Quality Improvement (QI) helps us identify what works well and where we can make changes. In primary care, we don't have time or resources to spend on things that don't work, don't serve our patients, and that could be done more efficiently or effectively. QI is a commitment to continuously improving the quality of healthcare, focusing on the preferences and needs of the people who use services. (Royal College of General Practitioners 2017)

“In order to practise medicine in the 21st century, a core understanding of quality improvement is as important as our understanding of anatomy, physiology and biochemistry. (Stephen Powis, Medical Director, Royal Free London NHS Foundation Trust, 2015. Academy of Medical Royal Colleges)

Driver Diagrams

When dealing with complex change it is often difficult to differentiate between cause and effect and to be able to attribute a particular outcome to one particular change you have made. Driver diagrams can be used to show your theories of cause and effect in your system – in other words, your theories about what changes will likely cause the desired effects. It is helpful to create driver diagrams during the initial planning stages of your change programme, but they should also be used throughout your change programme. Regular review of your driver diagrams will allow you to update them as you refine your theory of change in your system and learn more about the cause and effect relationships that are in play.

Further information from NHSE - Driver Diagrams

You can also download and print this template to complete your own Driver Diagram. Wessex AHRN have also put together an example template.

Plan Do Study Act (PDSA)

Wessex AHRN have produced a simple slide deck showcasing the Plan Do Study Act (PDSA) methodology, along with a checklist of items to consider. The slide deck also includes information around Root Cause Analysis (RCA) using 'Fishbone' and 'The 5 Whys' methods.

In addition you can print out this summary check list to 'tick off' elements as they are considered and completed, and download and tailor this project plan template to help you manage your FeNO planning.

Action Learning Sets (ALSs)

It can be really helpful to plan projects as a mixed group. Inviting your key stakeholders and contributors along to develop and structure your project. To assist you Wessex AHSN have developed this Action Learning Set Template which has been designed to take you through from project initiation through to planning, implementation and evaluation.

Clinical Coding - SNOMED CT codes

Wessex AHSN have engaged with NHS Digital to explore currently available SNOMED CT codes for FeNO - Download suggested codes