Delivering quality improvement: the need to believe it is necessary.

Quality improvement (QI) is described as being about changing the way in which patient care is delivered. It is more than just a theoretical framework against which innovations can be introduced; it is about a rigorous patient-centric approach to the design and delivery of care. In this paper we will explore some of the practicalities of delivering quality improvement in paediatrics and child health, and explain why it is an approach that we all must take.

An introduction to quality improvement in paediatrics and child health.

Quality improvement is a focus on changing the way in which patient care is delivered. Central to this is developing a more rounded, patient-focused approach to the design and delivery of care. Here, in the first of a series, we introduce the concepts of quality improvement, explain why quality improvement should matter to paediatricians and give some pointers as to where and how paediatricians can learn and do more.

Engaging paediatricians in planning the training of our future workforce.

Fundamental reform to the way we train and develop our future workforce is planned. In order to successfully achieve change the engagement of those delivering care is necessary. In this study the authors used a novel participatory design to seek the opinions of medical students, foundation doctors, specialty trainees and consultants on some key statements regarding proposed improvements to postgraduate medical education. While there was overall agreement on many of the recommendations of the Temple report, some aspects were potentially divisive, with significant differences between the views of consultants and those more junior to them. This work emphasises the importance of engaging all members of the healthcare workforce, both present and future, in the reasons for, and outcomes of, healthcare reform.

Clinical teaching in paediatrics: understanding perceptions, motives and concerns.

BACKGROUND: Children and young people are used as cases and standardised patients in clinical exams and teaching courses. Consultation with them suggests that education and training are areas they feel they should actively participate in. AIMS: To examine the perceptions, motives and concerns of children and young people participating in exam-focused clinical teaching, and to compare these views with those of their parents, trainees and tutors. METHODS: Consultation and a pilot study were used to design an anonymised questionnaire with 5-point Likert scales and free text answers. This was sent to 112 children and young people, their parents, and tutors and trainees attending a clinical teaching course. Results were analysed using the Mann-Whitney U test. RESULTS: 71% of the questionnaires sent to children and young people and their parents were completed. For children and young people the major reasons for taking part were the enjoyment of helping people to learn (92% agreement) and wanting to "give something back" (85% agreement). Parents put significantly more emphasis on giving something back than anything else. Tutors and trainees felt the chance for children and young people to earn pocket money was their most important motivation. The major problem highlighted was that it is tiring being repeatedly examined. All children and young people and their parents said that they would participate in future clinical teaching. CONCLUSIONS: This study demonstrates that in the context of well-planned, structured clinical teaching, most children and young people are primarily motivated to participate to help educate doctors.