How to define the aim statement for your quality improvement project

When you are starting your Quality Improvement (QI) project, creating an aim statement is an excellent way to help you gain clarity and share the motivation behind your project.  Your aim statement will help you to identify and share your goals with clinical teams and leadership and should cover not only the potential benefits of your proposed project, but also any potential issues you have identified. In this article we’ll be looking at how to create and structure and your improvement project aim.

What is an aim statement?

If you have not come across an aim statement yet in your improvement journey – let’s drill down into the detail.

The Institute of Healthcare Improvement (IHI) defines an aim statement as ‘the answer to the first question in the Model for Improvement, ‘What are we trying to accomplish?’ While the NHS Improvement document ‘Developing your aims statement’ describes an aim statement as a ‘written documentation of what you want to achieve from your improvement project and a timeframe for achieving it.’ The document then talks through how to define the aim and provides very detailed support to help develop goals.

The Life QI article ‘How to write an aim worth sticking to’ describes how to write your aim statement, advising that ‘rather than adopting a top-down approach and dictating an aim, bring your team together to collectively determine what the aim should be. Improvement is a team sport, so bring the team together to unite around a common goal.’

An aim statement can help set the foundations for intrinsic motivation and is also recommended in order to ramp up productivity and motivation among your project team.

What does a good aim statement look like? (S.M.A.R.T. criteria)

You may already be familiar with the SMART technique for mapping out objectives. The SMART acronym stands for: Specific, Measurable, Achievable, Relevant and Time-bound and this structure can be really helpful when putting together your aim statement, as a good aim statement should possess all of these elements.

Let’s take a look at SMART in more detail and how it can help you to create a compelling aim statement.

S.M.A.R.T. criteria:

Specific – this is making it clear exactly what you would like to achieve in your QI project.

Measurable – measuring your success is really important in an improvement project, so you can see what has worked and what hasn’t and what you might want to replicate going forward. It’s important to think about how you can measure your project and to reflect this in your aim statement.

Achievable – a really important point – is your QI idea realistic? Have you allowed enough time or resources? This should also be articulated within your aim statement.

Relevant – this is where you need to explore your organisation’s aims and demonstrate how you can map them to your own project and patient outcomes. It's crucial that aims are relevant to your department, your organisation and your quality improvement issue.

Timebound – or timely – this means that you can set out a realistic and clear timeframe for your QI project.


All of these points are really helpful when creating your aim statement, providing clarity of thinking and guiding you to success.

The two types of aim statement - global aim and specific aim

There are two types of aim statement in QI: a global aim and a specific aim. A global statement is primarily linked to your organisation or collaborative as a whole and is a written statement of what you intend to improve in your focus area. On the other hand, a specific aim looks more closely at your QI project and the aims associated with this, as well as showing how you intend to meet the global aim with specific measurements and timeframes.

How to link your project’s aim to your organisation’s objectives

A key strategy for ensuring a successful QI project is linking your project’s aims to your organisation’s aims. The NHS Improvement document ‘Developing your Aims Statement’ recommends a ‘Four Column’ approach. Using this approach enables you to multiply the benefits from a single project across an organisation. It goes on to say that: ‘Aims should be consistent with national goals. By linking your aims to the strategic objectives of the organisation you will increase the chances of your project being successful.’

Examples of a great aim statement

The National Institute for Children’s Health Quality states that ‘teams who develop a good aim perform better. A good aim statement captures the voice of the customer, of those we serve. It provides alignment of multiple stakeholders, helps keep the team focused on the tasks at hand, creates the urgency to accomplish the goal, provides a vision of what success looks like, and serves as a predictor of success.’ So, it is well worth spending time getting your aim statement right – and there are plenty of resources to help you with this.

We’re going to look at a few resources which will help you create a great aim statement.

The IHI set out the following advice for creating an aim statement in their piece ‘Tips for Setting Aims’ which includes:

1. State aim clearly
2. Use numerical goals
3. Set stretch goal
4. Avoid aim drift
5. Be prepared to fully shift aim

They go into a bit more detail in their article ‘Across the Chasm: Six Aims for Changing the Health Care System’. This explores the Institute of Medicine’s (IOM) six overarching Aims for Improvement, which expands upon the SMART acronym, i.e.: safe, effective, patient-centred, timely, efficient and equitable.

They give examples thus:

Safe: Avoid injuries to patients from the care that is intended to help them.
Effective: Match care to science; avoid overuse of ineffective care and underuse of effective care.
Patient-Centred: Honour the individual and respect choice.
Timely: Reduce waiting for both patients and those who give care.
Efficient: Reduce waste.
Equitable: Close racial and ethnic gaps in health status.

Many organisations use these six IOM aims to help them develop their aim statements.

In addition, the National Institute for Children’s Health Quality sets out some really helpful guidance for creating a great aim statement, namely to consider:

• The concrete goals you want to achieve
• Who will benefit from this improvement? Whose interests are served?
• What will be done? Is it supported by evidence or experience?
• Where will the change occur?
• When will it start and stop?
• What are the boundaries of the processes? What is in, what is out?

You may also want to have a look at our blog ‘How to write an aim worth sticking to’ which gives an example of using the SMART acronym to craft your aim statement, and cites the example ‘the indistinct idea of "reducing pressure sores" becomes something along the lines of: "Reduce the number of patients leaving Ward D with hospital-induced pressure sores by 50%, by the 1st April 2021."

Conclusion

Your aims statement is a crucial way of sharing the objectives and outcomes of your project. Evidence shows that clinical and senior leadership buy-in is vital, so if you are able to share clearly what you intend to achieve in your aims statement, you are more likely to achieve success. Good luck!