How to make an impact via QI projects
Introduction
In the midst of the pandemic, healthcare systems are forced to evolve to improve their services and reflect the changing needs of the population. Such advancements in healthcare are made partly due to Quality Improvement (QI) projects, which serve to identify limitations in the system and implement effective and sustainable solutions.
QI projects not only add value to patient care and safety, it also benefits all clinicians involved in the project. For project leaders and clinical trainees alike, it proffers an opportunity to hone leadership and communication skills, and sheds light on care processes within complex healthcare structures [1].
Tips for a successful QI project
QI projects are notoriously daunting for numerous reasons. Not only are you questioning existing dogmatic approaches that are familiar to all, you also need to actively engage and empower relevant clinical teams to implement solutions effectively [2]. This can be challenging when the wards are busy and fulfilling a requirement for a QI project is the last thing on their minds.
Most successful changemakers implement the traditional PDSA (Planning, Doing, Studying, and Acting) cycle in their projects [3]. This article aims to distil key concepts and highlights four key skills that will help make your QI project a success.
1. Curiosity
The first bridge to cross is having a curiosity about how things work and how to make things better. Whether it is via a novel device, or finding solutions to streamline care processes, being inquisitive allows you to ask the right questions and motivates the changemaker to research on potential solutions which are sustainable and impactful.
2. Lateral thinking
There is often a misconception that implementing effective change requires the conception of novel ideas. In fact, some of the most effective improvements in healthcare have simply been the application of ideas from other industries.
For example, checklists from the Aviation sector were applied in Anaesthetic practice, resulting in a significant decrease in the number of human errors reported [4]. The key is to analyse such ideas and tailor it to suit the needs of local healthcare settings.
3. Communication and Leadership
It is recommended to work with individuals from both clinical and non-clinical backgrounds for a diverse mix of skillsets and perspectives. However, the challenge of getting various groups of people on board with the project and ensuring that they are implementing change in their everyday practice can only be tackled with good communication and leadership skills.
Negotiating an incentive for all, delegating tasks according to skillsets, and empowering them with the confidence and platform to shake up dogmatic approaches would thus be vital.
4. Reflection
Not every solution will be perfect at first go. It takes critical reflection of the data collected to identify further areas of improvement. As a team, one also needs to identify methods of making the solution sustainable, so that when you move on to other roles, the impact achieved by your team will not be negated.
As daunting as a QI project sounds, someone has to rise to the occasion in order to improve healthcare systems and streamline processes for better patient care. It is a step forward to the future of medicine. If you are reading this article to the very end, you have already ticked off the first key skill (curiosity). Good luck being a changemaker — we have faith in you and can’t wait to hear about it.
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About the author
Jaclyn Tan is a fifth year medical student at UCL with a particular interest in healthcare leadership and policy. She hopes of one day being able to empower healthcare professionals by getting them a seat at the Board table, making their voices heard, and impacting real change from within the healthcare industry. During her spare time, she serves as a freelance journalist and takes painting, poetry, and jazz pretty seriously!
References
1. Jones B, Vaux E, Olsson-Brown A. How to get started in quality improvement. BMJ. 2019;364:k5408. doi https://doi.org/10.1136/bmj.k5437.
2. Curry LA, Brault MA, Linnander EL, et al. Influencing organisational culture to improve hospital performance in care of patients with acute myocardial infarction: a mixed-methods intervention study. BMJ Qual Saf2018;27:207–17. doi:10.1136/bmjqs-2017–006989.
3. Reed JE, Card AJ. The problem with Plan-Do-Study-Act cycles. BMJ Qual Saf2016;25:14752.https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=26700542&dopt=Abstract doi:10.1136/bmjqs-2015–005076.
4. Chopra V, Bovill JG, Spierdijk J. Anaesthesia Patient Safety Foundation. 1991. [Accessed Feb 2021]. Available at: https://www.apsf.org/article/checklists-aviation-shows-the-way-to-safer-anesthesia/.
