The concept and determinants of return on investment for quality improvement in mental health NHS Foundation Trusts

CASE博士研究生项目将开发一个测量系统，用于评估南伦敦和莫兹利NHS基金会信托精神卫生服务质量改进项目的投资回报率（ROI）。在英国财政紧缩时期，医疗保健质量的提高使投资激增。评估投资回报的指导很少，特别是在精神卫生方面。这阻碍了与医疗保健领导者和董事会就质量改进在组织内实现其全部潜力的程度进行沟通。稳健的ROI度量将使为医疗保健领导者生成定期报告成为可能。这些常规报告可以提供总体情况，为医疗保健领导者提供关于质量改进方面的资源承诺获得回报程度的战略见解。在此基础上，可以对能力建设和培训的投资策略做出决策。我们还可以比较NHS基金会信托在其组织战略和质量优先级方面的投资回报率。通过产生对ROI的见解，常规使用此度量还可以培养组织学习的文化，这对于学习型医疗保健系统至关重要。这项研究将涉及整合心理测量学、卫生经济学和跨学科社会科学领域的实施和改进科学的知识和方法。首要任务是澄清ROI的概念，以便我们有一个适当的基础来为医疗保健领导者提供见解。投资回报率和基于价值的医疗保健之间的联系将特别有趣。在King的健康合作伙伴中，以价值为基础的医疗保健是通过公平、可持续和透明地利用现有资源，为每个人实现更好的结果和体验的关键方法。我们将在研究文献中探讨这些联系，并通过与行政领导团队（如首席医疗/财务/运营官）以及高级管理团队（如临床/服务总监）的个人/小组访谈来探讨这些联系。基于这些最初的见解，我们将通过不同阶段的小组咨询开发ROI度量的现场测试版本。这些小组包括执行领导和高级管理团队，他们将审查内容有效性和项目设计，并讨论诸如例行ROI报告的可接受性、覆盖范围和可持续性等实现问题。新开发的ROI测量方法将使用SLaM的三家精神病医院（Bethlem皇家医院、Lambeth医院和Maudsley医院）的数据进行实地测试。验证研究将完善现场测试版本，并得出最终版本，该版本可以嵌入到日常评估中，以告知组织在质量改进投资方面的决策。

The CASE PhD studentship project will develop a measurement system for evaluating return on investment (ROI) of quality improvement projects in mental health services of the South London and Maudsley (SLaM) NHS Foundation Trust. Quality improvement in healthcare has seen a surge of investment amidst times of austerity in the UK. Very little guidance exists for evaluating return on investment, particularly in mental health NHS Foundation Trusts. This impedes communication with healthcare leaders and boards regarding the extent quality improvement is achieving its full potential within the organisation. A robust ROI measure will make it possible to generate regular reports for healthcare leaders. These routine reports can provide a big picture to give healthcare leaders strategic insights about the extent resource commitments in quality improvement paid off. On this basis, decisions can be made about investment strategies for capacity building and training. We would also be able to compare NHS Foundation Trusts in terms of ROI of their organisational strategies and quality priorities. By generating insights on ROI, the routine use of this measure can also foster a culture of organisational learning that is pivotal for a learning healthcare system. The research will involve integrating knowledge and methods from psychometrics, health economics, and the interdisciplinary social science fields of implementation and improvement sciences. The first priority is to clarify the concept of ROI so that we have an appropriate basis to generate insights for healthcare leaders. The links between ROI and Value Based Healthcare will be of particular interest. Across King's Health Partners, Value Based Healthcare is established as a key approach to achieve better outcomes and experiences for every person with the equitable, sustainable and transparent use of the available resources. We will explore these links in the research literature as well as through individual/group interviews with the executive leadership team (e.g., Chief Medical /Financial / Operating Officer) as well as the senior management team (e.g., Clinical / Service Directors). Based on these initial insights, we will develop field-test version of a ROI measure through group consultation in various stages. The groups comprise both the executive leadership and senior management teams who will review content validity and item design, as well as debate on implementation issues like acceptability, reach, and sustainability of routine ROI reports. The newly developed ROI measure will be field-tested with data from three psychiatric hospitals of SLaM (Bethlem Royal Hospital, Lambeth Hospital and the Maudsley Hospital). The validation study will refine the field-test version and derive a final version that can be embedded in routine evaluation to inform organisational decision making on quality improvement investments.