Getting Started: Defining your Project
Getting Started: Defining your Project
Model for Improvement
The Model for Improvement is a simple but powerful framework for structuring any quality improvement project. First, every project should be able to answer three fundamental questions:
The Model for Improvement was developed by Associates in Process Improvement and is the foundation of the quality improvement support activities and training programs at the Institute of Healthcare Improvement (IHI).
What are we trying to accomplish?
QI projects should have clear aim statements in order to succeed. The aim should have a specific measurable target and a target time for reaching it.
Examples of good aim statements include the following:
“We will improve management of diabetes patients served at the Brown St. Clinic. By May of next year, we will aim to increase the percentage of patients meeting their targets for A1C and blood pressure from 50% to 75%.”
“We will reduce wait times for new patients referred to our specialty clinic from 53 days to 26 days. We will accomplish this 7 months from now.”
Examples of poor aim statements include the following:
“Through the implementation of an electronic medical record (EMR) our chronic disease patients will get better care.”
“We will create a truly interdisciplinary team to provide patient-centred care for those suffering from chronic conditions.”
While implementing an EMR or teamwork may have important benefits, this aim does not specify what will be accomplished from the patient’s perspective. Also, there is no target time frame for completion.
Tip: What should the target be?
We encourage teams to set stretch goals. This may include the best recorded practice in any comparable quality improvement initiative elsewhere. Aiming for small incremental change (e.g. 10%, or aiming to move from below average to average) does not represent a real breakthrough in quality, and likely will not justify the investment in people’s time to participate in the QI team. If there are no clear examples of leading practices elsewhere, consider decreasing the amount of suboptimal care, adverse events, or undesirable wait times by half as a first goal.
How will we know that a change is an improvement?
Teams should select specific measures that demonstrate whether a specific change lead to an improvement. Click here to go to creating a measurement plan.
What changes can we make that will result in improvement?
Many QI initiatives have the tendency of identifying a single idea for improving care, and then jumping straight into implementing it. QI science suggests a more reflective approach. First, QI teams should identify all the different ideas for improving care.
This is can be done by:
Recommended reading:
GL Langley, KM Nolan, TW Nolan, CL Norman, LP Provost. The improvement guide: a practical approach to enhancing organizational performance. Jossey-Bass, San Francisco, 1996.
- model for improvement
- quality improvement project charters
- project execution
Model for Improvement
The Model for Improvement is a simple but powerful framework for structuring any quality improvement project. First, every project should be able to answer three fundamental questions:
- What are we trying to accomplish?
- How will we know a change is an improvement?
- What changes can we make that could lead to an improvement?
The Model for Improvement was developed by Associates in Process Improvement and is the foundation of the quality improvement support activities and training programs at the Institute of Healthcare Improvement (IHI).
What are we trying to accomplish?
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“Some is not a number, soon is not a time.” Dr. Don Berwick, CEO, Institute for Healthcare Improvement, December 2005 |
Examples of good aim statements include the following:
“We will improve management of diabetes patients served at the Brown St. Clinic. By May of next year, we will aim to increase the percentage of patients meeting their targets for A1C and blood pressure from 50% to 75%.”
“We will reduce wait times for new patients referred to our specialty clinic from 53 days to 26 days. We will accomplish this 7 months from now.”
Examples of poor aim statements include the following:
“Through the implementation of an electronic medical record (EMR) our chronic disease patients will get better care.”
“We will create a truly interdisciplinary team to provide patient-centred care for those suffering from chronic conditions.”
While implementing an EMR or teamwork may have important benefits, this aim does not specify what will be accomplished from the patient’s perspective. Also, there is no target time frame for completion.
Tip: What should the target be?
We encourage teams to set stretch goals. This may include the best recorded practice in any comparable quality improvement initiative elsewhere. Aiming for small incremental change (e.g. 10%, or aiming to move from below average to average) does not represent a real breakthrough in quality, and likely will not justify the investment in people’s time to participate in the QI team. If there are no clear examples of leading practices elsewhere, consider decreasing the amount of suboptimal care, adverse events, or undesirable wait times by half as a first goal.
How will we know that a change is an improvement?
Teams should select specific measures that demonstrate whether a specific change lead to an improvement. Click here to go to creating a measurement plan.
What changes can we make that will result in improvement?
Many QI initiatives have the tendency of identifying a single idea for improving care, and then jumping straight into implementing it. QI science suggests a more reflective approach. First, QI teams should identify all the different ideas for improving care.
This is can be done by:
- reading reviews of best practices from elsewhere
- using system analysis tools (e.g. process flow maps, Ishikawa diagrams, Pareto charts) to identify where problems are occurring and potential solutions
- using generic change concepts (a general approach to improving quality) and then brainstorming about how to apply these concepts in a local setting
Recommended reading:
GL Langley, KM Nolan, TW Nolan, CL Norman, LP Provost. The improvement guide: a practical approach to enhancing organizational performance. Jossey-Bass, San Francisco, 1996.
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