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Improving Improvement

A toolkit for Engineering Better Care


How to use this toolkit

Engineers routinely use a systems approach to address challenging problems in complex projects. This allows them to work through the implications of each change or decision they make for the project as a whole. They consider the layout of the system, defining all the elements and interconnections, to ensure that the whole system performs as required.

The Engineering Better Care report was co-produced with engineers, clinicians, and healthcare leaders to explore how an engineering approach could be applied in health and social care to develop systems that meet the needs of patients, carers and NHS staff. It presents a novel framework to support ongoing work in service design and improvement in health and care.

The Engineering Better Care report forms the basis of this toolkit, which contains 4 sections:

  1. Improving Improvement - An introduction to the toolkit, with reference to existing improvement approaches, to highlight tools and resources that could further improve their use. This section will appeal to those with experience of improvement who are interested in developing their skills further.
  2. Improvement Questions - A summary of the systems approach described in the Engineering Better Care report, to facilitate its use in existing improvement projects and approaches. This section will appeal to those with no formal background in improvement, but who have a desire to deliver change in their organisations.
  3. Improvement Process - A detailed description of an improvement process based on the systems approach, to enable the delivery on systems that are measurably better. This section will appeal to those with experience of improvement who are not constrained in their thinking to the existing approaches.
  4. Improvement Resources - A selection of tools and resources useful in delivering a systems approach, to enhance any improvement approach. This section should appeal to all readers, whatever their level of experience or skill in improvement.

Sections of this guide and the accompanying tools may be particularly helpful to different readers:

  1. Experienced improvers who wish to continue to use their existing improvement approaches should read the Improving Improvement section and, in particular the sections relevant to their current approaches. They should also find the Improvement Resources section useful.
  2. Novice or experienced improvers who wish to investigate a system-based improvement approach should read the Improving Improvement, Improvement Questions and Improvement Process sections. They will also benefit from exploring the Improvement Resources section.

The diagram shows the questions, activities and tools contained within this toolkit. In later sections they are also mapped to the IHI Model for Improvement, Lean Thinking, and Six Sigma models. The colours of the circles reference those used later to identify the strands of the improvement process, namely: Understand the Context, Define the Problem, Develop the Solution, Collect the Evidence, Make the Case, Manage the Plan and Agree the Scope. The strands are all described within the Improvement Process section.

The questions, activities and tools are described under their respective tabs at the top of this page.


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