When you are starting out on your Quality Improvement (QI) journey, one of the first things you will need to consider is choosing the right improvement idea to work on. If you’ve read other blogs in our improvement series, you will know that we strongly encourage collaboration with other team members throughout the improvement process, as success can be a tricky task to achieve on your own. With the help of your team – and by putting in the right preparation – you will find it easier to select your first improvement project.
Identifying the problem you want to solve
Although picking an idea to kick off your QI project can seem quite a daunting prospect, ideas can come from anywhere. So working with a team to share ideas can be an excellent place to start.
It’s often better to ‘think small’ when picking an idea. This could be looking at every day and routine processes and how a small change could enhance them. If smaller ideas work, then you can look to build on them; if they don’t, there has been minimal disruption. Smaller changes can be easy to measure too.
Another option, when you come to choose your project idea, is to imagine that the sky is the limit. And that you can achieve whatever you want. With this ‘no limits’ approach, your creative imagination may help to spark ideas which you can develop and progress. Once you have an idea you can then work on identifying a suitable scope so you aren't attempting to achieve too much first time round.
The Plan Do Study Act (PDSA) approach is also recommended to help you choose an idea for a QI project. This approach enables you to implement and trial small scale ideas quickly with minimal disruption to patient care. Using an improvement platform like Life QI, which supports the PDSA approach, can really help you plan and measure your new projects and work out how to take them forward.
Successful improvement thrives on sharing ideas and learning from other improvers. It’s a good idea to read around the subject and engage with experts when you try to generate quality improvement project ideas. You can ask other people with QI expertise for advice, as they might have run a similar project.
Solutions like Life QI provide an instant network of other improvers that you can access to help you to choose the right improvement project idea. If you have a particular improvement area in mind, using Life QI’s Projects and People sections, you can look up keywords to see if there are already completed projects in this area of expertise. Building a network of expertise to help you is recommended.
Brainstorming to understand the problem and identifying ideas
Once you have selected a problem to solve and have established an improvement idea – inspiration for solving the problem can come from anywhere. You might want to benefit from networks or systems that are already in place, as patient safety ideas can often come from the least likely place, while creativity can be sparked by looking at the problem from a different angle and looking to others to spark enthusiasm.
Brainstorming is a great way of developing and identifying ideas. If you are already working on a QI project, you will hopefully be part of a team. And in this case, getting together to discuss, debate and brainstorm ideas can really help. Or you could even put the idea to vote if there isn’t a clear ‘winner’.
You could also think about playing devil's advocate with ideas that you come up with. This can help you create the criteria for your next project. By questioning solutions and ideas, new ideas will spring up and debate. Even if just with yourself or a small team, can help fuel creativity.
You can hook into existing QI networks to start up conversations with like-minded people and learn from their experience. The Central & North West London NHS Foundation Trust uses Life QI to provide a visibility of its quality improvement projects across the trust. It means that people can look at local colleagues' improvement work and see if they can apply the same principles with their teams and projects.
You could also consider looking at ideas from a different perspective. Or from the perspective of someone who is affected in a different way. By using a different lens to look at a QI idea, you could come up with a novel approach.
Creativity is an important element in improvement. The AHRQ (Agency for Healthcare Research and Quality) has researched the implementation of ideas related to care coordination. They found that the tactics used by improvement leaders in meetings were vital. The leaders that were successful in creating a culture for the implementation of great patient experience ideas used brainstorming and reflection in their QI toolkit which helped create ideas and cultivate a culture of change and improvement.
What criteria should you use when choosing your next quality improvement project idea?
When you come to choose an idea for a QI project, smaller ideas can help. By keeping your change ideas small and easily measurable, you will be less likely to encounter resistance when testing them.
The QI team at East London NHS Foundation Trust operates on the basis that improvement efforts should be identified, initiated and led by teams that have the closest proximity to the quality problem. They have worked together to roll out a collaborative learning system, whereby - although each team has its own locally determined aim - they also set a collaborative aim. When they set the aim of: ‘Improving access to services for new patients by increasing uptake, reducing waiting times or reducing DNAs according to locally set targets by March 2017,’ the project showed the value of using a collaborative learning system and quality improvement to tackle a complex quality issue across the board.
As QI ideas need a planning and an implementation phase, the Institute of Healthcare Improvement (IHI) recommends that you need essential ‘tools’ to fix a QI problem. They have created a helpful Quality Improvement Essentials Toolkit which you might find helpful, which provides details on how these tools should be used.
You might also want to look at shared projects on Life QI, which will enable you to review current and past projects. You could also draw on experts across the Life QI community to hold both public and private QI discussions.
We hope you have found this article helpful in supporting you to choose the right quality improvement project idea. You might also find our blog ‘10 easy ways to create great Change Ideas’ useful. Good luck in choosing your next QI project!