Chinese philosopher and poet Confucius said, “Study the past if you would divine the future.” Those ancient words of wisdom have not lost their value to modern society and are particularly appropriate for successfully developing and completing quality improvement (QI) projects. Hospitals and health systems budget annually for QI, EBP, and research projects to help move a department or their entire organization to the next level. More improvements mean greater patient satisfaction, higher quality scores, and a better reputation.
But how much of that quality improvement budget is wasted because teams neglect to look back? Examining previous QI efforts enables healthcare facilities to fully answer the question, “Why is this a problem now?” Let’s look at how evaluating previous projects can positively impact your QI program — and why studying the past has been so complicated when it comes to QI.
Past QI projects can inform new ones from beginning to end
When a problem is identified and a QI project proposed, the team is eager to get it off the ground. But it’s important for the team leader and/or members to explore previous related projects to avoid duplication of efforts and to build on previous learnings. Key information that can benefit a new QI, EBP, or research project right from the start can include:
- What were the specific project focus and metrics?
- What was learned?
- What was implemented?
- What results were achieved?
- Was it sustained, and if not, why?
Reviewing prior projects can also help team members who are new to QI methodologies. Seeing how other QI efforts unfolded helps give novice researchers a stronger foundation as well as more confidence in their participation in the team. For new complex projects requiring experience in a methodology or a specific area, such as Six Sigma® Black Belt or Master Black Belt, historic information may spur the team to see its project in a new light.
Challenges to reviewing previous QI projects and information
Your hospital or health system may use collaboration software, such as Microsoft SharePoint, to store data and QI-related documents. For higher-level employees who have frequent access to these sites, the ability to retrieve and examine information about past QI projects may be fairly easy. But it could be a barrier to reviewing information if a QI team member such as a general staff nurse or a resident must request access to documents to see what’s been done or might currently be underway.
Besides the consistent lack of accessibility to old projects, there’s also the challenge of employee turnover. Some QI projects may be saved on an individual’s hard drive or stored in a desk drawer or filing cabinet. When the team leaders leave a department or the organization, the history of QI projects often goes with them. Even if the person trying to outline a new project wants to consult about earlier efforts on the same or similar topic, no one might have access to the details.
There is often a perception that revisiting old projects offer little value to current projects because “things have changed” in the hospital or health system. Many care issues such as pressure ulcer reductions, heart failure readmissions, falls, catheter-associated urinary tract infections (CAUTI), and patient satisfaction have been the subjects of QI projects for decades. But identifying additional or new gaps in performance, evidence-based practice, or regulatory drivers is a worthwhile project — and there could be precedents to help make that project more manageable and more successful.
Imagine a single, cohesive view of all QI projects
There is a way to leverage past quality improvement projects: by making them easily accessible to all members of all teams in a single health system. A centralized QI workflow solution enables transparency of past, present, and planned projects, helping to eliminate duplication and guide both seasoned and less experienced project participants. Having historical insight quickly allows teams to see how their proposed project aligns with the department’s, hospital’s, or health system’s strategic plan and goals and reducing the search to find documents or people connected to similar projects.
Quickly identifying and referencing past projects is also valuable to the hospital or health system’s reporting and regulatory requirements. For example, the Joint Commission believes care processes and patient outcomes can be improved and sustained only by gathering and analyzing performance measurement data with an organized and comprehensive approach to performance improvement.
During the JCAHO accreditation cycle, the Commission will ask the institution to demonstrate how they identify problems and use data, and will also request an overview of the QI program and an individual project description from beginning to end. To meet these asks, the organization could log into the Ovid® Synthesis Clinical Evidence Manager, show the dashboard, open a project, and the project lead could walk the surveyor through the project from description to implementation and results.
In another scenario, wrong-site surgery or another reportable clinical event could prompt an unannounced visit by the state health department to the facility to review the reported issue. The team could easily show the inspector the documented root cause analysis (RCA) of the event and the QI project undertaken to prevent such events in the future.
Teams addressing health quality improvements need all the best evidence to improve your healthcare standards — and that might be corroboration from QI projects done weeks, months, or years ago. Learn how a single workflow solution could benefit your hospital's or health system's QI initiatives.
