Planning for Quality Improvement

State and community leaders can play a central role in leading health care quality improvement efforts. They can:

• Articulate a vision that inspires action and change
• Involve strategic partners and champions who can reach the front lines of health care
• Assemble information that focuses the attention of health care providers at the local level
• Enable health care improvement strategies to be tailored for state and local health care markets

MyQI Planning for Quality Improvement presents an operational approach to planning, implementing and evaluating quality improvement efforts. The approach was synthesized from Deming Cycle concepts, methodology from the Institute for Healthcare Improvement (IHI), elements of the Chronic Care Model, and the CMS Quality Roadmap. Application of the Plan-Do-Study-Act model to health care quality improvement is discussed in this article published by the Mayo Clinic.

There are three key steps for health care quality improvement. Each builds upon the next:

Step 1. Create a vision and provide leadership

• Collect information and learn from others
• Make the business case
• Identify champions and key stakeholders

Step 2. Work in partnership with champions/stakeholders

• Present the process
• Facilitate design of an intervention and apply it
• Test its impact

Step 3. Implement improvement through the partnership

• Spread successful change
• Evaluate the results
• Tackle another problem

Step 1: Create a vision and provide leadership

Effective leadership using the Plan-Do-Assess framework forms the core of quality improvement.

• Plan - prepare evidence of the need for quality improvement; identify areas for improvement and potential partners
• Do - convene partners in a high profile kickoff; present the business case; discuss partnership; set goals
• Assess - ask the group to assess the partnership; adjust if necessary

Step 2: Work in partnership with champions/stakeholders

Working in partnership is the next layer of quality improvement. Again, the Plan-Do-Assess approach forms the framework.

• Plan - strategize and obtain commitment to a focus area; design the intervention
• Do - define measures of success and apply intervention
• Assess - test impact of the intervention; refine as needed; repeat cycle until successful intervention is achieved

Step 3: Implement improvement through the partnership

This figure illustrates the final layer and the complete process - spreading change.

• Plan - write a plan for spreading successful interventions, specifying a timeline and how partners contribute
• Do - implement the change
• Assess - reconvene group and analyze/evaluate successes and failures; modify implementation or address next area for improvement

How can I design an approach for quality improvement?

The Institute for Healthcare Improvement shows you how the Plan-Do-Study-Act model can accelerate quality improvement

Develop skills to spread organizational change using frameworks from the Institute for Healthcare Improvement

Improvement Stories submitted to the Institute for Healthcare Improvement describe how various organizations tested and implemented quality improvement programs

Improving Chronic Illness and Care shares strategies for regional quality improvement and examples of coalitions that effected change

New Health Partnerships provides support for family members and clinicians working together to improve health care quality for patients with chronic conditions

Identify local Quality Improvement Organizations using the QualityNet Directory Listings

AHRQ's Community Quality Collaborative provides organizations with tools for identifying and collaborating with stakeholders to improve health care delivery in a community

Implement health care program tracking and evaluation using the CDC's Framework for Program Evaluation in Public Health

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