QUALITY IMPROVEMENT

Using Quality Improvement to Improve Patient Care Course

What the course is about

The course is intended for people who will work with clinical teams to achieve important improvements in the quality or safety of patient care or service. The course takes participants though a systematic, scientifically-sound process to achieve an important improvement. The process starts with motivating a group of staff to work as an effective improvement team and continues through sustaining improvements over time.

Participants work in teams on quality improvement projects (QIPs) during the course. Following each presentation in the course, teams are given time to work on their QIPs consistent with the advice given in the presentation. The course facilitator helps teams with their work, as needed.

Who  the  course  is  for

The course is for people who will work with teams on QIPs and others who have a role in managing or supporting teams to improve the quality of their services.

Learning objectives

The learning objectives for the course are to help participants to know:

• a structured and systematic approach to planning the achievement of an improvement in the quality or safety of patient care or service working with a team
• what’s involved in working within a multiprofessional team on achieving a quality or patient safety improvement
• approximately 30 practical tools to use in various stages of an improvement project working with a multi- professional team

and know how to:

• lead and contribute to the work of a multiprofessional team on achieving an improvement in the quality or safety of patient care
• reach consensus among team members on specific improvement objectives to be achieved, using consensus- building techniques
• identify key stakeholders in an intended improvement and ensure there is team, stakeholder and organizational commitment to achieving the improvement, using testing commitment tools
• analyse current processes of care, using a variety of process mapping tools, in order to identify inefficient or ineffective steps and change a patient care or service process
• learn about best practice from elsewhere, using critical appraisal of evidence or benchmarking
• measure how current practice affects patient care quantitatively using a range of quantitative tools including using descriptive statistics to interpret existing data, a clinical audit, a run chart or control chart, a survey, costing, or demand and capacity analysis
• measure how current practice affects patients, carers, or staff qualitatively using focus groups, critical incident technique or short or in-depth interviews
• analyse the evidence gathered to identify shortcomings in current practice and their root causes, using tools including a fishbone diagram, a tree diagram, asking why five times, an affinity diagram or benchmarking
• plan the change process using ‘theory of change for improvement’ thinking and its implementation, using a range of tools including a tree or driver diagram
• confirm the effectiveness of the change process in achieving the intended improvement, using appropriate measurement tools
• plan the sustained implementation of the improvements achieved.

What is included

Each participant receives a copy of our 20–chapter, 580–page Quality Improvement Methods for Healthcare Manual, each chapter giving detailed how-to instructions on key stages in the QI process and tools to use at each stage.

In addition to the Manual, each participant receives:

• a Learning Diary for the Using Quality Improvement to Improve Patient Care Course, a tool for reflection on learning throughout the course and planning how to apply learning after the course
• a Learning Objectives questionnaire, which supports formative and summative evaluations of the course
• a ‘welcome pack’ that includes a brief introduction to the course, the course programme, a short bio of the course leader/s, and a summative evaluation form
• some published journal articles
• a template QIP design form
• a template for reporting on a QIP
• useful resources on quality improvement, including links to journals, organizations and websites.

Certificates of completion of the course are provided.

Course programme overview

The course runs from 9.00 am to 5.00 pm each day or equivalent times consistent with normal working hours. There is extensive team work on QIPs on each day of the course.

The course can be provided in five consecutive days, or it can be divided into segments for a total of five days. The segment options are:

• 3 days, then 2 days
• 1 day, 2 days, 2 days

The content per day is as follows.

Day 1 — Getting ready for the project

• Refining the improvement project and the project’s objectives
• Learning to use consensus-building tools in a team
• Identifying and planning the involvement of stakeholders
• Testing commitment of the team and stakeholders
• Deciding on what to measure for the baseline

Day 2 and Day 3 — Planning measurement of the effects of current practice before introducing change

• A survey of tools and techniques, including process analysis, care pathways and checklists; tree diagramming; critical appraisal of evidence; benchmarking; qualitative techniques such as focus groups, critical incident technique, or focused or detailed interviews; and quantitative tools such as descriptive statistics; survey; clinical audit; run chart and control chart; costing; and demand and capacity analysis
• Reviewing all the tools and techniques to make decisions about what will be used for the team’s project
• Making a plan for measuring the effects of current practice

Day 4 — Interpreting current practice and planning change

• Reflections from teams on how measuring the baseline might go (or has gone) and what the teams could learn (or learned, if the course is in segments)
• A survey of tools and techniques to analyse the baseline data including fishbone diagramming, tree or driver diagramming or asking why five times; identifying exactly what has to change and how
• Applying a ‘theory of change for improvement’ by defining the cause-and-effect relationship between planned actions to achieve change and the outcomes of actions, including practical tools for setting priorities for actions.

Day 5 — Measuring the effectiveness of change and sustaining improvement

• Planning the implementation of changes in practice in detail, using project management tools
• Carrying out and interpreting repeat measurement to see the effects of implementing change
• Planning how to maintain improvements achieved
• Preparing to take the work forward and report on the project
• Reflecting on the QI team experience.

Our course has continuously included several forms of individual and group reflection at every stage of the course. We include teaching teams to manage their own individual and team reflections on performance.

Certification

The workshop is Certified as conforming to Continuing Professional Development (CPD) requirements in the UK by The CPD Certification Service.