Does sustained involvement in a quality network lead to improved performance?

The purpose of this paper is to explore the effects of prolonged investment in one quality improvement method, which are uncertain. The authors aim to examine the extent to which sustained involvement in a quality network over five years led to improved performance against standards, and whether improvement was achieved in areas where service staff could exercise direct control.

A prospective cohort design was used to examine data from 48 UK inpatient child and adolescent mental health units between 2005/2006 and 2009/2010, which had been Quality Network for In-patient CAMHS members for two years. These were selected to remove the initial marked increase in compliance identified in an earlier study. The main outcome measure was compliance with organisation process standards.

Units meeting "excellent" quality status across all standards rose from seven (14.6 per cent) to 18 (37.5 per cent). Standards for Environment and Facilities and Access, Admission and Discharge improved the most. Units meeting the "excellent" quality status for criteria over which staff had direct control criteria rose from 17 (35.4 per cent) to 29 (60.4 per cent) over the five-year period. The unit modal quality status categorisation for criteria where staff had no direct control in 2005/2006 was "poor" (n=25; 52.1 per cent) but had progressed to "good" in 2009/2010 (n=24; 50.0 per cent).

The authors provide evidence that sustained investment in one QI method raises service compliance against standards. Trends showed improvement for direct control standards from "good" to "excellent" levels and improvement for no direct control from "poor" to "good".