Breaking barriers to quality improvement: major study outlines roadmap

A large-scale study led by RCVS Knowledge and carried out by RAND Europe has for the first time shed light on the current position of quality improvement (QI) within the veterinary professions, and culminated in a six-point roadmap to industry advancement.

Among the top-level findings was that although 96% of respondents agreed that QI improves veterinary care, a lack of time, know-how and organisational support – among other barriers – are preventing professionals from engaging with quality improvement. 60% were able to spend no more than three days on quality improvement activity in the previous year, while 11% spent no time at all on QI. As such, there is a significant discrepancy between what veterinary teams believe they should be doing and what they are actually able to do in practice.

Continuous quality improvement: a roadmap for the veterinary professions, a 16-page summary of the full report, outlines an image of the future in which QI is fully embraced by the sector. In a future that places increased value on continuous improvement, the research suggests:

• Outcomes would be measured sector-wide, helping to identify what works well, and what does not, with the overall aim of raising the standards of care.
• There would be fewer unwarranted variations in treatment, thanks to guidelines based on the best available evidence.
• Teams would work together more closely and unite in a reflective learning culture: discussing areas for improvement with openness and understanding rather than discipline and blame.
• Teams would have a ‘safe haven’ in this competitive environment for sharing and anonymising data acquired through benchmarking, auditing and rapid learning cycles.
• Organisations would have the opportunity to improve value, by reducing poor patient outcomes and wasted resources.
• Clients would be reassured that their practice measures the quality of care for their animals.

The research suggests achieving these aims will require evolution – rather than a revolution – of the professions, given the activity in these areas that is already taking place in some quarters of the veterinary industry.

Chris Gush, Executive Director of RCVS Knowledge, said:

“We are proud to reveal this research today, which provides a clear picture for the first time of the use of quality improvement in the veterinary sector.

“The resounding agreement from colleagues across the professions that quality improvement enhances veterinary care confirms that the time is now to embrace the opportunities QI presents for safer, more efficient and improved outcomes for patients – aims that we know drive veterinary professionals in their work every day.

“We acknowledge this will require leadership support and great commitment. Our six-point roadmap is designed to make the process of fully embracing a culture of improvement as collaborative and time-efficient as possible – and through our ever-growing suite of resources, we are committed to supporting our colleagues at practice-level as they continue or embark on their QI journey.”

Pam Mosedale, Chair of the RCVS Knowledge Quality Improvement Advisory Board, said:

“I would like to thank everyone who contributed to this valuable research, especially the hundreds of veterinary team members who shared their insights with us.

“For me, a key takeaway from the findings is that we are all striving to do our best in a high-pressure environment, and it is incumbent upon every single one of us to find new ways to support each other to do this.  

“Quality improvement is one such way we can help ourselves and our colleagues to perform consistently at our best, which is why RCVS Knowledge will continue to encourage the whole sector to get more engaged with QI.”

The study’s findings and recommendations are based on views from across the breadth of the professions, gathered during the course of 2019. A national survey, focus groups, interviews with animal caregivers and an in-depth literature review gave the research team substantial insight into the state of play of veterinary quality improvement, complemented by last May’s ‘National Summit for Supporting Quality Improvement in Veterinary Care’, which attracted more than 50 industry leaders.

“The RAND Europe team has been impressed by the commitment of the veterinary sector to embed good quality improvement practices into their work with the aim of achieving better outcomes for animals and wider public benefits,” said Head of Evaluation Tom Ling.

“Our study demonstrates the high level of enthusiasm for this. We also found that while there are things that can be learned from elsewhere – the NHS in particular – increasing use of quality improvement in the veterinary world will need to be tailored to the particular challenges and opportunities facing vets. These include new technologies, professional development, changing public expectations, and evolving business models.

“The future is always uncertain but I am sure that the veterinary sector is well placed to implement a coherent and sustainable strategy that will see quality improvement processes steadily create even better services for animals and their owners. Our report, commissioned by RCVS Knowledge, should help in this important task.”

The research brief and the full report, Assessing the landscape and future actions for quality improvement in the veterinary sector – the insights, expectations and aspirations of the profession, can be downloaded from our dedicated webpage.