Where to focus your quality improvement efforts

Healthcare organisations are continually striving to enhance the quality of care they provide to patients. These quality improvement initiatives are not always visible to patients but should still work in harmony behind the scenes to make sure they make a positive impact on patient care and operational efficiency.

Apart from having to meet specific standards, with lives at stake hospitals are held more responsible for excellence than any other organisation out there. In this view, it is essential to focus improvement efforts on key areas that will have the most significant impact on patient outcomes, operational efficiency, and overall quality of service delivery.

By identifying the right performance indicators, analysing data effectively, implementing evidence-based practices, engaging stakeholders, and fostering a culture of continuous improvement, healthcare organisations can drive meaningful change and achieve sustainable quality improvements.

In this article we explore where healthcare organisations should concentrate their quality improvement efforts to achieve optimal outcomes and deliver high-quality care and will showcase some extraordinary examples from leading organisations to give you real-life examples.

Analysing data and outcomes

Let's face it – for a successful QI initiative, you need to pinpoint exactly what you will be focusing on. To quote a noted management expert, Peter Drucker, “If you cannot measure it, you cannot manage it.”

You must identify those key metrics that matter most to your organisation's strategy. Look at your current performance metrics. What's working? What's not?

Analysing your data and metrics will help you uncover insights that can drive meaningful improvement. This evaluation will also give you the baseline for setting realistic and achievable KPIs. Clear goals will help steer your quality improvement efforts in the right direction.

Utilising quality improvement tools

QI tools are like your trusty sidekick in the quest for quality improvement. Embrace these tools to get to the data more quickly and with less effort and unveil hidden gems of information.

Spotting trends and patterns in data is crucial to make informed decisions and pave the way for positive change.

Implementing evidence-based best practices

If you’re thinking about embarking on a new QI initiative, you don’t need to reinvent the wheel. Take a peek at best practices and evidence-based results in your field to see what's been proven to work. It's like having a cheat sheet for success.

We have a dedicated blog article where you can find inspiration for your next quality improvement project.

Just to give you inspiration, here are some examples of quality improvement ideas in healthcare:

• Reducing hospital readmissions through follow-up care and patient education.
• Enhancing patient safety by implementing protocols to reduce medical errors and infections.
• Improving patient flow by streamlining processes and reducing wait times.
• Implementing electronic health records (EHRs) to enhance data accuracy and accessibility.
• Adopting patient-centred care approaches that involve patients in decision-making and tailor care to their individual needs.

3 examples of quality improvement initiatives in healthcare

There are many resources out there for you to take some inspiration from. Organisations like the Institute for Healthcare Improvement (IHI) and the Virginia Mason Institute (VMI) regularly publish case studies and useful resources showcasing successful initiatives. Also individual healthcare providers like East London NHS Foundation Trust (ELFT) routinely publish their own success stories for others to learn from. At last, but definitely not at least, we also regularly publish our customers’ success stories.

But let’s see some concrete examples.

1. WakeMed improved patient flow in primary care

WakeMed embarked in a journey to better deliver timely patient care, foster more efficient stewardship of clinical resources, and effectively address ongoing staff burnout. They organised 4 trainings led by the Virginia Mason Institute to successfully implement flow concepts. The most important outcome was to get the operational pieces in place and create a new standard of work.

Implementation and consistent practice around 5S, standard work, and mistake-proofing has resulted in the following performance improvement metrics:

• 100 percent completion of medical notes for all patients seen and walk-in patients are accommodated within 15 minutes
• All in-basket items are processed in flow
• All administrative emails are answered
• Staff enjoyed a full one-hour for lunch without work to do
• All work was completely done by 4:30 p.m.
• Real-life scenarios were collected to create a Practice Manager’s Playbook to enable greater ease coaching others through flow implementation

For more information: https://www.virginiamasoninstitute.org/resource/case-study-improving-patient-flow-in-primary-care/

2. Fostering an improvement culture at ELFT

Over the last 10 years, the East London Foundation Trust (ELFT) has already seen many positive outcomes from their improvement efforts. From addressing safety issues to reduced waiting times and staff engagement they managed to reach incredible results and have been recognised by the Care Quality Commission, the quality regulator in England, which awarded ELFT three consecutive “Outstanding” ratings — the first organisation of its type to attain this achievement.

One of the main pillars to foster an improvement culture was to involve senior leadership right from the beginning and enroll them into a QI training.

“The role of the executive team is to ensure that staff feel empowered and supported through the QI infrastructure, that teams know that they can take action and make a difference. Local leadership is key.” - Richard Fradgley, Executive Director of Integrated Care and Deputy CEO

The new attitude of the executive leadership was a key aspect in the culture shift. Adopting the new quality improvement approach of learning and wanting to improve has empowered staff to question what happens in their services, review feedback and outcomes, and consider steps to be more effective. They achieved that now all teams apply QI and they involve service users in the process to identify new ideas and test them to successfully solve problems.

For more information: https://www.ihi.org/sites/default/files/2024-03/IHI_Fostering-Improvement-Culture-ELFT-10-Years.pdf

3. Lowering the rate of preterm birth at Women’s Healthcare Australasia

Women’s Healthcare Australasia (WHA) along with their partners, the Australian Preterm Birth Prevention Alliance and the Institute for Healthcare Improvement (IHI), commenced their largest collaborative yet in Life QI – the Every Week Counts National Preterm Birth Prevention Collaborative with the goal to safely lower the rate of preterm and early term birth across the 63 participating maternity services by 20%.

They’ve already worked on some more localised improvement projects, but they still required a systematic and more structured approach was needed to achieve and sustain improvements of this scale, nationally.

Hospital teams were principally involved with conducting iterative tests of change using the Plan-Do-Study-Act (PDSA) methodology. Teams were also responsible for recording key Outcome Measures on a monthly basis and selected Process Measures on a weekly cycle. All data was automatically aggregated to allow visualisation of the progress and impact on a national scale.

In total, a staggering 900 PDSA cycles were run across the project teams and 823 Run or Control charts were generated in Life QI through the course of the collaborative.

For more information: https://blog.lifeqisystem.com/national-collaborative-to-prevent-preterm-birth-using-life-qi?utm_content=307840334&utm_medium=social&utm_source=linkedin&hss_channel=lcp-18768373

Where to focus your quality improvement efforts in healthcare

1. Continuous monitoring and evaluation

In the world of healthcare quality improvement, consistency is key. We recommend setting up regular check-ins to monitor progress and identify areas for enhancement. There might be a need to adapt your strategies based on real-time feedback and data to ensure continuous improvement.

2. Building a culture of quality improvement

Transparency breeds trust. We strongly believe that encouraging open communication and holding everyone accountable for their roles in maintaining quality standards are both central pillars of a successful improvement culture. You should embrace a growth mindset and cultivate a culture where mistakes are seen as opportunities to learn and improve, fostering innovation and continuous growth.

3. Addressing root causes of quality issues

To identify what to focus on, it might be useful to start with reviewing your current issues. Get to the bottom of them. Dive deep into the root causes of quality issues through thorough analysis and work on the factors that could make the biggest impact. You should develop and implement targeted plans to address identified root causes, improve the processes and prevent future quality issues.

4. Leveraging technology for quality improvement

Technology plays a crucial role in driving quality improvement in healthcare by increasing efficiency, accuracy, and accessibility of patient care. From Electronic Health Records (EHR) which reduce errors and enhance coordination of care to the use of AI technologies to assist in diagnosing diseases earlier and predicting potential complications, we’ve already seen many use cases of how technology can help improve processes and outcomes in the healthcare settings.

In addition to these technologies, an all-in-one improvement software solution like Life QI comes very handy to collect and analyse data and help identify patterns and trends in patient outcomes, enabling you to achieve their quality improvement goals and secure outstanding regulator and accreditation results (e.g. CQC or JCI).

Life QI allows healthcare organisations to track and manage QI initiatives efficiently, collect data, and measure the impact on key metrics. Our platform allows QI teams to complete projects quicker with greater success rates thanks to easy-to-use best practice tools and access to learn from others.

5. Collaborating with community partners

Collaborating with community partners is another strategy for maintaining high-quality care in financially constrained times. Partnerships with local organisations, such as non-profits, educational institutions, and government agencies, can provide additional resources and support.

These collaborations can take many forms, from joint health education campaigns to shared services and facilities. By working together, healthcare organisations and community partners can pool their resources, reduce costs, and expand access to care. This not only benefits the organisations involved but also enhances the overall health and well-being of the community.

Summary

For healthcare organisations improving the quality of care they provide is always a top priority. And to do that, they should focus on key areas such as analysing data, using quality improvement tools, and implementing evidence-based practices to drive meaningful change. By setting clear goals and engaging stakeholders, organisations can achieve sustainable improvements and deliver high-quality care.