What is Quality Improvement? Basics, Models and Tools

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What is Quality Improvement?

Quality Improvement (QI) is a structured, methodical way to analysing practice performance and making improvements. QI strategies are identified as part of an organisation’s overall strategic planning process. To collect and analyse data, several approaches or QI models are available. While choosing a recognised QI model to guide your efforts is important, it is even more important to completely commit to adopting the QI process and implementing the best QI practices.

Let us understand the QI strategy with the example of a healthcare industry.

For healthcare delivery systems, understanding and correctly applying QI is critical for any practice looking to improve efficiency, patient safety or clinical outcomes. Furthermore, improved patient outcomes and good QI processes position your clinic for success:

  • Assisting in preparing for the move to value-based payment models.

  • Taking part in the public reporting of physician quality data.

  • Giving the option to engage in one of two tracks in the federal Quality Payment Program (QPP): Merit-based Incentive Payment System (MIPS) or Alternative Payment Model (APM) (APM).

  • Providing with the skills to apply for and complete national recognition programs including the NCQA’s Diabetes, Heart/Stroke, and Patient-Centred Medical Home (PCMH) programs.

  • Assisting in meeting the requirements for Family Medicine Certification-Performance Improvement activity credit (previously Maintenance of Certification).

Quality Improvement Basics

The following key concepts constitute the QI method:

Create a Quality-oriented Culture in Your Practice

Your practice’s organisation, methodologies, and procedures should all support and integrate your QI efforts. A practice’s culture, attitudes, behaviors and actions reflect how committed the practice team is to excellence. Every practice’s QI culture is unique, but it may involve things like forming specialised QI teams, conducting frequent QI meetings or developing policies around your QI objectives.

Determine and Prioritise Potential Areas for Improvement

You will need to figure out and comprehend how you can improve your practice. Examine your patient population and practice operations(for example, to detect impediments to care, frequently identified chronic diseases, or groups of high-risk patients)

Collect and Analyse Data

The gathering and analysing of data is at the heart of quality improvement. Your data will assist you in determining how well your systems work, identifying potential areas for improvement, establishing quantifiable targets and tracking the impact of change. Before you start a QI project, you should gather baseline data, commit to frequent data collection, thoroughly assess your results during the project and make decisions based on your findings.

Communicate Your Results

Your staff, physicians, and patients should all be aware of your efforts to improve quality. When designing and implementing QI projects, involve the entire practice team and patients and make sure everyone is aware of the project’s needs, priorities, activities, and outcomes (patients included). Celebrate and appreciate a project’s accomplishment when it is completed.

Commit to Ongoing Evaluation

It is a never-ending process to improve quality. A high-functioning practice will strive to improve performance regularly, revisit the effectiveness of interventions, and regularly collect patient and staff feedback.

Spread Your Successes

To enable wide-scale, quick progress that benefits all patients and the healthcare industry as a whole, share what you have learned with others.

Quality Improvement Models and Tools

Quality improvement models provide a structured, methodical approach to implementing QI activities in your practice.

The following are some examples of frequent QI models:

  • Plan-Do-Study-Act (PDSA) cycles are a model for improvement: Total Quality Management (TQM) and rapid-cycle improvement are two major quality improvement strategies combined in the Institute for Healthcare Improvement’s Model for Improvement (RCI). As a result, a framework that employs PDSA cycles to test interventions on a small scale has been developed.

  • Six Sigma: Six Sigma is a quality improvement strategy that aims to reduce variance and failures.

  • Lean: A methodology for eliminating waste and increasing the efficiency of work processes so that all activity provides value.

  • Quality improvement tools are stand-alone techniques or processes that can assist you in better comprehending, analysing, and communicating your QI efforts. Run charts, process maps, and fishbone diagrams are examples of QI tools.

ISO 9001 establishes a practical quality management system (QMS) structure that can address improvements starting with the organisational environment and progressing through leadership, planning, support, operation and performance evaluation.

In general, well-planned quality improvement opportunities can be recognised:

  • Customer needs, expectations
  • Management policy, objectives, priorities
  • Process expertise, product specifications and raw material requirements
  • Production / operational instructions, flow charts, control parameters
  • Supply chain control parameters
  • Process control, monitoring/measurement
  • Inspection, audit, management review
  • Equipment/machinery maintenance programs
  • Parameters for HR, Administration, and other support processes
  • Packing and despatch control
  • Post-sales controls

There are a variety of tools that can be used in the context of QI, and they are usually used in conjunction with larger frameworks such as the model for improvement.

Model for Improvement

The improvement efforts are framed by three essential questions in this model:

  • What are we attempting to achieve? The improvement programme’s goal is spelled out as clearly as possible.

  • What criteria will we use to determine if a change is beneficial? Improvement is specified and measured against a clear baseline or existing state, for which specific metrics can be selected.

  • What changes can we make that will make a difference? Change ideas that are founded on a thorough grasp of the problem can be put to the test in a controlled environment.

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