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A Brief Guide on Quality Improvement Project



Hi, I am Dr Neenu, an International Medical Graduate from India working in the NHS as an SHO in Emergency Medicine. As the name suggests, Quality Improvement Projects (QIP) are projects done in order to improve the quality of care provided to the patients. Any doctor working in the NHS would need to do a QIP at some stage in their non-training or training job to progress further in their career. Hence, it is crucial to know how to conduct one.


In today's blog, I will be discussing the following:


1. Difference between audit and QIP?

2. Why is QIP important in healthcare setting?

3. How to do a QIP?

4. What are the different approaches to do a QIP?

5. How to come up with ideas for QIP?


What is the difference between audit and QIP?


Audit is essentially data collection to identify whether current practice in the hospital is according to the national standards. There can be a single or multiple cycle audit and is mostly focused on adherence to standards. However, QIPs are proactive initiatives to drive improvements beyond mere adherence to standards.


QIPs involve a continuous cycle of identifying problems, implementing changes, and evaluating outcomes to achieve sustainable quality enhancement. For eg, an audit can be done to see if asthma management in primary care is done according to the standard NICE guidelines. On the other hand, a QIP can be about implementing changes to the current handover system, wherein you can propose a new more effective form of handover, which is not necessarily according to national standards but could benefit your team.


Why is QIP important in healthcare setting?


QIP are essential to improve the care we provide to the patients. It aims to identify areas where patient care and safety can be enhanced. By continuously evaluating and improving processes, protocols, and practices, hospitals can minimize errors, reduce adverse events, and ensure better patient outcomes. They are designed to identify underlying issues or challenges within healthcare processes. By actively seeking out these problems, sometimes we can address the root causes rather than just treating symptoms.


How to do a QIP?


1. Problem identification - To begin with, you need to identify the issue or problem that needs changing.


2. Once you know this, define your aim using the SMART Framework.


Specific – Narrow your focus to something really specific rather than taking on a broad view Measurable – Ensure you can find data to demonstrate change

Achievable – Ensure that data collection is easily achievable.

Realistic/Relevant – Ensure that is relevant to your practice and patient care

Timely – Ensure it can be completed in a specific time period


3. Start your data collection – this is to identify where you can implement the changes


4. Once you have your data, implement a change that can be carried out.


5. Measurement - Once the change is implemented, you can re-audit to see if there are any improvement and whether the change you suggested is improving patient care or not.


6. If improved, carry on with the proposed changes and propose it to the wider team.


7. If there is no improvement, suggest another method, and re-audit again until you see improvement.


What are the different tools to do a QIP?


PDSA Cycle is the most commonly used tool and ideally you would need at least 2 cycles to complete a QIP. The PDSA cycle essentially involves:


Plan – Identify the aim, how will it be carried out, who will be collecting the data, when will it be implemented

Do – Collect your data, address any issues that you may have encountered

Study – Analyse the data

Act – what are your findings, what changes can you implement, how can you ensure that the changes you have suggested will improve the problem.


There are other tools such as process maps and driver diagrams which I would not be discussing in detail.


How to come up with ideas for QIP?


• The easiest way is to ask your registrars or consultants. Most of them would be happy to guide you to carry out a project. You could also ask your colleagues if they want another helping hand.

• When you start working in a department, there might be certain aspects that you would want to change for effective functioning of the department. Identify these key areas and propose this to your senior colleagues or hospital QIP lead.

• Every hospital has a QI Lead. Approach them to see if they have any ideas/projects that you could help with.


My tips:


• Don’t try a project that would take up too much of your time. Remember implementing changes can take up time and having too many things to do on one project might not be effective.

• Be proactive in managing and leading the QIP

• Sometime the change you implemented might not be effective and you may have to keep implementing new changes, this might be exhausting. But be patient and ensure you are actively learning from each failure.

• Register your QIP with the hospitals’ QIP team and present your findings in the local departmental meeting. You can also present it as a poster or oral presentation in different national/international conferences.


Overall, doing a QIP is an effective way to improve quality of care provided to the patient and also a great way to enhance your leadership, team work and communication skills.


Need some help?


TrewLink has an amazing website which will help you in your journey to the UK. If you need any help or guidance with regards to your exam preparation and journey to the UK, you can always approach us here: https://www.trewlink.com/ You can register using this link https://trewlink.com?referrer=nee420214 I hope my post will help those of you who needs a basic idea about QIPs.


Good luck,

Dr Neenu

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