Little Things Matter, a Practice Based Reviewer’s Reflections

Quality assurance is everyone’s business. The big picture is about taking a structured approach to measuring patient / client care, and education and training, against national and local standards, sharing and comparing, identifying the best, and constantly striving to improve and get even better, in order to meet the general public’s high and exacting expectations.

Often the process of quality assurance can make front line staff, delivering essential nursing care, feel they are on a constant merry - go round, being watched and scrutinised by strangers, “who do not know what it is like in the real world.” More importantly, service staff may not see how they as individuals can contribute to, and influence quality assurance in their work environment. They may not see the importance of a simple “thank you” from a grateful patient who they have given a cup of tea to, or the beaming smile of a learner, who a mentor has taught how to measure a blood pressure and suddenly hears the Korotkoff’s sounds for the first time, but these little things do matter and contribute to and shape the qualify assurance agenda.

Patient / client feedback, service users satisfaction surveys and student evaluations often tell us that the most important things to them, the things that make a difference and provide a quality experience, are the little things. An anxious patient seeks an encouraging smile; it costs nothing, or providing reassurance and a sense of belonging to a nervous learner on their first shift in a new placement. Remember once upon a time, we were that panic stricken student nurse seeking a friendly face.

Delivering essential nursing care in a hospital / community environment and university education are not divorced from each other, but often it can feel separated and that colleagues are working in silos, competing against each other, with conflicting targets and pressures, when this occurs the little things get missed and this tips the quality assurance scales into a downwards spiral. Reverting back to equilibrium is a challenge, but a challenge foreseen by HLSP and the NMC. Making the little things matter is part of the quality assurance processes, which involves ensuring a robust system, with due regard for patients / clients needs and education programmes, reviewed by “real” practitioners from the busy world of service and academia, working in collaboration. Currency, networking, due regard for the field of practice and sharing experiences by reviewers all enhance the quality assurance agenda, and enable reviewers to know what those little things that matter are, and to make sure they are reflected in the HLSP processes.

Every one of us involved in the nursing profession has a responsibility to make sure little things that matter are given the importance they deserve. If we invest our time in the “essence of caring,” for our patients / clients and each other the big quality assurance processes will, to an extent, take care of its self.



Karen Hill,
Professional Development Advisor, Derby hospitals NHS Foundation Trust.

Karen.Hill@derbyhospitals.nhs.uk

To read about monitoring from another perspective, click here