York Trials Unit (YTU) is working with Northumbria Healthcare NHS Trust to assess the effectiveness and cost effectiveness of the Institute for Health Improvement (IHI) Breakthrough Series Collaborative model for introducing service improvements at scale in the NHS, specifically for improving outcomes in patients undergoing elective total hip and knee replacements.
An IHI Breakthrough Series Collaborative is a short-term (6- to 15-month) learning system that brings together a large number of teams from hospitals or clinics to seek improvement in a focused topic area. Each team typically sends three of its members to attend Learning Sessions, with additional members working on improvements in the local organisation. The Learning sessions are facilitated by experts in the topic area of interest and individuals trained in the methodology.
Implementing service improvements that have been show to work remains a challenge for the NHS. Screening pre-operatively for MSSA and providing patients with a decolonisation pack where necessary and identifying and treating anaemia pre-operatively are two such service improvements. Both have been shown to improve patient outcomes and to save costs but neither is included in routine practice across the NHS. There is a need to identify effective mechanisms for introducing change at scale in healthcare.
QIST is a cluster randomised controlled trial. Twenty NHS Trusts taking part in the study will be randomised to receive training and support in how to introduce the MSSA quality improvement initiative in their own Trust. A further 20 Trusts will be allocated to training for the anaemia quality improvement initiative. The groups of Trusts will act as controls for each other and at the end of the trial will be given the option of training in the alternative initiative. The trial will use quantitative and qualitative methods to examine the process of implementing the protocols in each Trust and assess the cost effectiveness.
|Start date:||1st September 2017|
|End date:||31st July 2020|