Closing quality and safety gaps through Clinical Communities

To improve quality of care, patient safety systems are needed for sharing knowledge and coordinating and organising activity.

To do this, the Health Foundation funded the Closing the Gap through Clinical Communities programme. We were commissioned to complete an evaluation alongside it.

This involved three detailed case studies. We developed eight key lessons on how to use the Clinical Community approach effectively in practice. Important insights were also created around the types of quality problems the approach could and could not be used to address.

The Clinical Communities model has been used as a basis for improving key indicators of the quality of care at Johns Hopkins Hospital and Health System in the US.

It has also been adopted by other healthcare systems such as NHS Quest, an alliance of NHS provider organisations that seek to be at the forefront of improving quality and safety. NHS Quest provides facilitation and support to clinical communities to tackle specific problems, such as improving theatre safety and medication safety. The Reducing Falls Clinical Community, supported by NHS Quest, resulted in a sustained reduction in patient falls with harm of more than 50%.

Relevant publications

• Optimising the community-based approach to healthcare improvement: Comparative case studies of the clinical community model in practice.
• Professionalism redundant, reshaped, or reinvigorated? Realizing the ‘third logic’ in contemporary health care.
• Quality improvement through clinical communities: eight lessons for practice.