How to get started in quality improvement: Best Practices

Quality improvement is a core component of many undergraduate and postgraduate curriculums. Numerous healthcare organisations, professional regulators, and policy makers recognise the benefits of training clinicians in quality improvement.

Engaging in quality improvement enables clinicians to acquire, assimilate, and apply important professional capabilities such as managing complexity and training in human factors. For clinical trainees, it is a chance to improve care; develop leadership, presentation, and time management skills to help their career development; and build relationships with colleagues in organisations that they have recently joined. For more experienced clinicians, it is an opportunity to address longstanding concerns about the way in which care processes and systems are delivered, and to strengthen their leadership for improvement skills.

The benefits to patients, clinicians, and healthcare providers of engaging in quality improvement are considerable, but there are many challenges involved in designing, delivering, and sustaining an improvement intervention. These range from persuading colleagues that there is a problem that needs to be tackled, through to keeping them engaged once the intervention is up and running as other clinical priorities compete for their attention. You are also likely to have competing priorities and will need support to make time for quality improvement. The organisational culture, such as the extent to which clinicians are able to question existing practice and try new ideas, also has an important bearing on the success of the intervention.

This article describes the skills, knowledge, and support needed to get started in quality improvement and deliver effective interventions.

Best Practices

• Recognize needed skills- Enthusiasm, optimism, curiosity, perseverance, relational skills, practical skills, managing complexity, time management, and enjoying the experience are all necessary to build quality improvement.  
• Build your team- The first step is to recruit your improvement team. You need a blend of skills and perspectives in your team. Find a colleague experienced in quality improvement who is willing to mentor or supervise you.
• Identify a problem- Next, identify a problem collaboratively with your team. Use data to help with this. Take time to understand the contextual factors and what might be causing the problem. 
• SMART framework- Next, develop your aim using the SMART framework: Specific (S), Measurable (M), Achievable (A), Realistic (R), and Timely (T). This allows you to assess the scale of the intervention and to pare it down if your original idea is too ambitious. Aligning your improvement aim with the priorities of the organisation where you work will help you to get management and executive support.
• Map stakeholders- Having done this, map those stakeholders who might be affected by your intervention and work out which ones you need to approach, and how to sell it to them.
• Find support- You need support from both your organisation and experienced colleagues to translate your skills into practice.

The full article can be downloaded below.