, publication and professional activities for our clinical advisors.
Summary We cannot deliver the objectives of Healthcare Improvement Scotland without clinicians. The clinical community is our source of knowledge, our eyes at the coalface of the NHS and our ears to hear what is important to patients. Healthcare Improvement Scotland sets out to be a champion of clinical engagement; we are committed to involving clinicians and other healthcare professionals to ensure our work addresses the current challenges of the service and provides the best possible care for patients. Declaration of conflicting interests None declared.
Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
References 1. NHS Institute for Innovation and Improvement and Academy of Medical Royal Colleges. Engaging doctors: what can we learn from trusts with high levels of medical engagement? http://www.institute.nhs.uk/newa/ leadership/medical_leadership:_engaging_doctors_-_ learning_from_trusts_with_high_levels_of_engagement. html (2011, accessed 13 March 2012). 2. Institute for Healthcare Improvement. 90-day research and development process, http://qualityimprovement faculty.pbworks.com/f/IHI+90+Day+Research+and+ Development+ProcessApr09.pdf (2009, accessed 13 March 2012). 3. The Health Foundation. Evidence: how do you get clinicians involved in quality improvement? http:// www.health.org.uk/publications/how-do-you-get-clinicians-involved-in-quality-improvement/ (2011, accessed 13 March 2012). 4. Dickson H and Ham C. Engaging doctors in leadership: review of the literature, http://www.birmingham.ac.uk/ Documents/college-social-sciences/social-policy/HSMC/ research/leadership-literature-review.pdf (2008, accessed 13 March 2012). 5. National Leadership and Innovation Agency for Healthcare. Engaging clinicians in a quality agenda, http://www.wales.nhs.uk/sitesplus/documents/829/ EngagingCliniciansinaqualityagendaApril08.pdf (2008, accessed 13 March 2012). 6. Healthcare Improvement Scotland. Improving healthcare together. Clinical engagement strategy 2011-2014, http:// www.healthcareimprovementscotland.org/previous_ resources/policy_and_strategy/clinical_engagement_strategy.aspx (2011, accessed 13 March 2012).
Downloaded from scm.sagepub.com at University of Hawaii at Manoa Library on January 26, 2015
66
Scottish Medical Journal 59(1)
7. Siriwardena AN. Engaging clinicians in quality improvement initiatives: art or science? Qual Prim Care 2009; 17: 303–305. 8. Virginia Mason Institute Web site, http://www.virginiamasoninstitute.org (2014, accessed 8 January 2014).
9. Association of American Medical Colleges: Virginia Mason Medical Center. Applying LEAN methodology to lead quality and transfer healthcare, https://www. aamc.org/download/278946/data/virginiamasoncasestudy. pdf (Accessed 8 January 2014).
Downloaded from scm.sagepub.com at University of Hawaii at Manoa Library on January 26, 2015
