Continuous Quality Improvement Initiative
Interventions
Armed with your prior discussions and baseline data, the QI Team can begin to identify opportunities for improvement. Together, look at your data and discuss the process points at which things break down or something can be changed to improve performance on the measures you have selected. As a general rule, interventions are desirable when:
• the process step is under the control of individuals participating in the quality improvement project (i.e., it is not readily affected by outside forces or considerations)
• there is some reason to think that changing the process step will lead to improved performance
• the process change can be implemented without severe disruption to other activities and processes going on at the same time
• the process change can be readily incorporated into the current workflow.
Potential interventions vary depending on the nature of the process focus--possibilities could include:
• writing or revising formal policies and procedures
• obtaining new equipment to automate a vulnerable process
• create or revise educational materials for patients or staff
• staff training
• development and deployment of process cues and assistive devices.
If several potential improvement strategies are identified, have the team prioritize them. Whatever the method used to prioritize the list, the team should work toward consensus on what can be accomplished within the allocated timeframe and available human, financial, and legal resources.
Start with the highest priority intervention and implement it. Do not make multiple changes at the same time, because if something improves you will not be able to say with confidence which change was responsible for the improvement or--possibly worse--the changes could cancel each other out and leave a mistaken impression that they were all ineffective.
QI Tools to assist in selecting an area for improvement and designing an intervention can be accessed by clicking on the following links:
After a predetermined amount of time has elapsed, collect your
Measures again. You determine whether your improvement strategy was effective by comparing the data collected before (baseline) and after you have implemented your intervention. The measurement strategy and the types of data you collect must be consistent, or you will not be able to accurately assess whether change has occurred.
If you see an acceptable level of improvement, the team should discuss methods for
Sustaining Improvement. If not, the team could decide to:
• Continue the intervention and measure again at the next agreed-upon evaluation point
• Add a second intervention strategy from the prioritized list to supplement the first one
• Substitute a different intervention strategy from the prioritized list
• Use the information gained from the intervention to return to brainstorming and analysis about strategies for attacking the problem.
Be patient--the first intervention doesn’t always work, or it may take a while to have an impact. Use the data you have collected and the team discussions to evaluate and strategize on an on-going basis.
