Oct 29, 2024
Whether you are starting your first quality improvement (QI) project or want to learn more about QI in general, we have some tips and tricks to help you on your improvement journey. In this post, HQC’s quality improvement experts share their knowledge and advice on PDSAs, automation, project charters, and more (don’t worry if those words don’t make sense to you right now as they will when you are done reading the article)!
11 Tips and Tricks
- Start small. If everything is a priority, nothing is a priority
- Keep an open mind
- Remember that PDSAs are small tests of change – think you have it small enough? Nope, even smaller
- Set your team up first using a project charter
- Readiness for change is an important component for any QI project
- In QI it’s important to start with the problem, not the solution.
- Continue to re-visit the fundamentals. With new information, comes new interpretation
- Make friends
- Never underestimate the power of a good question
- Automate automate automate. As much as you can, offload the tedious stuff to macros/formulas/scripts
- Get ready to practice complexity and grow a compelling future together through relatively simple interactions
Tip #1: Start small. If everything is a priority, nothing is a priority
“When you are first introduced to QI tools, it can be tempting to want to apply them everywhere to everything. The art of QI is tenacity.
As you delve into a problem, there are many paths for improvement that will open up to explore. It’s very easy to get distracted from what you set out to accomplish when you start to see all of the potential opportunities for intervention and improvement. It’s imperative to keep your goal front and centre and continue to ground yourself in what you are trying to accomplish.
To achieve sustainable, meaningful improvements, rigour (being thorough and accurate) to the QI process must be maintained. What seems at the surface level to be an “easy fix” requires a thoughtful establishment of the new way of doing things for improvement to truly take hold.”
Related Resources
- Plan-Do-Study Act Cycles: A problem-solving tool for improvement work
- Standard Work Template
- Training skills matrix
Chelsea Schwartz
Position: Manager of Learning Programs
In her current role as Manager of Learning Programs, Chelsea oversees various programs that build capacity for quality improvement to help system partners continuously improve systems related to health and health care. She draws her energy from helping others learn new skills and seeing them approach old problems with new ways of thinking.
Tip #2: Keep an open mind
“There are many potential solutions to a problem. Any of them could be right in the right context. Stay committed to your aim or your goal, be flexible about how you can get there. Try out potential ideas on a small scale first to find out what works best in your setting.”
Related Resources
- Driver Diagrams
- Breaking Down Wicked Problems – The Driver Diagram (QI Power Hour)
- Quality Café: Using Driver Diagrams to Plan Improvement Initiatives
- Family of Measures Template
Tracey Sherin
Position: Chief Executive Officer
Since joining HQC in 2005, Tracey has become an accomplished and experienced leader with expertise in research and analysis, measurement for improvement, quality improvement methods, coaching, teaching, and facilitation. During her time at HQC, she has worked in a variety of areas including drug management in long-term care, chronic disease management, Clinical Practice Redesign, quality improvement teaching and coaching, and leadership for improvement.
Tip #3: Remember that PDSAs are small tests of change – think you have it small enough? Nope, even smaller
“QI is all about small, incremental tests of change using the Plan Do Study Act (PDSA) cycle. It can be tempting to try to change everything all at once, but you will thank yourself for keeping it small and manageable. You can use the data from your PDSAs to ramp up your changes and spread at a wide scale.”
Related Resources
Glenda Beauchamp
Position: Improvement Lead
As an Improvement Lead with the Learning and Development team, Glenda develops and designs educational curriculum to build quality improvement capability within the health system.
Tip #4: Set your team up first using a project charter
“The project charter helps to create clarity about what the project is and who is responsible for what. Starting with this saves a lot of frustration later.”
Related Resources
Malori Keller
Position: Improvement Lead
Malori has worked in the health system from 2008 to 2012 in various roles including as a Patient and Family Centred Care Specialist and the Manager of the Saskatchewan Transplant Program. Since joining HQC, she has worked in quality improvement and as the Patient Engagement & Empowerment Lead with the Saskatchewan Centred for Patient-Oriented Research (SCPOR). Malori is a Certified Associate in Project Management and a certified Lean Leader.
Tip #5: Readiness for change is an important component for any QI project
“All the QI tools in the world won’t matter if there is little appetite to apply them or lack of consensus about what change is needed.”
Related resources
Andrea MacKay
Position: Improvement Lead
Prior to working at HQC, Andrea spent five years with the Saskatchewan Medical Association, focusing on health system improvement initiatives such as the Prince Albert Demonstration Project, the Clinical Quality Improvement Program, Choosing Wisely Saskatchewan, and Patient’s Medical Home.
Tip #6: In QI it’s important to start with the problem, not the solution.
“When we encounter a problem we want to solve, it’s human nature to jump to solutions to the problem. In QI, we shift that mindset and instead focus on identifying and analyzing the problem. Once you know more about the problem you’re trying to solve, you can start thinking about ways to solve it.”
Related resources
Charlsie Ogaick
Position: Improvement Lead
In her role as Improvement Lead, Charlsie facilitates learning and fosters networks that help build capacity for continuous improvement within the healthcare system.
Tip# 7: Continue to re-visit the fundamentals. With new information, comes new interpretation
“Re-visiting assists in building your depth in understanding on QI. When you first learn about a concept you form a basic node of understanding. However, as other nodes in QI are formed (i.e., you learn other QI concepts), you may find that your original understandings need to be adjusted. You also start to connect the nodes together. I also recommend re-visiting these fundamentals from different lenses. Different people explain concepts differently, and that helps to deepen your understanding!”
Related resources
Tami Waldron
Position: Improvement Lead
As an Improvement Lead, Tami works collaboratively to assist with the instructional analysis, development, design, implementation, and evaluation of varying training modules offered through HQC.
Tip# 8: Make friends
“QI is a team sport. There are very few (if any!) processes that can be improved by a lone individual. Diversity of ideas will lead to stronger, more sustainable solutions. Find other people who care about the problem (especially patients, clients, residents, and families), find out what’s important to them, what they think needs to be done to solve the problem, and get busy doing it!
Talk to the teams whose work links to the process you are trying to improve: what teams feed into your process? Who receives the outputs of your process? These teams will likely have some insightful feedback about what changes could be made to make the process better. They may even help.”
Related resources
- Working Remotely Series: Building Trust with Teams in a Virtual Environment (QI Power Hour)
- Workplace drama got you down lately? Flipping the Drama Triangle might be the solution
Tracey Sherin
Position: Chief Executive Officer
Since joining HQC in 2005, Tracey has become an accomplished and experienced leader with expertise in research and analysis, measurement for improvement, quality improvement methods, coaching, teaching, and facilitation. During her time at HQC, she has worked in a variety of areas including drug management in long-term care, chronic disease management, Clinical Practice Redesign, quality improvement teaching and coaching, and leadership for improvement.
Tip #9: Never underestimate the power of a good question
“Shifting the mindset from having the right answers to having the right questions. In improvement, those doing work are in the best position to improve the work. As a facilitator of QI, it’s not my job to be the content expert of the QI efforts, but rather I view my role as to facilitate the process and use the power of good questions to support/guide those engaging in QI through the process. ‘Questions open the door to dialogue and discovery. They are an invitation to creativity and breakthrough thinking. Questions can lead to movement and action on key issues; by generating creative insights, they can ignite change’ (The Art of Powerful Questions, 2003).”
Related resources
Jennifer Wright
Position: Improvement Lead
As an Improvement Lead, Jennifer supports a variety of improvement initiatives/projects that aim to build quality improvement capability and report on the quality of care for those living in Saskatchewan. She values any opportunity to collaborate, and make meaningful connections, with partners across Saskatchewan in efforts to improve health and health care for everyone. Jennifer became a certified Lean Leader in September 2014.
Tip#10: Automate automate automate. As much as you can, offload the tedious stuff to macros/formulas/scripts
“Rapid feedback is important, especially in the early stages of a QI project. The faster data can be turned into insights, the faster changes can be made. Tweaks can also be made to the reporting as you go.”
Related resources
(There are lots of tools and resources out there, a lot of which depend on the software being used and the context.)
- Excel Automation: 10 Tasks You Can Automate Today
- Excel VBA tutorial for beginners: The Visual Basic Editor (VBE)
Alvin Yapp
Position: Improvement Lead
As an Improvement Lead, he works on a variety of projects aiming to improve healthcare in Saskatchewan with a focus on measurement.
Tip #11: Get ready to practice complexity and grow a compelling future together through relatively simple interactions
“Quality Improvement can be part of strategies for change leveraging relatively simple interactions and tools to create new patterns and systems, including awareness, adaptations, interconnections, and resilience. So, quality improvement leads to transformative and iterative change and new possibilities. Improvement is how we intentionally change in ways that grows our capacity to embody transformation. Rely on the strength of relationships and collaborations. Be prepared to be flexible, adaptive, and relational considering the complexity of the systems we are part of and work to improve/transform.”
Related resources
A quote I would like to share from the book Emergent Strategy: Shaping Change, Changing Worlds by Adrienne Maree Brown:
“Small is good, small is all. (The large is a reflection of the small.) Change is constant. (Be like water). There is always enough time for the right work. […] Never a failure, always a lesson. Trust the People. (If you trust the people, they become trustworthy). Move at the speed of trust. Focus on critical connections more than critical mass—build the resilience by building the relationships […]. What you pay attention to grows.”
Suelen Meira Goes
Position: Improvement Lead/ Researcher
Suelen joined HQC as an Improvement Lead in November of 2020. She brings to this role her diverse experience with health-related measurement designs and knowledge translation approaches supporting the planning, implementation, and evaluation of patient-driven initiatives.
Wrapping it all up
We hope that these tips inspire and help you along your quality improvement journey! From recommendations on PDSAs to how vital automation can be, our staff love the opportunity to share their favorite tips and tricks. As you continue on your quality improvement journey, a great next step would be to check out some quality improvement books or quality improvement podcasts. If taking an online course is more your style, you can take HQC’s free two-hour virtual Introduction to Quality Improvement course.
Thank you to our Improvement Leads for providing your quality improvement wisdom for us to share.
