Who doesn’t want to provide their clients and customers with the best products and services? All businesses want to improve the quality of their offerings, but not everyone has the same idea of what constitutes the best or the highest quality. And people differ on how to achieve such aims. Especially in fields like healthcare and education, where evaluations often rely on results rather than tallies, a formal quality improvement (QI) process can be essential. Show
In this article, we will explore quality improvement processes in fields such as healthcare and education, uncover the must-haves in a good QI plan, and study the methods and tools to pursue a strong strategy. You’ll also find links to templates and best practices from a QI expert. What Is Quality Improvement?Quality improvement is a structured approach to evaluating the performance of systems and processes, then determining needed improvements in both functional and operational areas. Successful efforts rely on the routine collection and analysis of data. A quality improvement plan describes an ongoing, or continuous, process through which an organization’s stakeholders can monitor and evaluate initiatives and results. Based on the thinking of such experts as W. Edward Demings, QI principles were developed in manufacturing in the 1940s. In the last two decades, QI processes have also become popular in healthcare and education. Although organizations take many approaches, QI at its foundation concerns process management. If organizations operate according to many processes, by reviewing and improving one process at a time and leveraging the Pareto principle, they can more easily and gradually improve their entire system. Quality improvement processes share these characteristics:
What Is the Main Purpose of Quality Improvement?Quality improvement aims to create efficiencies and address the needs of customers. In healthcare, the main purpose of quality improvement is to improve outcomes. In healthcare settings, quality improvement may be associated with continuous quality improvement, the method used to identify problems and implement, monitor, and provide corrective action. The Benefits of a Quality Improvement ProcessA quality improvement process can offer organizations the following benefits:
Primary Issues in Quality ImprovementQuality improvement plans are frequently measured in terms of results, employee and stakeholder satisfaction, ease of change, and cost. Quality improvement plans must also help companies understand how to meet the needs of diverse stakeholders (employees, customers, regulators, and others), find a method for prioritizing the improvement requirements of these stakeholders, comprehend the threshold of variation that will permit required change, and know how employees can succeed in a program if leadership support is inadequate. Why Don’t People Believe in Quality Improvement Processes?Who could fault an effort to make work more efficient or effective or to deliver higher-quality output to internal and external customers? No one, you would assume — yet employees often shudder at the mention of quality improvement efforts. Their suspicions have assorted origins:
Natenstedt notes, “The CFO, when they’re sending out a memo, assumes everybody is reading it. But if your team communicates exclusively by corkboard, how're you supposed to know what decisions have been made and how they affect you?” Difficulties in Pursuing a Quality Improvement Process PlanHere are some of the common difficulties in following through with a QI plan:
How to Succeed with a Quality Improvement Process PlanAccording to Natenstedt, every successful QI plan needs a champion: “The most important factor contributing to successful implementation is highly committed senior leadership. For any quality improvement process, you need that leader who wants to make it happen. Success comes because someone at the top is pushing for it.” In addition, Natenstedt says that QI projects flourish when stakeholders are invested in the outcome. “The projects that tend to go the best also tend to be the ones that tie back to the main mission of the organization,” he explains. “If you're trying to get traffic to flow better in the parking garage, nobody's committed. But if you're reducing infections, every employee gets involved, because people care about the quality of what they're providing. “That’s when leadership has the crucial job of getting everybody on board. They accomplish this goal by explaining exactly why this particular solution is important and showing precisely who reaps the benefits,” Natenstedt continues. Leadership for QI initiatives may be separate from the organizational structure and should best suit your particular system. In any case, leadership provides the needed resources, as well as the direction and support for core values and priorities. Because leadership is essential, it’s crucial to report any successes and obstacles back to them. In addition to leadership, Natenstedt says teams need time, space, and opportunities to talk. “The primary team and other teams who will have great insights need collaborative, open, free thinking time. You have to get in a room, spend some time together, and not be afraid, no matter what you have to say or who you're saying it to — a no-stupid-ideas environment,” he adds. Natenstedt emphasizes that different perspectives are essential: “Make sure the team is not dominated by one type of person or employee. Get a diverse range of voices — even clients' opinions. That fosters creative exchange.” Other characteristics that contribute to a successful QI initiative include the following:
Common Outcomes of Successful Quality Improvement Process ProjectsMany organizations have found the following successes with QI:
A Case Study in Quality Improvement Process ImplementationAs an example of what can go right and wrong in a QI plan, Carl Natenstedt tells the story of his company’s plan to remove and reallocate old product to save a hospital tens of thousands of dollars. “But those benefits weren't communicated to the clinicians who actually used the product every day,” he explains. “When the time came for our team to come into the hospital and remove medical supplies, we were met with resistance. Nurses and doctors were worried about running out of what they needed, which is totally understandable. No one had presented them with the numbers or communicated with them. No one had said, ‘You actually don't need these eight extra boxes of sutures. We know because we've analyzed your usage history. You could reduce your patients' cost of care by X amount,’” he notes. Resistance continued until senior leadership explained the benefits. “As soon as you quantify just how much you're helping your community, people are interested. They're excited,” Natenstedt says. What Is the First Step in the Quality Improvement Process?No matter which model you choose or what you call it, planning has to be the first step. You need to decide what problems you want to solve, how you will solve them, and how you’ll know when they are solved. What Is a Quality Improvement Plan?A quality improvement plan is the written, long-term commitment to a specific change and may even chart strategic improvement for an organization. A QI plan defines what your organization wants to improve, how it will make improvements, how it will test for success, and what are the anticipated outcomes and evidence of success. In essence, the plan becomes the monitoring and evaluation tool. Additionally, a QI plan provides the roadmap and outlines deliverables for grants, funding, or certification applications. A plan differs from a QI project or QI program, both of which are considered subcategories of a plan. Projects grow out of the target areas you identify in the plan or those noted by stakeholders. With regular monitoring of changes, you can spotlight further targets for improvement. Ensure that your quality improvement plans include the following elements:
What Steps Are in the Quality Improvement Model?Regardless of the framework you choose, the following six steps generally describe all quality improvement approaches:
Quality Improvement Tools and FrameworksQuality improvement methods provide frameworks for pursuing change. Quality improvement tools provide strategies and documentation to gather and analyze data, as well as communicate results and conclusions. The History of Quality ImprovementMost modern quality improvement approaches trace their history to modern efficiency experts, such as Walter Shewhart, who perfected statistical process control modelling. Other foundational methodologies include the Toyota Production System, which evolved into lean management. W. Edwards Deming heavily influenced both the former and the latter. In healthcare, beginning in the 1960s, the Donabedian model became globally influential. Developed by Avedis Donabedian at the University of Michigan, the approach examines structure, process, and outcomes to inquire into the quality of care. Subsequently, healthcare organizations began to turn to frameworks used in other fields. Here are the most prominent of those additional frameworks:
Commonly Recognized Quality Improvement MethodsOrganizations choose methods based on their specific improvement goals. Each method offers varying advantages, depending on the company’s particular scenarios and environments:
Quality Improvement ToolsThe following tools work in conjunction with the quality improvement methodologies mentioned above:
Health Failure Modes and Effects Analysis (HFMEA): The U.S. Veterans Administration National Center for Patient Safety created the HFMEA for the purpose of risk assessment. Application of the tool includes identifying failure modes, then applying a hazard matrix score. Statistical Process Control for Quality ImprovementStatistical process control (SPC), which measures and controls quality, started in manufacturing, but can apply in a range of other fields. SPC relies on the continuous collection of product and process measurements, as well as the subsequent subjection of said data to statistical analysis. In manufacturing, you collect data from machines in the production line. You can even compare data of different sizes and characteristics. For example, in Statistics and Data Analysis in Geology, John C. Davis writes, “In order to compare resultants from samples of different sizes, they must be converted into a standardized form. This is done simply by dividing the coordinates of the resultant by the number of observations, n…” PDSA for Quality ImprovementThe PDSA cycle of plan-do-study-act offers a common framework for improvement in healthcare, education, industry, and other areas. PDSA may take several cycles to test and perfect, but the cycles of implementation also disseminate ideas. The framework scales from small to large organizations. At its core, PDSA maps to these active, iterative learning steps:
The PDSA cycle can have three implementation expressions. The healthcare industry uses rapid-cycle problem solving, usability testing, and practice-policy communication loops; educational organizations use practice-policy communication loops. The three implementation expressions operate as follows:
PDSA steps capture the following activities:
What Is a Quality Improvement Process in Healthcare?With its life-and-death focus, healthcare is a prime field for quality improvement initiatives. You can use QI processes for enterprises, clinics, labs, and individual practices. In healthcare, goals and objectives may be functional or operational, and they may include process measures and outcome measures. For example, you may improve your front-desk admissions process or your wound-care process. In healthcare, we measure improvements in terms of desired outcomes. As this professional journal article states, “Evidence for variable performance of colonoscopy indicates that patient outcomes could be improved by a constructive process of continuous quality improvement.” In this specific context of improving the performance of colonoscopies, this journal notes further that professionals can implement quality improvement by “educating endoscopists in optimal colonoscopic techniques, procedure documentation, interpretation of pathological findings, and scheduling of appropriate follow-up examinations.” Pathologists can improve their work through the “appropriate reporting of pathological findings. Continuous quality improvement is an integral part of a colonoscopy program.” STEEP: A Quality Improvement Process in HealthcareSTEEP is a quality improvement tool unique to healthcare. Developed in 1999 by the Institute of Medicine (IOM), now the National Academy of Medicine, it is similar to FMEA and describes six goals for optimal patient care and safety:
In addition to general challenges inherent in pursuing quality improvement, healthcare presents particular obstacles. For example, healthcare organizations face a likelihood of adverse events recurring, and they must anticipate overcoming resistance to change among key parties such as physicians, as much as 16 percent of whom may be unwilling to revise processes. Nevertheless, QI cycles and data capture support applications for financial programs. In addition, certifications provide measures to contribute to public reporting schemes and offer data to support value-based payment models. What Is a Quality Improvement Process in Nursing?In nursing, the quality improvement process purports that the floor nurse is best situated to monitor the status of processes and make improvements. QI efforts from nurses can include safety issues (such as preventing patient falls), clinical issues (such as wound care and surgical procedures), and self-care for maintaining practitioner safety, health, and mental well-being. What Is a Quality Improvement Process in Education?Continuous quality improvement is the framework for consistent improvement in education, both in higher education and in K-12 in public education. Although common in manufacturing and healthcare, quality improvement methods for education are now beginning to blossom. Methodologies in education include Six Sigma, PDSA, PDCA (plan-do-check-act), and in a few cases, lean. What Is a Quality Improvement Process in Information Systems?Because they support data collection and analysis, information systems are key to the quality improvement processes of many types of organizations, especially healthcare. IT in healthcare leverages electronic health records (EHR) and health information exchanges (HIE), in addition to in-house data sources. Information systems can assist with such quality enhancements as generating patient reminders for screenings and preventive health checkups, as well as providing access to laboratory, radiology, hospital, and specialist reports and records. What Is a Quality Improvement Process in Software?Software quality management (SQM) is a management process that aims to develop and manage the quality of software to best ensure the product meets the standards expected by the customer. At the same time, it also meets regulatory and developer requirements. What Is a Quality Improvement Process in Supply?In terms of supply, quality improvement focuses on mutual objectives across the supply chain, rather than on competition between suppliers. QI in supply commonly adheres to Baldrige National Quality Award 2002 criteria, which emphasizes the needs of the end-customer, not just those of the next customer in chain. Some examples include the idea, expounded upon by Evan L. Porteus in “Optimal Lot Sizing, Process Quality Improvement, and Setup Cost Reduction,” that smaller lots provide less opportunity for defects and errors. Build Powerful Quality Improvement Processes and Workflows with SmartsheetEmpower your people to go above and beyond with a flexible platform designed to match the needs of your team — and adapt as those needs change. The Smartsheet platform makes it easy to plan, capture, manage, and report on work from anywhere, helping your team be more effective and get more done. Report on key metrics and get real-time visibility into work as it happens with roll-up reports, dashboards, and automated workflows built to keep your team connected and informed. When teams have clarity into the work getting done, there’s no telling how much more they can accomplish in the same amount of time. Try Smartsheet for free, today. What are the key elements of a quality improvement initiative quizlet? make care safer by reducing harm caused in the delivery of care.. ensure that each individual and family is engaged in their care.. promote effective communication and coordination of care.. promote the most effective prevention and treatment practices for the leading causes of mortality.. What is the purpose of the quality assurance program select all that apply?Why are quality-assurance programs important in nursing? They enable nursing to be accountable for the quality of care. The primary purpose for evaluating data about a client's care according to a functional health approach is to: revise or modify the client care plan.
What is quality improvement quizlet?Quality Improvement (QI) A continuous process of root causes of problems in health-care delivery prospectively and retrospectively, examines solutions to those problems, and regularly monitors the solutions for improvement. Prevents errors, customer focused and avoids blame.
Which are components of an evaluative statement?So, to review, an evaluative essay contains three key elements: judgment, criteria and evidence.
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