Quality Improvement Processes: Basics and Beyond | Smartsheet

According to Natenstedt, every successful QI plan needs a champion: “The most important factor contributing to successful implementation is highly committed senior leadership. For any quality improvement process, you need that leader who wants to make it happen. Success comes because someone at the top is pushing for it.”

In addition, Natenstedt says that QI projects flourish when stakeholders are invested in the outcome. “The projects that tend to go the best also tend to be the ones that tie back to the main mission of the organization,” he explains. “If you’re trying to get traffic to flow better in the parking garage, nobody’s committed. But if you’re reducing infections, every employee gets involved, because people care about the quality of what they’re providing.

“That’s when leadership has the crucial job of getting everybody on board. They accomplish this goal by explaining exactly why this particular solution is important and showing precisely who reaps the benefits,” Natenstedt continues.

Leadership for QI initiatives may be separate from the organizational structure and should best suit your particular system. In any case, leadership provides the needed resources, as well as the direction and support for core values and priorities. Because leadership is essential, it’s crucial to report any successes and obstacles back to them.

In addition to leadership, Natenstedt says teams need time, space, and opportunities to talk. “The primary team and other teams who will have great insights need collaborative, open, free thinking time. You have to get in a room, spend some time together, and not be afraid, no matter what you have to say or who you’re saying it to — a no-stupid-ideas environment,” he adds.

Natenstedt emphasizes that different perspectives are essential: “Make sure the team is not dominated by one type of person or employee. Get a diverse range of voices — even clients’ opinions. That fosters creative exchange.”

Other characteristics that contribute to a successful QI initiative include the following:

• Offer consistent and continuous commitment.

• Secure funds and other resources to support the plan.

• Create a vision for quality by using shared goals within and across teams. Engage all stakeholders to help define priorities for safety or cost savings. Take a multidisciplinary approach that includes peers from all teams, as well as frontline workers who implement and champion changes.

• Develop and agree on a plan for how to implement improvement activities, who will lead them, and how they will start.

• Build a quality improvement team. Work with that team to prioritize and implement improvements.

• Spread the word about initiatives and successes. Use one-on-one opportunities, newsletters, and other channels to discuss wins. Openly discuss successes and failures.

• Publicize the successes. Stories of success build motivation. Encourage people to talk regularly about quality and contribute suggestions.

• Educate stakeholders to prepare for initiatives by scheduling ongoing training and weekly meetings, especially with teams that have no previous experience with QI programs. Provide staff with the training and tools they need to measure and improve efforts. Seek outside support if necessary.

• Educate stakeholders on the subject area of the initiative.

• Collect the right data — however difficult — and use it well.

• Measure progress regularly.

• Use current resources as much as possible.

• Identify incentives that help members of an organization appreciate and cultivate change. Incentives may be financial or nonfinancial. Think about reducing errors, improving communication, and diffusing tension.

• Find influencers (i.e., people who others in the organization respect), and leverage that influence to spread ideas about change. Most people do not conduct research; they simply listen to the opinions of others.

• Establish realistic goals. Don’t aim for 100 percent success.

• Find an approach to metrics and documentation that suits your organization. “Within any project, you need a meaningful set of KPI (key performance indicators) that you can measure before and after,” says Natenstedt. “The old adage of ‘what gets measured gets improved’ is 100 percent true. And people will respond to the measurement simply because a measurement is being taken.”

• Create a robust IT implementation to record data, changes, and plans, as well as to leverage electronic health records (EHRs) and public databases where appropriate.

• Involve customers through surveys, exit interviews, and suggestion boxes. This information generates valuable ideas based on clients’ direct experiences with your services. In return, find user-friendly ways to help customers understand data.