Quality Improvement

Quality Improvement (QI) is a systematic process using measurable data to improve health care services and the overall health status of patients (Study.com, n.d.). QI is one of the competencies of the Quality and Safety Education (QSEN) project and defined as, “using data to monitor the outcomes of care processes and using improvement methods to design and test changes to continuously improve the quality and safety of health care systems” (QSEN Institute, n.d.). 

The overall goal of the QI process is to improve the quality and safety of health care. The process of quality improvement is very similar to the Nursing Process, but its purpose is to answer these three main questions

• What are we trying to accomplish?
• How will we know if a change is an improvement?
• What changes can we make that will result in an improvement?

See Figure 6.1 (Cliffnorman, 2018.) for an illustration of the Quality Improvement Process.

To answer these questions, QI is a continuous process in which a project is planned, interventions are implemented, data is collected, results are studied, and outcomes are evaluated. The process is repeated after additional planning. During the QI process, four key steps are used to evaluate current patient care and determine if changes are needed. These components are referred to as Plan, Do, Study, and Act:

• Plan: The first step in the QI process is to identify what you will be testing or focusing on and what will be measured. Similar to the Nursing Process where subjective and objective data are collected, the nurse determines what data will be needed during the QI process. The nurse also determines a timeline for the QI project, such as one year, including a specific framework for when data is collected and when it will be reviewed. For example, fall rates will decrease 10% in one year.
• Do: After the plan is determined, the nurse works with a health care team to implement the project and ensure data collection occurs.
• Study: During this phase, the nurse works with the health care team to review and analyze the data that was collected and determine if the outcomes were achieved or not.
• Act: In the fourth step of the QI process, the team discusses the outcomes. In this step the team identifies barriers, strengths, and weaknesses and then decides if additional changes are needed in nursing practice. The QI process is continuous, so the QI team uses outcome findings to continue the process of Plan, Do, Study, and Act to ensure safe, quality patient care.

It is important to note that quality improvement is different from nursing research. QI evaluates processes in place and determines if changes are needed, whereas the goal of research is to identify new innovations in nursing practice (Agency for Healthcare Research and Quality, 2013).

Next: 6.2 Quality Improvement Measures