Quality health care can be defined by a framework of six domains: care that is safe, effective, patient-centered, timely, efficient, and equitable. A quality improvement intervention (QI) is a change in systems or processes that is made to increase quality health care.
QI can be measured for their effectiveness in different ways, like the reduction of health disparities, or the improvement of outcomes for a patient population.
Examples of quality interventions for health care include:
- Physician education, auditing, and benchmarking
- Patient education and patient reminder systems
- Patient health initiatives (e.g. immunization, tobacco cessation)
Why do we need quality interventions?
A 2009 National Healthcare Disparities Report (NHDR) report found that disparities related to race, ethnicity, and socioeconomic status still pervade the American health care system. These disparities are caused by a combination of factors, including social determinants of health, differential access to care, implicit bias, and lack of culturally competent care.
QI can be used to improve patient outcomes by analyzing the health disparities facing patient populations and executing processes to address them. For example, one intervention focused on the racial disparities of breast cancer diagnosis in Latine/x and Hispanic women, and the implementation of a Spanish language-based breast cancer screening program was shown to be effective for promoting mammograms.
How quality improvement works.
Quality interventions in health care begin with developing a goal, identifying strategies to achieve the goal, and then creating a plan of action.
First, determine the areas your organization is seeking to improve.
- Is there a specific patient population you are targeting?
- What health disparities affect these patients?
- What are their barriers to care?
- What interventions would be most helpful for these patients?
Next, it’s important to analyze the systems and processes at work.
- Who are the health care professionals involved?
- What are the current processes? (e.g. intake, sharing patient information, emergency care, preventive care, etc.)
- What are the environmental conditions? (e.g. staffing, training, scheduling)
Once this stage of research is completed, you can create your organization's plan of action by answering the following:
- Is this a culturally competent solution?
- How will this intervention be communicated to patients, providers, and staff?
- How will data be captured throughout this process?
Once you have established your QI goals, you can use trusted frameworks such as the IHI Model for Improvement (Plan-Do-Study-Act), Six Sigma, and/or Lean to measure outcomes.
Use the data collected over the course of the intervention to inform the next steps.
- Review feedback from patients, providers, and staff.
- Where are there areas of improvement?
- Can this be achieved through process change? Communication? Training?
- Share the lessons learned and celebrate positive outcomes that are achieved.
Building a culture of quality.
The AAFP explains that your care organization's practices and procedures should be aligned with your QI efforts: “QI culture looks different for every practice, but may include establishing dedicated QI teams, holding regular QI meetings, or creating policies around your QI goals.” By building a culture of quality, QI becomes integrated into day-to-day operations in ways that can benefit both patients and providers.
One way to get started with QI initiatives is by better understanding your health care delivery team’s ability to provide culturally competent care through provider benchmarking and continuing education. These benchmarks can be used to create personalized education pathways for providers using Violet’s e-learning platform. These targeted interventions to improve outcomes for culturally diverse patients can be implemented and measured through Violet. Learn more here.
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