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Quality impact assessment (QIA) was instigated by the National Quality Board in 2010 as a way of ensuring high patient care standards during the large-scale National Health Service (NHS) restructuring process and the accompanying cost reductions required by national Government. QIA is used as part of the decision making process for cost improvement programmes (CIPs), in addition to the standard business case presented with proposed CIPs.
A tool to facilitate the QIA process was designed by Simon Polak, Head of Nursing and Quality at Northern, Eastern and Western Devon Clinical Commissioning Group (NEW Devon CCG). The Quality Equality Impact Assessment (QEIA) tool uses subjective evidence-informed scoring of a CIPs impact on patient safety, treatment quality and patient experience to produce an overall score of a CIPs's potential impact on the quality of care.
PenCHORD was approached to produce a report assessing the QEIA tool in terms of validity, usefulness and appropriateness. Subsequently, there has been interest from NICE and other NHS England organisations in the QEIA tool. The initial QEIA tool appraisal project formed the basis for a second project that sought to further develop the QEIA tool and study the role of quality impact assessment in the context of NHS systems and processes.
Stage One – Initial QEIA tool appraisal project
To review the QEIA tool and suggest changes to improve the validity, appropriateness of measurement and usability of the tool and develop future directions for research and use of the QEIA tool.
Stage Two – Scoping project for research into quality impact assessment and further development of the QEIA tool
Building on the changes to the QEIA tool and the further research ideas proposed in the stage one project report, the objectives of stage two were:
The stage one project is complete and a report of the QEIA tool appraisal findings has been produced. The findings of this report informed an immediate revision of the QEIA tool.
Stage two of the project is also now complete and involved carrying out a review of the literature around quality impact assessment in healthcare and other contexts. Measurement mechanism, scales and matrices for this were sought and compared. The distinction between quality, risk and safety was also examined. The literature review incorporated optimisation of web/mobile application principles and any literature specific to their use in healthcare.
From the findings of the literature review and the stage one project report several research studies will be designed with the overarching aim of investigating stakeholders use and understanding of quality impact assessment in healthcare.