The foundations of quality improvement science

Reed, Julie; Davey, Nicola; Woodcock, Thomas

doi:10.7861/futurehosp.3-3-199

Cited by 27 publications

(26 citation statements)

References 7 publications

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“…16 The use of a PDSA approach is tailored to achieving this by making alterations to processes of care in direct response to stakeholder feedback while maintaining a structured experimental approach. 17 The upward trend in patient numbers supported by FORWARD over time may also have been, in part, a result of the fact that a significant proportion of patients who might be eligible for riskfeeding are attended to by a relatively small group of healthcare professionals, usually incorporating SLTs and dietitians, who would have been cognizant of FORWARD, helping to promote its use, overcoming natural cultural resistance.…”

Section: Discussionmentioning

confidence: 99%

Improving the care of patients feeding at risk using a novel care bundle

Sommerville

Lang

Harbert

et al. 2017

Future Healthcare Journal

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Feeding with acknowledged risk is appropriate for patients unsuitable for tube feeding who have an unsafe swallow that is unlikely to improve. However, without excellent multidisciplinary decision making and communication, patients may spend unnecessarily long 'nil by mouth' (NBM) and advance feeding/care plans may not be made or communicated. The FORWARD bundle (Feeding via the Oral Route With Acknowledged Risk of Deterioration) was sequentially co-designed and embedded across different services using 'plan-do-study-act' methodology to systematise best practice. Care before and after FORWARD was evaluated using a time-series analysis of 80 patients who had been risk-fed. Time NBM without tube feeding improved from 2 to 0 days (p=0.02) with signifi cantly better documentation of capacity assessments and discussions with next of kin. There were sustained trends to improved rates of best interest discussions and communication of feeding plans to downstream care providers. The signifi cance and applicability of these fi ndings is discussed.

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Section: Discussionmentioning

confidence: 99%

Improving the care of patients feeding at risk using a novel care bundle

Sommerville

Lang

Harbert

et al. 2017

Future Healthcare Journal

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“…An individualised ‘My Baby’s Summary Report’ will be administered to recruited parents in a sealed envelope every weekday. Quality improvement methodologies, including Plan-Do-Study-Act (PDSA) cycles18–20 and run-charts21 will be used to implement and further improve the communication tool. The content and the exact timing of the implementation in relation to the study will be fully described to avoid other concurrent parent-centred interventions influencing our study results.…”

Section: Methods and Analysismentioning

confidence: 99%

“…Data analysis will be aimed at improving the ‘My Baby’s Summary Report’ template and the piloting process. We will use PDSA cycles18–20 to analyse parental free-text feedback from PEC surveys and adapt the report’s template, creating the final template version for use in Stage 2 ‘Roll-out’. We will plot the parent and staff survey data on run charts, a standard method of quality control and a useful tool in quality improvement that enables one to monitor the performance of a process over time 21…”

Section: Methods and Analysismentioning

confidence: 99%

Better Use of Data to improve parent Satisfaction (BUDS): protocol for a prospective before-and-after pilot study employing mixed methods to improve parent experience of neonatal care

Sakonidou

Andrzejewska

Kotzamanis

et al. 2019

bmjpo

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IntroductionHaving a baby that requires neonatal care is stressful and traumatic. Parents often report dissatisfaction with communication of clinical information. In the UK neonatal care data are recorded daily using electronic patient record systems (EPR), from which deidentified data form the National Neonatal Research Database (NNRD). We aim to evaluate the impact of sharing neonatal EPR data with parents, on parent-reported satisfaction, parent–staff interactions, staff workload and data completeness.MethodsA prospective, before-and-after, mixed-method study. Participants are parents of inpatient babies (maximum 90) and staff in a tertiary neonatal intensive care unit, London, UK. The intervention was developed by former neonatal parents, neonatologists and neonatal nurses: a communication tool for parents comprising individualised, written, daily infant updates for parents, derived from EPR data. The intervention will be provided to parents over 6 weeks. Plan-Do-Study-Act cycles will inform the tool’s iterative development and improvement. The tool’s impact will be measured using a validated parent survey, staff survey, data completeness measures and interviews.AnalysisPrimary outcome: parent satisfaction ‘with communication of clinical information and involvement in care’. Secondary outcomes: parent–staff interactions, staff workload, data completeness. Baseline survey data will be obtained from clinical service evaluation preceding the intervention. Baseline data completeness will be derived from the NNRD. During the intervention, surveys will be administered biweekly and data completeness assessed daily. We will analyse outcomes using run charts and partially paired statistical tests. Parent and staff interviews will explore information exchange and the communication tool’s impact.DiscussionThis study will evaluate the impact of a parent co-designed intervention on communication with parents in neonatal care and the completeness of routinely recorded electronic clinical data. Better use of routinely recorded clinical data provides the opportunity to improve parent satisfaction and increase the research utility of such data, benefiting clinical care.Ethics and disseminationReviewed and approved by the West Midlands—South Birmingham REC (18/WM/0175).Registration numberISRCTN62718241.

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“…In recent years, the effectiveness of the PDCA methodology for quality improvement has been underscored in manufacturing [8], services, the health care system [9][10][11], and other environments. Matsuo and Nakahara examined and proved the positive effects of PDCA and on-job-training on significant improvements in workplace learning [12].…”

Section: Literature Reviewmentioning

confidence: 99%

Practical Application of Plan–Do–Check–Act Cycle for Quality Improvement of Sustainable Packaging: A Case Study

Nguyen

Schumacher

et al. 2020

Applied Sciences

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The research aims to give practical instructions for applying Plan–Do–Check–Act (PDCA) cycle in a packaging process. Eco-friendly, recycled material and a new packaging method for quality improvement and cost efficiency of heavily fragile product packaging are studied in this paper. A case study was conducted at GPEM laboratory, Vietnamese German University, Vietnam. In this case study, the current packaging style with Styrofoam material was analyzed and replaced by new packaging material and methods after applying the PDCA cycle for continuous quality improvement. Targets of the research were to find the new packaging method using friendly environment materials, to improve the quality, and to reduce the defect ratio due to packaging for fine-stone round surface fountains. Moreover, the extra cost should not be higher than 20% compared with the current packaging cost. The article proposes a simplified way that focuses on the combination of quality tools in the PDCA multiple phases to solve these problems. The quality tools are applied effectively through the PDCA cycle from collecting data, defining, analysis, testing, evaluation, and making decisions. New packaging design was been produced and tested successfully. One hundred percent of new packaging boxes for the mid-weight fountains (under 15 kg) passed the dropping test condition. Nearly 10% of the heavier weight products (above 15 kg) still had some small cracks on their top and bottom due to drop tests. Another PDCA cycle is recommended to continue applying for achieving a thorough solution. The conducted results show that PDCA is an effective method to tackle the damage product issue due to inappropriate packaging material and technique. It also brings good solutions for balancing sustainable packaging improvement and reducing the cost to ensure profit for companies. Besides contributing a guide reference for PDCA deployment, the authors intend to inspire practitioners and researchers to broaden exploration of the PDCA applications for sustainable packaging methodology. The research analysis shows that the PDCA methodology should be applied for defect reduction and quality enhancement in the packaging field. The field currently lacks systematic guidance for continuous improvement.

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The foundations of quality improvement science

Cited by 27 publications

References 7 publications

Improving the care of patients feeding at risk using a novel care bundle

Improving the care of patients feeding at risk using a novel care bundle

Better Use of Data to improve parent Satisfaction (BUDS): protocol for a prospective before-and-after pilot study employing mixed methods to improve parent experience of neonatal care

Practical Application of Plan–Do–Check–Act Cycle for Quality Improvement of Sustainable Packaging: A Case Study

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