Quality Improvement Basics

Quality improvement (QI) is the systematic use of data and tested changes to improve a local care process, patient outcome, or work system. It is not limited to investigating something that already went wrong. A team can use QI to reduce falls, improve medication reconciliation, shorten delays in treatment, or make discharge instructions more understandable. Health care quality has six connected aims: - Safe: care avoids preventable injury. - Effective: care is based on evidence and produces the intended benefit. - Patient-centered: care respects the patient's preferences, needs, and values. - Timely: care is not delayed unnecessarily. - Efficient: care avoids waste of supplies, time, and effort. - Equitable: care quality does not vary unfairly because of personal or social characteristics. These aims must be considered together. For example, a process that shortens discharge time but leaves a patient unable to explain medication changes may improve timeliness while worsening safety and patient-centeredness. That is not net improvement. QI and research use data differently. QI applies existing knowledge to improve a defined local system; research uses a systematic investigation to develop...