Finding project guides and toolkits to start your QI activity 

There are many different approaches to designing and implementing a QI activity, each being individualised by:

  • Context,
  • Objective,
  • Approach to measure change,
  • Type of data collection,
  • Analytical methods comparing outcomes against national or accreditation standards, and
  • Dissemination or reporting of findings.

For palliative care services, high-quality QI activity outcomes are measured against benchmarking or service quality elements within the Palliative Care National Standards (2018) and are mapped to Australian Commission on Safety and Quality in Health Care (ACSQHC) National Safety and Quality Health Service (NSQHS) Standards for practice accreditation.

Getting started with QI

There are many freely accessible resources available to support staff to design a high-quality activity, these include project guides, toolkits, websites and peer-reviewed articles. Some examples are provided here, and your organisation might also have a guide to QI.

The Australian Commission on Safety and Quality in Health Care (ACSQHC) has developed a freely accessible practical resource for healthcare professionals and organisations to support high-quality QI activity. Measurement for Improvement Toolkit (2006) provides:

  • A user’s guide to the toolkit and case examples
  • Background information and resources including current knowledge on patient safety
  • Summary of measurement tools and processes.

Palliative Care Outcomes Collaboration (PCOC)

Some Primary Healthcare Networks have developed a QI toolkit to support general practice provision of end of life care in the community including:

Quality Improvement Project Guide (30.6kb docx) published on the BMJ Open Quality website is a downloadable, interactive document (with linked examples of articles and websites) that helps to focus QI objectives providing a systematic planning guide to high-quality QI activities.

Aspects of QI design discussed within this document include:

  • Identifying an improvement model, framework or approach
  • Recognising severity and nature of localised problems for improvement
  • Developing primary and secondary study questions
  • Application of ‘SMART’ goals (Specific, Measurable, Achievable, Relevant, Timely) to formulate specific aims
  • Implication of setting on methods and ethical requirements of the activity
  • Undertaking background searches for evidence about the problem and possible solutions
  • Sustainability of QI activity over time
  • Upscaling and changes to the intervention over time using the PDSA cycle
  • Analysis of outcomes to national standards and dissemination of results.

Health Foundation UK has produced a guide to make QI understanding accessible for everyone.

Reporting and Assessing QI studies

Your health service is likely to have its own template for reporting QI activities. Detailed, structured reporting of findings of QI studies within the scientific literature also has the potential to progress QI practice within healthcare through contributions to an expanding evidence base.

To help with this the Standards for QUality Improvement Reporting Excellence (SQUIRE) group developed detailed guidance for reporting evaluations of QI interventions within a standardised format. This can help report writers but also reviewers. The SQUIRE guidelines are available on the SQUIRE website with detailed information on how to develop a report including a Quality improvement report submission template (16kb docx).

This interactive template addressed four critical questions about the QI activities:

  1. Why did you start?
  2. What did you do?
  3. What did you find?, and
  4. What does it mean?

There are also a variety of critical appraisal tools that can be used to assess the quality and the applicability of intervention outcomes to a localised context. The Quality Improvement Minimum Quality Criteria Set (QI-MQCS) [1] is an example of a validated and reliable critical appraisal tool for assessment of QI intervention publications within the scientific literature. This tool assists reviewers to identify higher-quality studies.

QI-MQCS provides a framework for critical appraisal in which staff can evaluate levels of quality by assessing and scoring against minimum standards for 16 content domains.

Watch: Five tips for carrying out a quality improvement project

Video from BMJ

  1. Hempel S, Shekelle PG, Liu JL, Sherwood Danz M, Foy R, Lim YW et al. Development of the Quality Improvement Minimum Quality Criteria Set (QI-MQCS): a tool for critical appraisal of quality improvement intervention publications. BMJ Qual Saf. 2015 Dec;24(12):796-804. doi: 10.1136/bmjqs-2014-003151. Epub 2015 Aug 26.

Page created 28 March 2022