This is a substantial revision of a previous module by Dr Michael Holland, Emily Doncaster and Sophie Hodge. The authors acknowledge their contribution.
Working in healthcare we all notice things that can be done better, but it is often difficult to know how to actually bring about change. What initially appears simple or obvious can seem insurmountable on trying to improve things, particularly when every component of any care pathway relies on so many different people and steps. This interconnectedness is part of the nature of healthcare leading to health systems being regarded as 'complex systems'. Making improvements in these circumstances requires a special set of skills, which is where quality improvement (QI) comes in.
Although there are many ways in which quality can be improved, the term 'quality improvement' specifically refers to the use of systematic methodologies to tackle complex problems. A well-known definition is:
'the combined and unceasing efforts of everyone – healthcare professionals, patients and their families, researchers, payers, planners and educators to make the changes that will lead to better patient outcomes (health), better system performance (care) and better professional development (learning).' (Batalden & Davidoff, 2007).
Applying QI methodology can accelerate positive change and the structure it brings helps to quantify what is being achieved. This assists not only in the improvements themselves but also when making the case for further resources, considering further changes and sharing what has been learned through the work.
This module gives an overview of quality improvement and will help you consider how it is relevant and applicable in your own practice.