PIP! One Paediatric Department’s Quality Improvement Journey


  • Amy Taylor North Middlesex University Hospital
  • Dalbir Sohi North Middlesex University Hospital
  • Jessica Austin North Middlesex University Hospital
  • Suzanne McFarlane North Middlesex University Hospital


quality improvement



The Paediatric Improvement Plan (PIP) is a 12 workstream plan covering the main paediatric areas in the hospital and key themes such as medicines management. It was constructed to ensure the department provides the level of care expected by the Trust and the Care Quality Commission.


The PIP started with 50 points to be actioned, and review identified a further six. These were split into three time divisions based on importance and feasibility of implementing the recommendations. The majority fell into the 0–6 month timeframe. Points were marked ‘Red’ if no action taken, ‘Amber’ for action in progress, ‘Green’ when complete, and ‘Blue’ when impact evidenced.


Over a four month period, 34 (92%) ‘Red’ actions have been addressed and 10 completed (‘Green’ or ‘Blue’). There are now no ‘Red’ actions in the 0–6 month timeframe.

Key achievements:

  • Establishing a rapid access clinic.
  • Factoring nursing competencies into rostering.
  • Resuming training on nurse-led discharge and medicine management.
  • Writing seven operational and clinical policies.
  • Starting a governance newsletter, a monthly medicine management meeting and a neonatal quality improvement group.
  • Involving 11 junior doctors in improvement projects.


A written plan with clearly documented actions, owner and timeframes proved invaluable, as did having a dedicated co-ordinator. Involving and motivating the whole multi-disciplinary team was crucial. My background as a paediatric registrar allowed me to see through a clinical lens and understand competing demands. The COVID-19 pandemic meant demands on the workforce were immense and many courses were cancelled or moved online. This remains a challenge.




How to Cite

Taylor, A. ., Sohi, D., Austin, J. ., & McFarlane, S. (2022). PIP! One Paediatric Department’s Quality Improvement Journey. London Paediatrics, 1(1). Retrieved from https://journal.londonpaediatrics.co.uk/index.php/1/article/view/26