Improving Quality in Healthcare

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.

Chapter 1: Context Chapter 2: The History of Quality in Healthcare Chapter 3: Cultures of Quality Chapter 4: Understanding Variation - Tensions and Dilemmas Chapter 5: Demand, Capacity and Utilisation Chapter 6: Understanding Failure Demand Chapter 7: Principles to Avoid Failure Demand Chapter 8: Defragmenting to Integrate Chapter 9: Understanding the Specialist, Generalist and Citizen Muddle Chapter 10: Supporting the Human System of Work Chapter 11: Understanding Need Chapter 12: Conclusion

True to form Murray & Nick invite a critical re-examination of the dominant approaches used in a great deal of improvement work in healthcare. Based on their extensive experience of working in the field over the last 25 years, they argue that many of the current approaches fail to take proper account of organisational and patient context; invite reductionism and the atomisation of complex issues, and ultimately create only an illusion of progress. They promote the use of a framework to "questioning the work", and discuss four interconnected domains to help guide inquiry. I was particularly drawn towards the chapters on "Cultures of Quality" and "Supporting the Human System at Work" in which they discuss a wide range of issues that impact on safety. They cite a lot of the great work done by Prof Mary Dixon-Woods (often referred to in this newsletter) and the Harmed Patient Alliance work on "compounded harm". Although the book is unashamedly an academic text, it's also pretty accessible, and offers a thoughtful analysis of how to understand some complex issues with case study examples to illustrate their points. -- James Titcome OBE * email * Of course, no one book could cover the hugely complex issues of healthcare. However, Anderson-Wallace and Downham make a valuable contribution and bring insights into areas where they are much needed. These insights cover both 'hard' and 'soft' aspects. The 'hard' aspects include the vital topics of demand and capacity. The 'soft' aspects include new insights into what the authors call 'avoiding the specialist, generalist and citizen muddle'. Many healthcare professionals - practitioners and administrators - will gain from reading this book. -- John Bicheno * email * Do not be deceived by the modest cover and title, this book is overflowing with original ideas highly relevant to current primary and secondary care. The authors take you on a journey from what has happened so far to develop and improve care, to a compelling vision for the future. I've been working as Primary Care network Clinical Director for 5 years now, and have been a GP partner for 19 years. This book absolutely resonates with the direction I think we need to go. It offers evidence and tools, grounded both in research and their considerable shared experience of leading system change. It is challenging but pragmatic, and it demonstrates what is possible. It has filled me with confidence and optimism for future enhanced approach to supporting community-based care. Everyone who cares about care, and the future of healthcare needs to read this book, and engage in the debate and action that they invite. -- Dr Ollie Hart * email * Drawing from diverse sources of evidence, this book offers a comprehensive overview of critical issues in healthcare quality improvement. It covers topics such as quality cultures, demand drivers, and the concept of failure demand. Importantly, the book also explores how the social determinants of health influence individuals' health and healthcare needs. The authors have effectively tackled a complex subject, presenting it in a clear and thorough manner that encourages readers to re-examine their assumptions about healthcare. This approach provides valuable insights for improving the quality of healthcare services, especially in these challenging times. -- Dr Ana Llamas, Public Health Consultant * Email *