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Quality improvement

Quality in healthcare has different aspects. These can be more easily remembered using TEPEES: (Health Foundation 2013).

  • Timely – reducing waits and delays
  • Effective - providing services based on evidence and which produce a clear benefit.
  • Person-centred - establishing a partnership between practitioners and patients to ensure care respects patients’ needs and preferences.
  • Efficient – avoiding waste
  • Equitable - providing care that does not vary in quality because of a person’s characteristics.
  • Safe - avoiding harm to patients from care that is intended to help them
Healthcare workers can draw on a wide variety of  quality improvement approaches and tools (HQIP 2015). They share simple underlying principles:
understanding the problem, with a particular emphasis on what the data tell you
understanding the processes and systems within the organisation – particularly the patient pathway – and whether these can be simplified 
analysing the demand, capacity and flow of the service 
choosing the tools to bring about change, including leadership and clinical engagement, skills development, and staff and patient participation – evaluating and measuring the impact of a change. (Health Foundation 2013).


HQIP (2015). Guide to quality improvement methods
Health Foundation (2013) Quality Improvement Made Simple

RCN support

RCN Principles of Nursing Practice. The Principles describe what everyone can expect from nursing practice, whether colleagues, patients, their families or carers and provide a framework for care and quality improvement. This resource introduces the Principles and describes how they relate to other publications about the quality of nursing care. Principle C focuses on the safety of all people (patients, visitors and staff), the environment, organisational health and safety, management of risk, and clinical safety.
Patient safety and human factors. An online resource which introduces a broad range of activities relating to patient safety and human factors. The resource signposts further resources and support available from the RCN, and provides an overview of the active patient agenda being pursued across the United Kingdom. 

Looking for articles and books on this topic?

The RCN library and heritage services provides books, e-books and e-journals on this topic. 

Page last updated - 03/08/2019