6 Tips for Community Hospitalists Initiating QI Projects

The Hospitalist. 2016 September;2016(09):

September 9, 2016 | The Hospitalist

Resources for Starting QI Projects in Community Hospitals

For hospitalists planning on initiating a QI program in their community hospital, the Agency for Healthcare Research and Quality website offers several online resources to help. The QI Toolkit delineates the steps to the improvement process, from how to set priorities to how to plan, implement, and sustain improvement strategies. The toolkit proposes a five-step program3:

Diagnose the problem.
Plan and implement best practices.
Measure results and analyze.
Evaluate effectiveness of actions taken.
Evaluate, standardize, and communicate.

The website also includes a Practice Facilitation Handbook to guide hospitals in the creation of QI teams and plans. The handbook offers advice on who to include on a QI team and how it should be run, plus key driver models, or roadmaps, to starting a project. These models outline desired outcomes, large changes that will drive these outcomes, and action items that will produce these changes.4

Although comprehensive, these resources are geared more toward larger, highly staffed academic institutions. The SHM website provides tools that are practical and scalable for the community setting. Beyond strategies for garnering institutional engagement, team building, and gathering and analyzing data, SHM offers signature programs that can be tailored to the needs of the hospital:

Implementation Toolkits provide step-by-step instructions to implement QI programs over various clinical topics.
Mentored Implementation Programs deliver phone and email coaching by nationally recognized physician experts.
eQUIPS, or Electronic Quality Improvement Programs, supply web-based resources to jump start QI programs in popular topic areas.5

—Maybelle Cowan-Lincoln

QI Start-Up Checklist

How to initiate a QI program in your hospital in eight (not always easy but achievable) steps:

Choose a QI project that you feel passionate about and one that will impact your hospital’s bottom line.
Obtain support from the hospital’s senior management by linking its importance to patient outcomes and the institution’s financial health.
Gather an interdisciplinary team, including clinicians and stakeholders in other departments such as nursing, finance, and quality, to lead the project.
Determine the responsibilities of the various members of the QI team.
Locate where data to measure your project reside in the hospital, and determine who will mine the data and how.
Engage those on the front lines of care to support making the changes happen.
Analyze data to determine the success of the project and communicate the results to the staff.
Make the improvements part of the institutional culture.

—Maybelle Cowan-Lincoln