NHS 8050 Discussion Health Care Improvement

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NHS 8050 Discussion Health Care Improvement

NHS 8050 Discussion Health Care Improvement

Review the “How to Study Improvement Interventions: A Brief Overview of Possible Study Types” article on health care improvement.

In your initial post:

Provide a synopsis of ways an improvement focus might be useful in bringing evidence to your practice.

Discuss if your own project might work as an improvement project. How do you see improvement ideas integrated into your own work?

Post according to the Faculty Expectations Response Guidelines. Be sure to include at least one APA-formatted citation (in-text plus full reference). The citation should be from materials you have read during this unit. It may be from course textbooks, assigned readings, or an outside source.

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. We’ve defined QI programs and provided some current examples of quality improvement in leading healthcare organizations in the US and Canada.

What is a healthcare quality improvement (QI) program?

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.

Why are QI programs important for healthcare?

Quality improvement programs are critical because they drive:

  • Improved outcomes for patients
  • Improved efficiency of staff
  • Less waste due to process failures

With lives at stake and specific standards that must be met, hospitals are held more accountable for excellence than your typical organization.CLICK TO TWEET

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.

General Structure Of QI Programs

Broadly speaking, the below are best practices for most QI programs. (Note that these are not absolutes, but general guidelines.)

  • Set targets aimed at making improvements in these four categories:
    • Safety
    • Effectiveness
    • Access
    • Patient-Centeredness
  • Summarize quality improvements made the previous year in regard to the above four categories, and outline the efforts in the upcoming year that will continue to drive improvements in those categories.
  • Demonstrate how QI priorities align with the organization’s vision and strategic plan, so your team understands how every effort ties to the high-level strategy.
  • Present and give context for the KPIs being used to track progress toward QI goals.

Are you tracking the right KPIs? See if you should add any from this list of 108 healthcare measures and metrics.

Quality Improvement Examples: Organization-Wide, Ongoing Programs

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:

      • Patient engagement. Sunnybrook created an external website to support patients, as well as an internal website to guide staff on engaging patients.
      • Compassionate care. This is measured in several ways, including patient surveys.
      • Safety. Reduce patient and staff infections by pioneering a hand hygiene measurement system.

Quality improvement example - Sunnybrook Health Sciences Centre (SHSC)

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.

Quality improvement example - Joseph Brant Hospital (JBH)

Quality Improvement Examples: Process-Specific Projects

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

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 Health

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.

A Final Thought

These are examples from leading healthcare organizations. Make sure you customize each program and process that you implement based on your organization’s goals. Not all healthcare organizations operate in the same way, so there’s never a one-size-fits-all approach.

What you SHOULD do once you’ve implemented those quality improvement programs, is find a way to report on them. Having a strategic management system like Clear Point 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.


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