Patient Safety and Quality Improvement: An Overview of QI

Abstract

It is important for pediatric providers to be involved in quality improvement (QI) activities to improve children’s health outcomes.• The Model for Improvement asks several key questions related to a process, then uses Plan-Do-Study-Act(PDSA) cycles to implement, test, and spread changes.• Lean and Six Sigma methodologies can improve quality by increasing workflow efficiency and decreasing variation.• Root cause analysis (RCA) is a retrospective quality tool that helps determine factors contributing to errors and adverse events, so that improvements can be implemented.• Failure modes and effects analysis (FMEA) isa prospective quality tool that anticipates system vulnerabilities and helps develop risk reduction strategies.• Evidence-based interventions, such as best-practice guidelines, promote standardization and reduce errors and adverse events, especially in high-risk health-care settings.• Team training can improve communication and situational awareness to create a safer health-care environment.

Use of Quality Improvement Strategies Among Small to Medium-Size US Primary Care Practices

“…Primary care practices use quality improvement (QI) strategies, such as monitoring and assessing outcomes, having skilled QI teams, and using system redesigns to improve patient and population health outcomes, system performance, and clinician experience, and to reduce health care costs. [2][3][4][5][6] Implementing QI strategies can help practices deliver appropriate health services efficiently and improve health outcomes, [7][8][9][10] yet much of what we know about the use of QI strategies in medical care comes from surveys conducted mostly in hospitals and health systems.…”

Improving Quality and Efficiency for Intussusception Management After Successful Enema Reduction

“…We used a plan-do-studyact cycle to provide feedback to health care providers on a quarterly basis. 9 Once in place, the project benefitted from rapid feedback because the first quarter of implementation had no patients discharged from the ED despite extensive groundwork that was in place before initiation. Staff from surgery and the ED were who were directly involved in the care of patients admitted to the hospital were queried as to the indications for admission and for sources of disagreement with the protocol.…”

Outcome quality assessment by surgical process compliance measures in laparoscopic surgery

“…Several authors have applied these measures to hospital business processes, in order to systematically improve hospital business processes [5], to relate process compliance with patient risk factors [7], or to improve quality management methods [8]. Furthermore, Schmutz and Manser [9] conducted a literature review to examine the impact of team process behaviors, including coordination, leadership, and communication, on clinical performance.…”