Continuous quality improvement methodology: a case study on multidisciplinary collaboration to improve chlamydia screening

Abstract

This article illustrates quality improvement (QI) methodology using an example intended to improve chlamydia screening in women. QI projects in healthcare provide great opportunities to improve patient quality and safety in a real-world healthcare setting, yet many academic centres lack training programmes on how to conduct QI projects. The choice of chlamydia screening was based on the significant health burden chlamydia poses despite simple ways to screen and treat. At the University of Michigan, we implemented a multidepartment process to improve the chlamydia screening rates using the plan-do-check-act model. Steps to guide QI projects include the following: (1) assemble a motivated team of stakeholders and leaders; (2) identify the problem that is considered a high priority; (3) prepare for the project including support and resources; (4) set a goal and ways to evaluate outcomes; (5) identify the root cause(s) of the problem and prioritise based on impact and effort to address; (6) develop a countermeasure that addresses the selected root cause effectively; (7) pilot a small-scale project to assess for possible modifications; (8) large-scale roll-out including education on how to implement the project; and (9) assess and modify the process with a feedback mechanism. Using this nine-step process, chlamydia screening rates increased from 29% to 60%. QI projects differ from most clinical research projects by allowing clinicians to directly improve patients’ health while contributing to the medical science body. This may interest clinicians wishing to conduct relevant research that can be disseminated through academic channels.

A scoping review of continuous quality improvement in healthcare system: conceptualization, models and tools, barriers and facilitators, and impact

“…Furthermore, a gap or failure opens another opportu- nity for establishing a data-driven learning organization [41]. • CQI cannot be implemented without a CQI team [8,19,37,39,[42][43][44][45][46]. A CQI team comprises individuals from various disciplines, often comprising a team leader, a subject matter expert (physician or other healthcare provider), a data analyst, a facilitator, frontline staff, and stakeholders [39,43,[47][48][49].…”

Systematic Decision-Making for Using Technological Strategies to Implement Evidence-Based Interventions: An Illustrated Case Study

“…For example, Kashani and colleagues used the effort-vs-impact assessment as a part of implementing quality improvement initiatives that involved critical care fellows (12), and Fieldston and colleagues used the assessment as a key tool for rapid-cycle improvements that were implemented at a large independent hospital (13). These are just a few examples, and the effort-vs-impact assessment has been used by numerous initiatives, from individual clinics to health care systems, to prioritize and select among potential interventions to implement change in health care delivery (14)(15)(16). For each intervention, the needed effort for implementation (e.g., whether needed resources are already available) and the likely impact from implementation (especially compared to other options) are considered.…”

Discovering and doing family medicine and community health research

“…Schneiderhan, Guetterman and Dobson12 turn to a common problem, the need to develop and evaluate a curriculum in medical education. Ursu, McKee and Greenberg13 discuss the steps in a rigorous, research-driven quality improvement project that they illustrate with a project conducted to improve chlamydia screening rates using the plan-do-check-act model. Next, Engelman Case, Meeks and Fetters14 cover steps in conducting health policy research that can be prompted by everyday dilemmas in clinical care.…”