Kidney Thinking. The blog from Think Kidneys

By Katie Fielding, Professional Development Advisor – Haemodialysis, Derby Teaching Hospitals NHS Foundation Trust.
In January 2016 I received a call inviting me to chair the Measurement and Understanding workstream for KQuIP. As a haemodialysis nurse, it was unexpected. I accepted the role with mixed feelings of excitement and apprehension, having limited experience of chairing groups. At this stage KQuIP was starting to evolve, but was still working to clarify exactly what it is and its aims.
I’ve always been keen to measure the impact of changes I’ve made in clinical practice, through small, local projects. This ensures what you implement either truly has the benefits you had aimed for, or if it does not, it means that you can make adjustments to ensure it meets its aims. Without measuring the impact of quality improvement, you don’t really know if it has made things better for both patients and clinical practice. Evidence of the impact of your intervention also supports further dissemination, another passion of mine. Ensuring beneficial practices are shared and inspire others, can only lead to good quality healthcare across the UK and a reduction in variation in outcomes. Becoming chair of the workstream would mean that I would be able to influence this at a national level rather than just locally, and so it was an offer I couldn’t refuse.
Initial plans involved clarifying what KQuIP was going to become and establishing the workstream. My involvement in multi-professional projects in my own unit, with direct experience of the benefits of this approach, gave me a strong desire to ensure the workstream had representation from different healthcare professions. Each member has unique skills and knowledge to offer to the measurement of quality improvement. To make quality improvement meaningful and cohesive to the patient, it requires a rounded approach, with contributions from the spectrum of healthcare professionals. With this aim in mind, I continue to be encouraged by the support and enthusiasm from the individuals representing this multi-professional approach within the workstream and their appreciation of individual contributions.
One project we have initiated is to develop the measurement section of the KQuIP Hub, using this multi-professional approach. The aim of this is to encourage development of a rounded measurement strategy for a QI project, providing information and access to resources and tools. This can then be accessed by those planning a local QI project to inspire them to identify measures appropriate to their project, but not limited by their own individual professional knowledge. QI should eventually have a beneficial impact on patient care, rather than fulfilling individual and professional agendas. To ensure we achieve this aim, we have an enthusiastic patient representative who is actively contributing to the development of the repository. Her perspective and thoughts are unique and keep the workstream focussed on what is truly important.
Within the measurement section of the KQuIP Hub, we are also looking at how the UK Renal Registry dataset can be used to support quality improvement locally, regionally and nationally. I am looking forward to finding out how this project develops. The contribution from our UK Renal Registry colleagues within the workstream is invaluable and connecting this with various healthcare professionals’ who are current in clinical practice is leading to an exciting project.
Our final project is supporting the regional days, led by the networks workstream. Since chairing the measurement workstream, the interest in the measurement aspect of quality improvement and KQuIP has at times been overwhelming. However it has been very positive to discover the enthusiasm that we have within the renal community to develop measurement of quality improvement into an established element. This enthusiasm has allowed me to identify that educating healthcare professionals in the measurement of quality improvement is an essential element of what KQuIP can offer, with a real need within the renal community. I’m looking forward to the first KQUIP regional day in March 2017, at which the measurement workstream will have a significant part to play.
Reflecting on the last 10 months of chairing the workstream, and I truly can’t believe it’s only been 10 months, there has been much that has changed and developed within KQuIP. It is exciting, motivating and surprising to see what KQuIP is becoming. For many, KQuIP is about the national and regional projects. For myself, who has developed in the haemodialysis setting from a junior to a senior nurse and experienced all the struggles of learning how to develop my own quality improvement projects, the real motivating factor is encouraging, inspiring and facilitating quality improvement at a local level. To be able to have an impact on individuals to encourage them to go on and make small changes will be what really improves patient care, patient outcomes and the patient experience. For me, that is what KQuIP is about. Others may have differing opinions and inspiration, but the beauty of KQuIP is that there is a breadth of opportunity to ensure it is relevant to the whole renal community.