Where do you focus your time and energy when you’re starting to do QIPs (Quality Improvement Projects)?
Well, where the government tells you to start! Look at http://www.health.gov.on.ca/en/pro/programs/ecfa/legislation/qualityimprove/qip_guide.pdf
Your organization has its own particular issues you want to tackle, such as patients, or physicians, that are habitually late. Maybe you need better wheelchair access. They’re both worthy QIPs. That ramp may be the most important thing to do, period. In your own medical practice, you may want to focus on increasing vaccination rates, or improving INRs. But we’re in a provincial system, and the powers that be have (quite rightly) picked three areas they want you to start focusing on.
Read the paper. But, in essence, they want that 5% of the population that chews up all the health care resources handled better. That’s why we all have our friendly neighbourhood LIHN, and why there are now healthlinks endeavours. Support your local lead physicians that are trying to make this happen. Doing a QIP that works towards helping support the “link” would be well accepted.
Clearly for QIPs, one emphasis has to be on readmissions, or as the government puts it, safe transitions. You know, this is the person you just know is going to ping pong right back. Access the link. Right there, in nice black lettering, are multiple suggestions, ranging from the “warm hand off” to health literacy, to medication reconciliation, to an actual safe discharge checklist. You want the pearl? You like those lectures where you’re spoon fed? Start here. Basically, the background research is done. That’s half the work. Figure out what maneuver you could do to improve things. Do some analysis of your current practice, implement, and number crunch again.
There is a requirement to look at satisfaction surveys, for which there is actually a pilot project for an Ontario- grown version for 2014/15. Look for the survey (it takes a bit of searching) at firstname.lastname@example.org. There is a patient satisfaction survey template there, take it from me! It strikes me as a bit flimsy, however. Last year, when I did a similar undertaking, I used a UK version developed for primary care. There is a new improved one at http://www.gp-patient.co.uk/. Take a look at this multi-page sucker! Look at the information you can accumulate! This one could lead to other research directions. I’d pick that one, myself.
The third area is improved access. For those primary care MDs that are following their own patients in hospital, it’s certainly easier. But having a QIP showing maneuvers to facilitate that quick office appointment would be well received.
1, 2, 3. Don’t look any further than these to start. Actually, if you only did Quality Improvement Projects, (QIPs) type research in these areas, each year jiggering your approach a bit to improve, you’d be stellar.