Improving Patient Care (QI)

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In this episode I am joined by my friends and colleagues, Stacey Davidson and Ru Clements of VetLed, to discuss the role of Quality Improvement (QI) in improving patient care. We discuss what QI is and why you should be engaged with it. We also talk about the role of human factors and workplace culture in QI.

VetLed website
VetLed Facebook page
Veterinary Human Factors private Facebook group started by VetLed

Some terms used in the episode:

Quality Improvement:

A number of definitions describe quality improvement as a formal approach that uses specific techniques to improve quality. The RCVS definition is ‘supporting effective, patient and client-centred treatment by implementing systematic, measurable approaches to advance high-quality care’

Clinical Governance:

Essentially a framework through which organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in care will improve. The RCVS definition is ‘a continuing process of reflection, analysis and improvement in professional practice for the benefit of the animal patient and the client owner’.

Clinical Audit:

The systematic critical analysis of the quality of veterinary care, including the procedures used for diagnosis and treatment, the use of resources and the resulting outcome and quality of life for the patient. This is considered a major component of clinical governance and QI.

Human Factors:

This has become a common way of referring to Human Performance in the working environment. It is scientific knowledge about the human body, mind and behaviour, specifically to understand human capabilities and limitations so that there is the best possible fit between people and the systems in which they operate.

In healthcare, clinical human factors have been described as enhancing clinical performance through an understanding of the effects of elements such as teamwork, tasks, equipment, workspace, culture and organisation on human behaviour and abilities, and application of that knowledge in clinical settings.

Non-technical skills:

Social, cognitive and personal elements of behaviour which combined with role-specific (technical) skills contribute towards successful outcomes. Examples include identifying and communicating anticipated complications prior to a procedure and awareness of cognitive bias’ during decision making.

Workplace culture:

The character and personality of your organisation. It's what makes your workplace unique and is the sum of its values, traditions, beliefs, interactions, behaviours, and attitudes. It is the unique social and psychological environment. Put simply it's measured by 'the way people do things' in any given environment and has a huge influence on the way people in that environment are likely to do things subsequently.


Crew Resource Management is the name given to the field of human factors within aviation. It is commonly defined as the effective utilisation of all available resources (people, equipment, checklists, procedures etc.) to achieve a safe and efficient operation and passenger well-being.

Blame culture:

A culture where blame is apportioned to individuals based primarily on the severity of outcome without a willingness to understand underlying causational factors.

Growth vs. fixed mindset:

A growth mindset is a fundamental belief that you can grow, learn and change for the better – through failure and success alike. This mindset motivates you to try, to reflect, to get back up, to ask for help and to learn. 

A fixed mindset is seated in the opposite and is a belief that your qualities are not able to develop or change. It assumes that our character, intelligence, ability, talent and so on are static and that we are unable to change them in any meaningful way.

[This podcast is closely aligned with the MedEdLIFE Research Collaborative's Quality Checklist for Podcasts.]

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