Editorial

Citation

Downey-Ennis, K. (2007), "Editorial", International Journal of Health Care Quality Assurance, Vol. 20 No. 2. https://doi.org/10.1108/ijhcqa.2007.06220baa.001

Editorial

Perusing the articles published in 2006 in this journal there is evidence that there are many innovative initiatives taking place in healthcare from both an academic and practice perspective. Topics such as Six Sigma, Appreciate Inquiry, Business Process Re-engineering (BPR), and Sharing Best Practice many originating in non-health sectors require a substantial amount of innovation to first adapt and second deploy these practices within healthcare to achieve quality improvement. In this issue the same innovation exists. Safety is well represented with a paper by Walsh and Antony presenting the challenges and gaps in using an electronic adverse incident recording and reporting system in an acute health care setting with Björkman, Schmidt, Holmström and Bernsten suggesting that the role of drugs and therapeutics chairs is an important factor in the overall pursuit of patient safety. O’Reilly and Schröder, Larsson and Ahlström expand and develop methodologies to involve patients and services users to assist organisations to both define and evaluate quality services in two diverse industries with an external quality assurance system described by Chalermchan in their effort to standardise HIV testing.

Berwick (1998) suggested that:

… improvement begins with the belief that improvement is possible, however the toughest, most fundamental, most frustrating barrier to improvement – the square at which we seem most often to get stuck – is the barrier we carry within: the barrier of the mind.

Attempting to overcome this will require practitioners to be innovative, however, (Plesk, 1999) argues that many erroneously believe that innovative thinking is a special gift or that it requires an air of light heartedness, which may appear inappropriate in a health care setting. Nevertheless, innovation is, sometimes, a difficult concept to understand and implement. Methods used in cognitive sciences have in the past helped people generate innovative ideas and these methods do not require any special gift plus they can be practiced in a serious way. The tools of idea generation according to (Plesk, 1999) are based on three principles – mental attention, escape, and movement – all three provide a powerful, scientifically based construct to guide idea generation. Activities that help people pay attention to their current situations in a different way, escape their current mental patterns about the situation, and maintain movement in their thoughts support efforts to generate innovative, testable ideas for health system improvements. The capacity for innovative thinking is common and a little bit of mental direction is often all that is needed.

Fostering cooperation is a further method to ensure that where innovation is present that improvement will accrue. Five scientifically grounded methods to foster cooperation have been put forward:

1. 1.

   develop a shared purpose;

2. 2.

   create an open, safe environment;

3. 3.

   include all those who share the common purpose and encourage diverse viewpoints;

4. 4.

   learn how to negotiate agreement; and

5. 5.

   insist on fairness and equity in applying rules.

These methods suggest that putting people first is an essential element of achieving improvement and innovation in healthcare. Indeed one of the elements of a learning culture is the recognition that frontline workers have the best grasp of operational processes and their inherent flaws. A key managerial skill therefore is to tap into this knowledge and make it work for the organisation. Thus the importance that leaders continue to create an unwavering vision and strategic direction for the organisation, generate processes and work systems that actively support that strategic direction, actively listen to staff who put forward good ideas, support calculated risk taking, encourage small scale changes and model experiential learning themselves. Additionally when the healthcare sector begins to open up thinking to receive “fresh knowledge” from frontline staff, its customers and other major stakeholders we can all look forward to fundamental changes. The vision for our organisations must be that they become the direct opposite of bureaucracies by which they are so often labelled to organisations which, are decentralised, team based, where open communication is encouraged, where collaboration replaces hierarchy and the predominant values are those of openness and trust then it is reasonable to expect an innovation explosion.

Kay Downey-EnnisCo-Editor