Quality improvement projects including principles, methods and reporting

  1. Home
  2. Applied Basic Science
  3. Quality improvement projects including principles, methods and reporting

TOPIC DETAILS

  Team Member Role(s) Profile
Paul Banaszkiewicz Paul Banaszkiewicz Section Editor
Mark Mark Sohatee Segment Author
  • Quality improvement is an integral part of clinical governance and aims to ensure that the level of health care that is delivered is in line with best practice standards and maximizes patient safety and experience
  • In June 2008 the Department of Health published “High quality care for all: NHS next stage review,”1 which aimed to provide strategies to deliver effective care and was reinforced by the publication of the Health and Social Care Act 2012,2 which aimed to establish provision of NHS services in England as well as addressing public health matters, social care issues and making provisions about a National Institute for Health and Care Excellence.
  • The Healthcare Quality Improvement partnership highlights that these documents show that there are three dimensions (Figure 1) which must be present to deliver high quality service.
  • These include clinical effectiveness, which is ensuring care is delivered in lines with best practice, patient safety where care is delivered in a way to minimise risk and patient experience, where care looks to address individual needs.3

BS12QUALITYIMROVEMENT1.jpg

Figure 1. Three dimensions quality improvement 
  • Problems in health systems are significantly affected by the processes involved in care delivery. Research methodology will not measure these problems nor will they help rectify them.4 For this reason there need to be specific methods that are designed to look at systems and how they run. These should have a focus on improving quality of the service these systems provide by addressing all of the possible factors that may influence the system.
  • There are many specific quality improvement methods that have been identified that are applied to organisations. There are particular ones that are thought to be most useful when dealing with healthcare organisations:3
    • Clinical audit [Hyperlink this to audit section]
      • This is a process whereby standards of clinical care delivered are compared with a set of agreed guidelines.
    • Plan, do, study, act
      • This is a process whereby changes are made in the form of a pilot study and analysed on this smaller scale, subsequently refined and then rolled out on to the whole system when perfected.
    • Six sigma
      • This is a process that comprises two sub-methodologies DMAIC (define, measure, analyse, improve, control) and DMADV (define, measure, analyse, design, verify). These alongside statistical methodologies look for variability in a process that leads to mistakes or inefficiencies and aim to minimise these.5
    • Root cause analysis
      • This is a process that is used following an adverse event and is subsequently considered a retrospective or reactive method of quality improvement. It requires a multidisciplinary team involvement to analyse processes that led to a negative outcome with the intention of putting measures in place to prevent such future outcomes.
  • Quality improvement aims to ensure that systems and processes allow for best possible patient care. However, to facilitate adequate dissemination of the information gleaned from quality improvement techniques, these must be adequately reported.
  • Within the UK the British Medical Journal quality improvement reports provide a platform to do this and look to publish reports that describe and evaluate interventions that aim to improve a process or system of healthcare.6
  • To ensure that these reports meet the required standards they utilise guidelines laid out by SQUIRE (standards for quality improvement reporting excellence). These give clear instructions and information for writing each section of a quality improvement report including: title and abstract, introduction, methods, results, discussion, other information.7
  • By making use of these standards and having a platform to publish this information, healthcare professionals are able to keep up to date with reports that look to promote excellence in the systems that allow them to deliver effective healthcare.
  1. Department of Health: High quality care for all: NHS next stage review, 2008.
  2. Health and Social Care Act 2012.
  3. Healthcare Quality Improvement Partnership. Guide to quality improvement methods. Healthcare Quality Improvement Partnership, 2015.
  4. World Health Organization. Patient safety curriculum: Topic 7: introduction to research methodolody. http://wwwwhoint/patientsafety/education/curriculum/who_mc_topic-7pdf (last accessed May 2016).
  5. Karadbhuje S. Six Sigma Qualities in Business. Int J Enging Innovative Technol (IJEIT) 2012; 1(4).
  6. BMJ. Quality reports website. http://qualitybmjcom/journal. (last accessed May 2016).
  7. SQUIRE guidelines. http://wwwsquire-statementorg/. (last Accessed May 2016).
Previous
Next

References

  • 1. Department of Health: High quality care for all: NHS next stage review, 2008.
  • 2. Health and Social Care Act 2012.
  • 3. Healthcare Quality Improvement Partnership. Guide to quality improvement methods. Healthcare Quality Improvement Partnership, 2015.
  • 4. World Health Organization. Patient safety curriculum: Topic 7: introduction to research methodolody. http://wwwwhoint/patientsafety/education/curriculum/who_mc_topic-7pdf (last accessed May 2016).
  • 5. Karadbhuje S. Six Sigma Qualities in Business. Int J Enging Innovative Technol (IJEIT) 2012; 1(4).
  • 6. BMJ. Quality reports website. http://qualitybmjcom/journal. (last accessed May 2016).
  • 7. SQUIRE guidelines. http://wwwsquire-statementorg/. (last Accessed May 2016).