Getting Started with QI
Quality improvement (QI) is about making healthcare safe, effective, patient-centred, timely, efficient and equitable.
QI can be defined as "The combined and unceasing efforts of everyone to make the changes that will lead to better patient outcomes (health), better system performance (care) and better professional development (learning)". Batalden and Davidoff (2007)
QI uses tools or methods to continuously improve the quality of care and outcomes for patients. QI tools and methodologies include Lean, Six Sigma and Plan, Do, Study, Act cycles. There is no evidence that one approach is more successful than another and all have overlapping principles including:
- understanding the problem
- understanding processes
- analysing demand
- choosing the correct tool for change
- evaluating and measuring impact of an intervention
Evidence suggests that consistency in approach is key and a systematic analysis of the impact of changes is important.
During our training we are advised to undertake and lead at least 2 QI projects in Respiratory and 1 General Internal medicine project, all of which must be evidenced by a QI assessment and a project report uploaded to your personal library on your e-portfolio, then linked to the curriculum goals.
Additional reading to understand Quality Improvement
- Jones Bryan, Vaux Emma, Olsson-Brown Anna. How to get started in quality improvement BMJ 2019
- The Health Foundation - Quality improvement made simple: What everyone should know about health care quality improvement
- The Health Foundation - The improvement journey: Why organisation-wide improvement in health care matters, and how to get started
- Royal College of Physicians - RCPQI: RCP quality improvement resources
- Quality Improvement Essentials Toolkit - Institute for Healthcare Improvement
- Dr Mike Evans: An Illustrated Look at Quality Improvement in Health Care - Institute for Healthcare Improvement
Respiratory Quality Improvement Resources
Examples of Respiratory QI projects
- Designing and implementing a COPD discharge care bundle.
- Quality improvement in Respiratory Medicine: Designing and implementing a bronchoscopy checklist at Southend University Hospital
- Sherwood Forest Hospitals NIV QI programme (Case study video)
- Worthing Hospital - Management of secondary spontaneous pneumothorax
- BTS NIV QI Tool
- BTS Tobacco Dependency QI tool
Training and post graduate qualifications
Several universities offer a postgraduate certificate (PGCert), postgraduate diploma (PGDip) and masters (MSc/MA) in Quality Improvement and related fields. Some examples of QI courses are listed below.
- NHS IMPACT Operational Improvement Training Programme
- UCLPartners Introduction to Quality Improvement
- Quality Improvement in Healthcare: the Case for Change, University of Bath
- Quality and Safety in Healthcare CPD, Leicester University
Guides to developing a QI project
- NHS Impact Improvement
- NHS England Change Model
- Institute for Healthcare improvement Quality Improvement Essentials toolkit
- Sustainability in QI – Centre for Sustainable Healthcare, Oxford.
Hints, tip and motivation
- The science of persuasion – The Influence Network
- How to start a movement – Derek Sivers – TED
- Got a wicked problem? First, tell me how you make toast – Tom Wujec – TED
- How great leaders inspire action – Simon Sinek – TED
QI Conferences
QI Journals
- Royal College of Physicians Future Healthcare Journal
- BMJ Quality and Safety Journal
- BMJ Open Quality