Effective use of interdisciplinary approaches in healthcare quality: drawing on operations and visual management

Thinkers from the broad field of quality management, such as Edwards Deming, have influenced the more focused field of healthcare quality including international organisations such as the Institute for Healthcare Improvement and The Health Foundation. Quality management was initially established for industrial settings but has since been applied in many other sectors such as education, travel and, in this context, healthcare. Quality management encompasses quality assurance, control and improvement. Healthcare practitioners and researchers have applied aspects of these in examples such Benneyan et al1 who in their much-cited text apply statistical process control in healthcare quality improvement using standard techniques developed in quality management. Other industrial research fields such as change management and organisational culture have also been adopted by the healthcare quality field. The value of learning from these fields was summarised by Davies et al2 who noted that ‘there is a rich literature from other industries’ available to researchers and practitioners. This rich literature continues to develop, and there remain many opportunities for those interested in healthcare quality to draw from fields beyond the healthcare context.

In this editorial, we explore the use of methods and findings from operations management and quality management to inform quality improvement initiatives within healthcare, particularly focusing on the use of ‘Visual Management’ techniques as an example. The value of these fields is exemplified by Woodward and colleagues in this issue of BMJ Quality and Safety.3 In this paper, Woodward et al use some approaches from visual management—the use of instinctive visual cues to make succinct, accurate information available within a workplace—to develop a clinical tool for use in maternity care. The paper tests Framework for co-dESign of Clinical practice tOol (‘FRESCO’), the framework of Woodward et al for developing practice tools, and trials it in a clinical setting. FRESCO applies several stages of development to allow the refinement of tools, including usability, evaluation and prototype testing. The paper provides detailed reporting of the FRESCO approach and tracks the development of a clinical tool in their case study. The paper concludes with a commentary on the application of FRESCO, identifying it as providing the possibility to underpin a practical approach for the co-design of clinical tools.