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2016 ; 11
(5
): 893-900
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English Wikipedia
How to Begin a Quality Improvement Project
#MMPMID27016497
Silver SA
; Harel Z
; McQuillan R
; Weizman AV
; Thomas A
; Chertow GM
; Nesrallah G
; Bell CM
; Chan CT
Clin J Am Soc Nephrol
2016[May]; 11
(5
): 893-900
PMID27016497
show ga
Quality improvement involves a combined effort among health care staff and
stakeholders to diagnose and treat problems in the health care system. However,
health care professionals often lack training in quality improvement methods,
which makes it challenging to participate in improvement efforts. This article
familiarizes health care professionals with how to begin a quality improvement
project. The initial steps involve forming an improvement team that possesses
expertise in the quality of care problem, leadership, and change management.
Stakeholder mapping and analysis are useful tools at this stage, and these are
reviewed to help identify individuals who might have a vested interest in the
project. Physician engagement is a particularly important component of project
success, and the knowledge that patients/caregivers can offer as members of a
quality improvement team should not be overlooked. After a team is formed, an
improvement framework helps to organize the scientific process of system change.
Common quality improvement frameworks include Six Sigma, Lean, and the Model for
Improvement. These models are contrasted, with a focus on the Model for
Improvement, because it is widely used and applicable to a variety of quality of
care problems without advanced training. It involves three steps: setting aims to
focus improvement, choosing a balanced set of measures to determine if
improvement occurs, and testing new ideas to change the current process. These
new ideas are evaluated using Plan-Do-Study-Act cycles, where knowledge is gained
by testing changes and reflecting on their effect. To show the real world utility
of the quality improvement methods discussed, they are applied to a hypothetical
quality improvement initiative that aims to promote home dialysis (home
hemodialysis and peritoneal dialysis). This provides an example that kidney
health care professionals can use to begin their own quality improvement
projects.
|*Total Quality Management
[MESH]
|Hemodialysis, Home/*standards
[MESH]
|Humans
[MESH]
|Leadership
[MESH]
|Models, Organizational
[MESH]
|Nephrology/*standards
[MESH]
|Organizational Innovation
[MESH]
|Outcome and Process Assessment, Health Care
[MESH]
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