Quality Improvement Projects

Introduction What is QIP? Purpose? How is it different from audit? What skills does it teach? Future plans for QIP

Quality Improvement Projects (QIP) Trainees identify an improvement, lead it and write up covering the following areas: 1. The Project: simple and SMART 2. The Background: how the need for improvement was identified. 3. Process Mapping: the steps needed with action plans 4. Stakeholder Analysis: identifies people or groups involved in the area to improve 5. The Intervention: collects, analyses and interprets data 6. Conclusions: describes the outcomes of interventions 7. Reflections: self-assessment Timescale: it should take about 8-12 weeks to complete 1-2 cycles of a simple QIP

Ideas for QIP projects Capture of important diagnoses from hospital discharge letters Repeat prescription pathway Improving DNA rate

Example Recording of fractures from hospital discharge summaries with aim of identifying fragility fractures Purpose : Osteoporosis risk Child protection Good record keeping

Process mapping Letter arrives in surgery ( mail, fax or electronic) Letter opened/accessed Letter processed and allocated to Dr Doctor highlights the readcode Administrator adds it to computer

Stakeholder analysis Practice administrators doctors in the surgery Care homes Pharmacist (Local osteoporosis clinic) (Fracture clinic) (A&E) (CCG)

The intervention Collect/analyse data eg looking at past 6 months worth of fragility fracture coding Develop a guideline on which discharge summaries to escalate: eg hip fractures, radial fractures, spinal wedge fractures, over 75s with fractures doctor to identify the fragility fracture and code fragility fracture

monitor the intervention for a short period of time to check it is working modify aspects of it if necessary Implement the change re-analyse data 6 months later

Conclusions Outcomes local vs wider impact implications eg financial, workload, prescribing, referrals, readmission rate ( falls prevention, osteoporosis management) plans for sustainability through potential further work dissemination of best practice via CCG/commissioning

Reflections Barriers Leadership skills Practice factors Impact on self/stakeholders Any unexpected findings