Description of a Quality Improvement Project:
Quality Improvement (QI) can be defined as all activities that contribute to defining, designing, monitoring, and improving the quality of healthcare. These activities can be performed as part of the accreditation of facilities, supervision of health workers, or other efforts to improve the performance of health workers and the quality of health services.
As healthcare professionals, it is of critical importance to acquire an appreciation for, and a heightened knowledge of the core principles that encompass the QI process. Additionally, it is equally important for each healthcare professional to develop a working knowledge of the general Quality Improvement model that is implemented within the institution or out-patient setting in order to more fully appreciate the mission, vision, and core value statements that are the foundation on which an organization builds a quality infrastructure.
Guidelines for Assignment:
Establish a hypothetical Quality Improvement program for your health care institution related to the clinical setting. Remember, a QI program needs to define quality, measure quality, and provide recommendations for improving quality. The length of the assignment should be 3-5 pages, double spaced in APA format. Two references are preferred for this assignment. The two can be two separate primary referencing of the chapter authors of Yoder-Wise book.
Guidelines for Preparing the Assignment:
According to the Quality Improvment Program on Health Care, four core principles guide quality in healthcare:
• The client: services should be designed so as to meet the needs and expectations of clients and communities
• Systems and Processes: providers must understand the service delivery system and its key service processes in order to improve them
• Measurement: data are needed to analyze processes, identify problems, and measure performance
• Teamwork: quality is best achieved through a team approach to problem solving and quality improvement.
Define Quality:
Defining quality means developing expectations or standards of quality. To achieve expected health outcomes, standards must be developed in such a way that they are:
• Realistic: The standards can be followed or achieved with existing resources
• Reliable: Following the standards for a specific intervention results in the same outcome (all factors being equal)
• Valid: The standards are based on scientific evidence or other acceptable experience
• Clear: The standards are understood in the same way by everyone concerned and are not subject to distortion or misinterpretation
• Measurable: Performance according to the standards may be assessed and quantified
Measure (Assess) Quality:
A quality assessment frequently combines various data collection methods to overcome the intrinsic biases of each method alone. These methods typically involve either some form of direct observation of health worker performance or indirect assessment of performance, such as through testing of providers, patient interview, or record review. Examples of such methods include:
• Observation of service delivery (by expert observers, peers, supervisors)
• Mystery client method
• Audit of individual patient records
• Review of data from automated information system
• Testing (written tests, simulation with standardized patients, computer-based testing)
• Health worker interview
• Patient exit interview
Improve Quality:
Improving quality involves applying appropriate methods to close the gap between current and expected levels of quality as defined by standards.
Four Steps to Improving Quality:
• Step one: Identify > Determine what to improve
• Step two: Analyze > Understand the problem
•Step three: Develop > Hypothesize about what changes will improve the problem and develop solution strategy based on these changes
• Step four: Test and implement > Test the hypothesized solution
Resources:
Yoder Chapter 19 of the 4th edition; and Chapter 20 of the 5th edition outline the QI process.
Students may also use other credible internet sources or textbooks. Be sure to include any outside sources.