Project : Promoting Health Care Quality

Section 4: Quality Improvement Strategies

Through your work on Section 3 of the Course Project, you have examined the gap between current performance and evidence-based targets and considered how addressing this gap relates to organizational priorities and large-scale aims for quality improvement.

In this section of the Course Project, you begin to think about quality improvement strategies that could help to bridge this gap. As noted in the Sadeghi, Barzi, Mikhail, and Shabot text, this is referred to as performance-driven planning.

Since the publication of the Institute of Medicine's report "Crossing the Quality Chasm," a good deal of attention has been paid to the need to examine processes that contribute to outcomes (Ernst, Wooldridge, Conway, Dressman, Weiland, Tucker, and Seid). As the USAID has noted, interventions "will not create the desired outcome to improve the quality of care unless the overall process of care delivery is also improved." Therefore, attention to process redesign is a central aspect of cultivating strategies for improvement.

Throughout this course you have been considering the relationship between structure, process, and outcomes as it relates to health care quality.

Looking at outcomes, alone, may not tell the "whole story." For instance, if you are concerned with improving fall rates, evaluating the process-related activities or practices-can help you identify factors that contribute to outcomes and develop strategies for improving them.

For this section of your Course Project, you create a process map to examine a current process related to your quality improvement issue. You will use the results of the process mapping to redesign a process to help minimize or close the performance gap(s). As you proceed, keep in mind the importance of maintaining a patient-centered focus so the patient experience is not negatively affected by any changes in process.

To prepare:

Refer to the modified Donabedian model (access, structure, process, outcome, and patient experience) presented in Chapter 9 of the Sadeghi, Barzi, Mikhail, and Shabot text.

Recall the performance targets that you identified for Section 3 (in Week 6). What does the recommendation that performance-driven planning should "begin with the end in mind" suggest given your established goals?

Review the information presented in Chapter 9 of the Sadeghi, Barzi, Mikhail, and Shabot text, and think about how you would assess the organization's strengths and weaknesses related to the performance gaps you identified in Section 3

Based on the above, start to think of specific evidence-based strategies that could be implemented to close/minimize the performance gaps you have identified. Consider both interventions (what) and processes (how).

Focus on strategies that are supported by the latest research and could create systems-level change. These may be tentative for now, but be sure to identify at least one that specifically lends itself to a change in process (i.e., practice, protocol, pathway, activity). To complete this Assignment, you will create a process map and write a paper describing quality improvement strategies.

Review the instructions provided in the Learning Resources for creating a process map.

With your quality improvement issue in mind, as well as the other work you have completed on your Course Project thus far, think about how creating a process map could help you to better understand your quality improvement issue and redesign an associated process.

Create a process map using Microsoft Word or PowerPoint.

Refine the strategies for promoting systems-level change to minimize or close the performance gap(s) that you began to think about in Week 7. As part of this, identify a way to redesign at least one process based on your analysis of the process map that you have created.

To complete:

Write a 2- to 3-page paper in which you describe quality improvement strategies that you selected related to your quality improvement issue.

Finalize your process map, which will be submitted along with the paper.

Submit your paper and process map.