OA36 Embedding quality improvement across paediatric and adolescent rheumatology: the JIA Learn experience

Background/Aims Juvenile idiopathic arthritis (JIA) is a relatively common chronic paediatric condition with significant potential for lifelong morbidity. Despite significant advances in medical treatment technologies, a persistent discrepancy between ‘ideal world’ (clinical research) and ‘real world’ (clinical practice) data suggests quality of care in JIA has room for improvement. Furthermore, understanding and prioritising the outcomes that matter to children and families will improve the experience of clinical care and reduce the impact of JIA on global health and well-being. Modern quality improvement approaches accelerate improvement in complex adaptive health systems because teams are empowered to test and adapt processes to suit local environments and populations. We report a novel and collaborative approach to quality improvement in paediatric JIA care across England between 2022 and 2024. The Institute for Health Improvement breakthrough series collaborative model informed development of a UK-wide learning system (termed JIA Learn) with the aim of improving care and outcomes, facilitating “social connectedness” and creating a lasting improvement culture. Methods Shared aims and an overarching driver diagram were developed following an introductory event in April 2022 with participating teams encouraged to identify related local improvement projects during the active phase of the collaborative. The collaborative included a further three formal learning events, three virtual action learning sets and individual or team support through improvement coaching. Participating teams were encouraged to collect the core set of agreed measures throughout the active learning period. Results 12 teams from across England engaged enthusiastically with the collaborative attending four learning events with an average satisfaction score of 9.8. The JIA Learn dataset, including the cJADAS10, JIA PROM and JIA PREM, was collected for 1320 discrete patient encounters (87.3% useable data) and multiple QI projects were delivered locally by participating teams. Improvements focussed on timely access to care, transitional care, patient pathways, patient education and local work with patient organisations. Participating teams reported that JIA Learn allowed them to innovate and work more effectively as a team, with learning accessible to the whole MDT. Limited time and capacity, no infrastructure for data collection and slow Caldicott approvals processes were common barriers to timely improvements. Conclusion The partnership between the clinical community, BSR, RUBIS.QI team and the many patient organisations involved in JIA Learn was central to the success of the project. The collaborative rejuvenated MDT members’ resilience and enthusiasm for improvement work, provided new mechanisms to share knowledge and learning, informed a range of local projects designed to improve the quality and experience of clinical care, and empowered paediatric rheumatology teams to become a confident and skilled community of improvers. Sustaining clinical confidence and enthusiasm as well as maintaining effective partnerships over time will be key to ensuring a legacy of improvement work. Disclosure F. McErlane: None. G. Cleary: None. N. James: None. A. Raine: None. A. Burhouse: None.