Establishing a culture of improvement in a Scottish hospice

The Scottish Government’s 2020 Vision for healthcare in Scotland is to provide safe, high quality care, whatever the setting. National quality improvement programmes have been developed to deliver these ambitions, resulting in an upwelling of improvement activity across NHS Scotland.

However, the spread of improvement methodologies through the Scottish hospice sector has been considerably less dramatic. Indeed, there appears to be relatively little uptake of improvement as a specific model for achieving quality and effectiveness, in spite of its adoption elsewhere.

Ardgowan Hospice has committed itself to utilising the model of improvement in order to continuously address the safety, effectiveness and person-centredness of its services. A Continuous Improvement Team was created to facilitate improvement projects, in conjunction with the creation of two new posts within the organisation to support data management and improvement activity. Key areas identified for improvement were referral pathways into the hospice, and referral-to-bed times. This is a joint project with the University of West of Scotland. Internal improvement projects are establishing and embedding the ‘what matters to you’ model; a quality of sleep study and the introduction of outcome measures, including the Integrated Palliative Outcome Scale (iPOS) and carers assessment tool.