Lack of ‘quality agenda’ at HSE Directorate meetings

The words ‘quality’ and ‘safety’ are not prominent at meetings of the HSE Directorate, which is the Executive’s top level of management and governance, heard a high-level internal workshop.

The workshop, held to develop a “better quality agenda” for the Directorate, also heard that the HSE focused “too much on looking ‘in the rear-view mirror’”, according to the then interim Director General Mr John Connaghan.

At the workshop, Mr Connaghan said he welcomed the opportunity “to look at [a] more sophisticated and comprehensive view of quality of care provided, including aiming towards prediction of how good HSE care will be in the future”.

The comments are published in the Directorate Quality Agenda Workshop Report, prepared by the Quality Improvement Division (QID) in November. According to the document, the Directorate approached the QID to assess what information and means of interpretation provided the best picture and understanding about the quality of care throughout the organisation.

Dr Philip Crowley, National Director of the QID, used a ‘word cloud’ of Directorate minutes to illustrate the fact that “quality and safety are currently not a prominent feature of Directorate meetings, and that this marks a significant point in increasing the focus on quality and its improvement”, according to the report. “He particularly emphasised that to support ‘the system’ to sign up, leadership support is key.”

In pre-workshop interviews, Directorate members stated the importance of including patient and staff experiences of quality at its meetings. “Patient and staff perspectives were considered important to provide a full picture of how quality, or failures of quality, are experienced by those who use our services and by our frontline staff,” outlined the report. “International best practice confirms the inclusion of person-centred patient and staff experience during meetings by exemplar boards such as Salford, the Scottish Ambulance Service and Oxford.”

Actions from the workshop included that the Directorate would test and evaluate a Directorate Quality Profile.