Quality Improvement (QI) is the first step on the path to enhancing care for patients and practice for staff. It provides basic tools and knowledge that healthcare settings can use to implement QI initiatives and improve care, satisfaction, and clinical outcomes. To support QI teams, the OHQC has developed the following free guides:

Quality Improvement Guide – This guide is intended as a jumping off point in the QI journey, and provides foundational knowledge necessary to start improvement projects. This document is divided into three main sections:  QI Project Cases — An introduction to structured improvement methods and examples of projects QI Model for Improvement — More details about the structured improvement model, including discussions and examples related to each component QI Methods and Tools— Examples of methods and templates of tools presented in the earlier sections of the guide Download guide.

Module 1: Access – to share principles and tools that can be applied to improve access in:  family physician clinics specialist clinics community health programs such as community health centres, diabetes education centres, rehab services, and other inter-disciplinary health teams interested in improving access.   Download guide.

Module 2: Efficiency – to share principles and tools that can be applied to improve efficiency in: family physician clinics specialist clinics community health programs such as community health centres, diabetes education centres, rehab services, and other inter-disciplinary health teams interested in improving efficiency.   Download guide.

Quality Improvement Guide for Long-Term Care – This guide is intended as a jumping off point in the LTC QI journey, and provides foundational knowledge necessary to start improvement projects. This document is divided into three main sections: LTC QI Project Cases — An introduction to structured improvement methods and examples of projects QI Model for Improvement — More details about the structured improvement model, including discussions and examples related to each component LTC QI Methods and Tools— Examples of methods and templates of tools presented in the earlier sections of the guide Download guide.

Additionally, this section provides resources to help individuals working in the health system improve quality. 

The tools here are not new but well established from quality improvement science – a rich field which has developed over the past 60 years through the work of people like J. Edwards Deming and Joseph Juran in manufacturing, and Don Berwick from the Institute for Healthcare Improvement. 

We provide examples in the Canadian context of how these tools can be used.  Our motto about the use of these tools:  share and share endlessly!  Feel free to adopt them and tailor them to fit your organization’s needs.  The information here is copyrighted but we grant permission to any practitioner, institution, or health care user in Canada’s publicly funded health care system to re-print and distribute these materials without charge.  (Use of these tools for commercial purposes, such as consulting, requires permission.)

Please give us feedback on whether you find these tools useful, how they can be improved, and what other tools you’d like to see in the future.  Furthermore, if you have examples of how you have implemented these tools in your own setting, please send them to us, and we would be glad to highlight your successes to your peers. 

OHQC would like to thank the following individuals for advising on the content of these tools:

Dr. Eric Fonberg, Rouge Valley Health System
Dr. Alan Forster, University of Ottawa
Lucy Fronzi, Group Health Centre
Ann-Marie Kungl, North Simcoe Muskoka Local Health Integration Network
Sudha Kutty, Ontario Hospital Association
Cynthia Majewski, Quality Healthcare Network
Cyrelle Muskat, Ontario Hospital Association

Index of Tools

Getting Started: Defining your Project

These tools help you structure and set a clear direction your quality improvement project.  

• Model for improvement
• Quality improvement project charters
• Project work plans
• Project execution project charters

Measurement Tools

These tools will help you measure quality throughout the project in order to monitor progress towards your target. 

• Creating a measurement plan
• Collecting baseline data
• Data collection tools:
  •  Mini-surveys
  • Defect check sheet
  • 3rd next available appointment check sheet
  • Chronic Disease Flow sheets
• Measuring cause of poor quality:  defect check sheet
• Sampling strategies
  

Analyzing your System

These tools will help you determine the most significant source of a quality problem, and will help identify which quality challenge you should tackle first.

• Ishikawa / Fishbone / Cause & Effect Diagrams
• Process Mapping
• Five Whys
• Pareto Charts
• Failure Modes & Effects Analysis
• Root Cause Analysis
  

Improvement: Testing and Implement Changes

These tools will help you test your ideas for improvement, refine your ideas, and implement change on a broader scale.  

• Change ideas and concepts
  • for chronic disease prevention and management
  • for improving work and patient flow
  • for preventing adverse events (Poka Yoke)
    
• PDSA cycles
• PDSA ramps
• Run charts
  

Links

Patient Resources