Despite their proliferation and importance, quality improvement programs aren’t something a patient would necessarily notice or observe in a hospital. They take place in the background of most day-to-day operations. Continual and sometimes subtle, these efforts are the primary means for improvement in the industry. Keep reading to learn more about QI programs, and get a look at some current examples of quality improvement in healthcare.
A QI program is a set of focused activities designed to monitor, analyze, and improve the quality of processes in order to improve the healthcare outcomes in an organization. By gathering and analyzing data in key areas, a hospital can effectively implement change.
Many programs are organization-wide, ongoing, and long-term (as you’ll see in some of the quality improvement examples later in this article). Concerned specifically with a hospital's more cyclical activities, such programs aim to continually increase levels of performance (e.g. improving patient safety or lowering patient mortality).
It’s important to note that QI programs are distinct from process-specific QI projects, which are designed to address and intervene on a specific issue. QI projects are shorter term and more reactive than programs.
Quality improvement programs are critical because they drive:
With lives at stake and specific standards that must be met, hospitals are held more accountable for excellence than your typical organization. Now more than ever, government and insurance reimbursement for patient care are based on health outcomes rather than procedures undertaken. Enter: quality improvement projects in healthcare.
Broadly speaking, the below are best practices for most QI programs. (Note that these are not absolutes, but general guidelines.)
In this section, we provide two examples of quality improvement in healthcare that are specifically related to programs. (Remember, programs are ongoing, long-term, and proactive initiatives that span the organization.) These hospitals have different focuses and priorities, but the QI programs for both reflect the overarching goal of improving the quality of care (encompassing patient experience, safety, and hygiene).
For its 8th annual QI plan, Sunnybrook Health had four strategic goals that were supported by multiple activities to improve the quality of service. Three of the top areas of focus for 2018/2019 included:
JBH’s 2018/2019 quality improvement plan comprises 10 indicators the hospital identified as critical areas of importance. The indicators align with JBH’s strategic plan and accreditation requirements. Targeting processes such as chronic obstructive pulmonary disorder readmissions and medication reconciliation at discharge, these quality initiative examples are very different from SHSC, but still focused on improving care overall.
In comparison to the programs above, the following are examples of quality improvement projects in hospitals.
QI projects are reactive and more focused on intervention.
After a series of news stories revealed medical errors and poor quality healthcare at Beth Israel, the hospital embarked on a quality improvement program to address the issues. This was a targeted intervention aimed at changing processes and the leadership structure to improve patient care.
The QI project included creating a board-level commission, establishing a best-practices group, replacing critical leaders, and introducing new clinical guidelines and policies to improve safety, communication, and transparency.
The outcomes were nothing but positive. Beth Israel was able to reduce readmissions, lengths of stay, incidents of deep vein thrombosis, infections, and complications, as well as patient mortality rates. Beth Israel is an excellent example of how tangible changes can result from a QI project.
Mount Sinai’s “Lose the Tube” project focused on improving metrics around one specific medical device: catheters. The hospital had realized that catheters were being given to patients who didn’t need them, and that they were being left in too long. The QI project was aimed at decreasing the number of catheter-associated urinary tract infections (CAUTI) in the hospital.
Over five months, a new system of nursing documentation and physician orders was implemented that ensured patients in need of catheters were appropriately cared for. The project successfully reduced CAUTI rates from 2.67/month to .2/month.
Something as simple as more regular and systematic check-ins was able to dramatically reduce infection for Mount Sinai.
UC San Diego’s QI project was based on improving hospital discharges. This project was undertaken simultaneously with the hospital’s efforts to improve medication reconciliation processes.
UC San Diego was able to improve the quality and consistency of discharge instructions. Results also showed better communication with the patient’s support network to ensure the transition of care went smoothly after they left the hospital.
Once you’ve implemented those quality improvement programs, you also need a way to report on them. Having a strategic management system like ClearPoint in place allows you to track your metrics for patient outcomes and patient care, identify areas that need improvement, and measure QI efforts and the resulting changes. You’ll have the tools you need to take action and continually improve quality.
Contact us to learn more about how our software can help healthcare organizations.
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