Overview
Initiative type
Service Improvement
Status
Deliver
Published
22 December 2021
Topic
Summary
Getting It Right First Time Queensland (GIRFTQld) is a clinician-led, data-driven quality improvement initiative aimed at reducing unwarranted variation and improving patient outcomes. The program supports clinicians across specialties to collaborate, innovate, and embed evidence-based best practice, enhancing quality, access and efficiency across the public healthcare system.
Key dates
Jun 2019 - ongoing
Implementation sites
Queensland Health Hospital and Health Services statewide as well as The Mater (Public) Hospital.
Partnerships
Professor Tim Briggs CBE, Chair of GIRFT and National Director of Clinical Improvement for the NHS, The Royal National Orthopaedic Hospital (RNOH), Directors of Orthopaedics (Queensland Health), Healthcare Purchasing and System Performance Division (QH)
Aim
GIRFTQld aims to identify and address unwarranted variation and system-level barriers to optimise value in care for patients, clinicians and the health system. It provides a robust quality framework enabling clinicians to share insights, collaborate across facilities and implement contemporary best practice. GIRFTQld aims to achieve the following outcomes:
- improved patient outcomes
- engaged and empowered clinicians
- improved value and efficiency.
Background
The GIRFT program was established in the United Kingdom’s National Health Service (NHS) by Professor Tim Briggs CBE. It was first piloted in Queensland in 2019 within Orthopaedic Surgery as part of the Delivering What Matters ministerial priority program.
Following early success, the program expanded to include Emergency Surgery, Diabetes, and Diabetes in Pregnancy across Queensland.
Outcomes
Through data review, benchmarking and peer-to-peer discussion, GIRFT helps identify opportunities for improvement and implement sustainable change to deliver better care for Queenslanders.
Methods
Local improvement
Participating sites co-design tailored recommendations based on local challenges and opportunities. These inform targeted improvement initiatives, such as the following for Orthopaedic Surgery:
- introduction of ring-fenced beds
- implementation of enhanced recovery after surgery (ERAS) protocols
- increasing access to trauma theatre sessions
- review of joint prosthesis use
- clinician-coder models to improve the accuracy of coded data.
Statewide collaboration
The GIRFT model promotes peer collaboration and shared learning across Hospital and Health Services (HHSs). In Orthopaedics, this has led to:
- the formation of the Queensland Directors of Orthopaedics Group, providing leadership and expert advice on orthopaedic services
- the development of the Infection Prevention in Elective Hip and Knee Arthroplasty Guideline, a statewide resource outlining evidence-based infection prevention strategies.
Discussion
The GIRFT program leverages benchmarked data to facilitate structured discussions at site visits, focusing on unwarranted variation, exemplar practices and improvement opportunities. Each site develops an action plan, with ongoing progress monitored through annual benchmarking.
Lessons learnt
- Clinician-led, data-driven discussion effectively drives local and system-wide improvement
- Peer-to-peer review builds engagement and trust, encouraging practice change
- Recognising differences in site context, resources and service profiles is essential for meaningful benchmarking.