In healthcare, the pursuit of quality improvement (QI) is not just a strategic decision but a critical component of patient care. Yet, as many professionals know, without the buy-in from top management, implementing and succeeding in QI initiatives can be challenging. At the heart of driving these improvements is a structured, open dialogue between healthcare providers and decision-makers, ensuring that quality initiatives align with organisational goals. This was the key focus of our recent webinar, “How to Get Buy-In for Quality Improvement Initiatives” organised by the ACQUIRE Community of Practice – Training Curriculum Working Group, held on 17th October 2024.
Here’s a summary of the key takeaways from this insightful discussion.
1. The Importance of Leadership in QI Initiatives
Without approval or sponsorship from top management, quality improvement efforts are unlikely to thrive. Dr. Nicholas Okumu, MD, MMed, MBA, Consultant Orthopaedic Surgeon and one of our expert panellists during the webinar, emphasised the importance of ethical leadership in driving QI initiatives. Quoting Stefan Klemmer, he noted that “A CEO’s most critical skill is ethical decision-making.” Ethical leadership ensures that decisions ultimately benefit both patients and the healthcare system. Leadership buy-in is crucial for aligning QI efforts with the organisation’s strategic objectives, from improving patient care to enhancing overall health outcomes.
2. Overcoming Cost Perceptions: The Case for Quality
A common challenge in getting leadership buy-in is the perception that QI initiatives are costly. Don Berwick’s research, as discussed in the webinar, illustrates that improving quality reduces healthcare costs in the long run. The Triple Aim approach – better care, improved health outcomes, and lower costs – can only be achieved through a relentless focus on prevention and the elimination of waste. When quality improves, outcomes improve, and costs drop.
3. Total Quality Management: Building a Sustainable QI Process
To achieve better care, improved health outcomes, and lower costs, organisations must adopt a Total Quality Management (TQM) approach. This involves:
- A customer focus – prioritising patient satisfaction at every stage.
- Building quality into every process rather than relying on one-off interventions.
- Employee improvement – ensuring that everyone contributes to the organisation’s quality outcomes.
- Being process-centred, where efficiency drives quality.
- Using data-driven methods to inform decisions, enabling leadership to make evidence-based adjustments.
4. Leadership and Communication: A Two-Way Street
For QI to succeed, there must be an environment of open communication between leadership, healthcare providers, and all employees. Dr. Salima Kanji, Quality Manager at Aga Khan University Hospital and one of our expert panellists during the webinar, highlighted the importance of understanding the different leadership dynamics within healthcare facilities. Clear communication across all levels of leadership – from governance boards to CEOs and operational staff – ensures that QI initiatives are prioritised. Additionally, feedback from all levels of staff provides a well-rounded perspective that enhances decision-making.
As one participant put it: “Leadership needs information to make good decisions.” Communication in QI is not just about structured reports and performance contracts but also informal discussions during leadership rounds or team meetings. These conversations create a culture where everyone feels empowered to contribute to QI efforts.
Bernard Omondi, the webinar’s moderator, aptly summarised: “Effective communication across all levels of leadership is vital for the success of quality improvement initiatives. Gathering feedback from every tier of the organisation allows input from all stakeholders, fostering collaboration and ultimately leading to more impactful and sustainable quality improvement projects.“
5. Accountability and Alignment with Organisational Goals
Leadership oversight is essential in the planning, implementation, and monitoring phases of QI programs. To gain management approval, QI initiatives must align with the organisation’s mission, vision, goals, and strategic plans. This includes considering factors such as budget, staffing, policies, and alignment with regulatory bodies. A well-aligned QI initiative not only improves patient outcomes but also enhances the organisation’s reputation with accrediting bodies and government agencies.
6. Humanising the Data: The Power of Storytelling in QI
One of the most profound insights from the webinar was the importance of humanising stories behind the data. Numbers tell only part of the story – it is the human experiences that resonate most with leadership. As one attendee noted, when QI stories are humanised, they create an emotional connection that can drive decision-makers to support initiatives. This can be especially powerful when illustrating how QI impacts patients, staff, and the overall healthcare system.
7. Case Studies: Learning from Best Practices
Throughout the webinar, examples from best-practice hospitals were shared, showing how QI initiatives can drive measurable improvements. From behaviour change initiatives that reduce human error to focusing on continuous improvement rather than quick fixes, the lessons learned from these case studies offer a roadmap for successful QI implementation.
Parting Shot
Achieving buy-in from top management for QI initiatives requires a combination of ethical leadership, cost-effective strategies, continuous improvement, and open communication. Leaders must be equipped with the right information and see the human impact behind the data to make informed, empathetic decisions that benefit both patients and the healthcare organisation. By aligning QI initiatives with organisational goals and communicating effectively, healthcare providers can ensure that quality becomes a cornerstone of their institution’s success.
Source: A webinar discussion by the ACQUIRE Community of Practice – Training Curriculum Working Group on ‘How to Get Buy-In for Quality Improvement Initiatives’ held on 17th October 2024.
Team of Experts
- Dr. Nicholas Okumu, MD, MMed, MBA, Consultant Orthopaedic Surgeon
Dr. Nicholas Okumu is an orthopaedic surgeon and a dynamic leader in the healthcare sector in Kenya. He has served as the Head of the Department of Orthopaedics at Kenyatta National hospital and currently leads the Orthopaedic Oncology Unit at the same institution. He is an honorary lecturer in the department of surgery at the University of Nairobi. In addition, Dr. Okumu is also the CEO of Stratus Medical, a medical imaging and healthcare solutions provider in Nairobi, Kenya. His main areas of research currently focuses on the confluence of Artificial Intelligence and Healthcare where he is currently working on AI tools that solve diverse problems such as the production of prosthetics, diagnostics and even development of precision medicine tools for low resourced communities such as Kibera, the largest slum area in Africa.
- Dr. Salima Kanji, Quality Manager
Dr. Salima Kanji is a distinguished quality manager at the Aga Khan University Hospital in Nairobi. She excels in elevating healthcare standards and patient safety. With a solid foundation in medicine and public health including a Bachelor of Medicine, Bachelor of Surgery and Masters in Public Health, Dr. Kanji combines clinical insight with a comprehensive understanding of healthcare systems. Her expertise is further enhanced by certification in healthcare management. Currently, Dr. Kanji is pursuing a fellowship with the international society for quality in healthcare reflecting her commitment to global standards in healthcare quality.
