Quality improvement is a systematic and deliberate approach towards improving the quality of healthcare by health practitioners in measurable ways. Quality improvement which is also known as QI is an ongoing effort to make the process of healthcare better. Quality improvement has picked up in relevance and popularity in recent times and the number of piqued interests of people in the health industry is at an all time high. https://www.healthcatalyst.com/5-Deming-Principles-For-Healthcare-Process-Improvement
Quality improvement put simply is making healthcare safe, timely, patient-centered, effective, efficient and equitable. Researchers and health practitioner constantly find ways to maximize quality improvement. Many health organization and practitioners are green on this topic and always have a hard time deciding where to start. Especially in large organizations with various departments, multilayered processes, and tons of staff.
Determining Where and How to Start Quality Improvement
So how does one determine where to start when it comes to quality improvement. Health organizations might not even realize what their pain point are but suppose they do how do they determine which pain point to pursue first. Health Catalyst mentions that usually before these questions can be answered the health organization needs to embark on process improvement. Many health organizations or health practitioners will answer this based on the number i.e they will choose to start their quality improvement in the area that has the largest potential return on investment (ROI). This may not be the best cause of action especially considering that health organizations should be patient driven and not profit driven. This points to a larger problem in the healthcare system of the United States but I digress. So how can they determine where to start?
Health practitioners are advised to take other factors into consideration when making this decision such as the readiness and openness to change in each department and area. For example, a certain department may show as needing quality improvement in theory or prove to provide the best potential return on investment, but in looking at the personnel you realize that they have a good team that is already inclined to exchange information and is very open to using evidence-based medicine. You also see that they have successfully navigated this type of change before, whereas it is uncharted ground for the other two areas. In this case, where you need a quick win and a showcase project, you will likely get your best overall return on your efforts by working with this team in a tweaked way. That is, of course, assuming your quality improvement plan has room for flexibility (which it should) They can then set the example, and perhaps even provide guidance to the other teams when it’s time to tackle opportunities.
Another key determinant is Variation. Let variation be your map. There are software and systems that have been designed to uncover significant variations in a system that can help health practitioners identify greatest opportunities for improvement and serve as the map to help you get started. This will not help you through the entire process or do the work for you, it but will serve as a nudge in the right direction, a guide down the right path,
Variation is a very important guide and it also helps eliminate waste. Put eloquently by Health Catalyst:
- Variation in what care is ordered
- Variation in how care is delivered
- Preventable complications resulting from care delivery—termed defects in Sigma/Lean terminology—that can harm or injure patients (e.g., hospital-acquired conditions)
Creating standardized clinical effectiveness guidelines that reduce variation can not only serve as a guide in a quality improvement plan but definitely improve clinical performance.