Thursday 22 May 2025 | 11:00-12:15

Format: Presentation

Stream: Science

Content filters: Recommended for those new to quality improvement

PART ONE: Time-series designs and counterfactuals: unravelling what works to improve C-section delivery in Bihar, India

While many efforts are underway to curtail the excessive and un-indicated use of C-section in emerging and high-income economies, this case study presents evidence of an interventional success addressing the difficult task of increasing access and quality of C-section for women in limited resource settings. This project in Bihar, India sought to increase Caesarean Section (C-section) delivery in District hospitals in India to >10% (WHO recommendation). We used a time series approach, creating an enabling environment with a QI collaborative and then observing the impact of adding skilled resources. We were able to compare the impact of these interventions with hospitals that had not received the intervention.This initiative demonstrated that a context-sensitive collaborative approach for Quality Improvement (QI) is an effective method to increase in C-sections in poor economies. Translation of this implementation research into policy and safe practice requires close collaboration with local government.

By the end of this session, participants will be able to:

• Understand the application of QI methods in a resource constrained environment


• Appreciate how Shewhart chart analysis can be used to detect changes in performance in relation to the timing of interventions


• Appreciate the use and importance of counterfactuals in confirming a cause and effect relationship between action and impact

Abha Mehndiratta Institute for Healthcare Improvement; India

PART TWO: Improving the efficiency of PrEP (Pre-exposure prophylaxis for HIV) consultations

An insightful session on our MDT lead and service user involved quality improvement project to improve the efficiency of PrEP consultations. Using innovative ideas to drive meaningful change with proven outcomes and positive feedback from service users and clinicians. Reflecting on the challenges of delivering change and ensuring sustainability. This projects success has delivered both proven service user benefit and financial savings for the service.

By the end of this session, participants will be able to:

• Explore successes and failures from a real-world case study of healthcare service improvement with service user involvement


• Learn from challenges when implementing system change with sustainable outcomes


• Take away practical change ideas to implement in other healthcare settings

Harry Coleman Mortimer Market Centre SHC; England

PART THREE: Enhancing Emergency Department efficiency: fast-tracking COVID-19 testing and patient flow with quality improvement

Join us to explore the successful implementation of a crucial Quality Improvement initiative during the second wave of COVID-19. Faced with unprecedented pressures to maintain patient flow while ensuring safety, our team utilized the 5-step KCH Quality Improvement methodology to optimize the turnaround times for COVID-19 swab results. Key Performance Indicators focused on reducing delays from swab labelling to results registration in the Electronic Patient Record system. Learn how the introduction of Point of Care swab testing in the Emergency Department played a pivotal role in enhancing patient throughput and alleviating lab burdens. This presentation will provide valuable insights for healthcare professionals seeking to improve emergency care processes under crisis conditions. Don’t miss the opportunity to gain practical knowledge and strategies for enhancing patient safety and operational efficiency in your own institutions.

By the end of this session, participants will be able to:

• Understand the application of the 5-step King’s College Hospital Quality Improvement methodology to optimise emergency department processes during a healthcare crisis


• Learn strategies for reducing turnaround times for COVID-19 test results, from swab labelling to electronic record registration


• Gain insights into the implementation and benefits of Point of Care testing to improve patient flow and safety in emergency settings

Andrea X Cortes Beltran Kings College Hospital; England

PART FOUR: Driving improvement: applying car manufacturing methodology to improve timely diagnosis for patients on the Suspected Cancer Pathway

This presentation will demonstrate how Toyota’s version of lean methodology has been applied to the Suspected Cancer Pathway (SCP) in Wales to reduce waiting times for patients and improve efficiencies within the system.

The SCP is a Welsh Government target for diagnosing cancer and starting treatment within 62 days from the point that cancer may be first suspected. Improving timely diagnosis also ensures those patients who do not have cancer will be reassured promptly, reducing unnecessary stress and worry.

This presentation will run through the three phases of work that took place across select Health Boards in Wales which targeted the primary components of the cancer pathway to benefit all cancers. Delegates will learn the methodology, process, results, lessons learned, what can be spread and scaled, and what’s next for the future of the SCP improvements in Wales.

By the end of this session, participants will be able to:

• Understand the difference between performance management and improvement methodology, inspiring collaboration between Multi-Disciplinary Teams (MDTs) and fostering a collective responsibility among all


• How to apply a wider system thinking approach to bring together multiple pathways that typically work in silo


• How to apply elements of Toyota’s lean methodology to identify waste in your current processes, examining the finer details to make small changes that can result in bigger wins

Jonathan Clarke NHS Executive; Wales