ABSTRACT

This chapter focuses on the first stage of any quality improvement (QI) process; how we decide what needs to be improved. We think of new ideas or want to try something we have seen work in a practice or network down the road, but we don't spend time working out what problem it is we are trying to solve. We will only know if the interventions have succeeded if we have worked out what problem we are trying to solve in the first place. There are a number of factors that influence how observant we are, whether we notice the possible impact of what we observe and then whether we decide to raise what we have noticed as a potential area for improvement. Barlow and Moller's book on customer loyalty, A Complaint Is a Gift focused on the value of negative feedback in helping us to fully understand our service and where there might be room for improvement.