Can my project be focused on something personal?
No. Your quality improvement project needs to be in a clinical setting that involves or affects patient care. In other words, it needs to somehow improve a patient’s experience. Why? Our goal here is to improve a system with interdependent parts; it requires working with other people who have a role in that system.
What if the focus of my project is on improving staff satisfaction?
Staff satisfaction can’t be the primary benefit of your project. It can be a secondary benefit, but the primary goal of your quality improvement project should be focused on improving the care process for patients. That doesn’t mean you necessarily have to be at the bedside. Projects such as reducing wait time in the emergency department or reorganizing the medication delivery process both involve patients. Improving the scheduling among providers in a practice or getting more staff to attend meetings, on the other hand, don’t have a direct impact on patient care and wouldn’t fit the requirements of the Practicum.
What if my project isn’t successful?
Your project doesn’t have to be successful for you to receive credit. We, of course, hope it is successful, but the goal of the Practicum is for you to practice using quality improvement knowledge in a clinical setting. The process and the learning are more important than the outcome.
What is the suggested timeline for the Practicum?
(Adopted with permission from the IHI Open School Chapter at the University of Toronto)
How long should a project take?
A project should take anywhere from 4 weeks to 6 months, depending on the complexity and other time commitments. (We do, however, understand that schedules at some schools include projects that take up to a year.) Projects can go on for longer, but try to scope your project accordingly. In other words, start small!
I came up with the idea for my project, but does that always have to be the case? Coming up with your own project is wonderful, but you can certainly get involved with ongoing quality improvement work. In fact, working closely with a health care organization often means there’s a better chance that the improvement will continue over time. Just remember that you have to lead at least a small piece of the project. You have to be in charge of at least two PDSA cycles – from set up to learning. If you just go in and collect data, that’s not really learning quality improvement.
Does my project need to be done with an interprofessional team?
We recommend that your team include learners from different backgrounds (e.g., nursing, medicine, public health, etc.), but it is not required.
How many students/residents should be working on one Practicum project?
We recommend that your team include 2-3 members but interdisciplinary group projects can be up to 6-7 members if this helps inclusivity of other professional groups.
Do I have to complete a project from start to finish?
Yes, you need to select a project and then follow it through to the end. Remember, the scope of your project can be very small. You don’t have to improve the discharge process at a 1,000-bed hospital down the street. Strive to improve the hand-off process on one ward. Make it easier for patients to get a good night’s sleep on one floor.
What exactly do you mean by “scope”?
Scope is the work that needs to be accomplished to finish a project. As you may recall from QI 102, quality improvement is different from clinical research. Instead of interviewing 100 patients before taking action (research), quality improvement encourages you to ask only one or two patients before putting a small test of change into action.
Quality improvement is about doing something, as we say at IHI, by “next Tuesday.” But remember that scope isn’t just about the number of patients; it’s also about the time and effort needed before you get to your first test of change. Think two to three weeks of time instead of two to three months. (If you find yourself three months into a project and you haven’t tested anything, take another look at the scope.)
Are there any prerequisites I need to complete before embarking on a quality improvement project?
Yes, you need to complete three IHI Open School courses:
Each course teaches an important piece of the quality improvement process and you’ll be using that knowledge in planning and carrying out your project.
What do I have to hand in during QI 201: Guide to the IHI Quality Improvement Practicum?
You’ll hand in a teacher-learner agreement, a charter, a cause and effect diagram, at least two Plan-Do-Study-Act (PDSA) cycles, at least one run chart, and one summary report. These are the elements our advisors have determined are crucial to constructing and conducting a quality improvement project.
Should projects be more intervention based (i.e. success of an educational program to increase diabetics compliance with treatment), and not descriptive (% of diabetic patients in a panel that have poorly-controlled sugars)?
Yes, projects should be more intervention based. The practicum is about creating change. That said, before and after descriptive tracking will be necessary for evaluation your intervention.
Can students/residents in the midst of a current practicum project on site still participate in the IHI Open School Practicum?
Successful completion of the IHI Open School Practicum is based on completion of QI 201: Guide to the IHI Open School Quality Improvement Practicum. Students working on quality improvement projects may complete the Practicum as long as they submit the necessary forms throughout the course.
Can test sites use other models (e.g., TPS, Lean, Six Sigma) for improvement?
No. IHI uses the Model for Improvement as the framework to guide improvement work and is required for completion of the course. The Model for Improvement, developed by Associates in Process Improvement, is a simple, yet powerful tool for accelerating improvement. This model is not meant to replace change models that organizations may already be using, but rather to accelerate improvement.
Will the IHI Open School provide any feedback to me during the process?
Yes. To help make sure your project is headed in the right direction, we will review the project charter you submit after Lesson 2 and provide written feedback. (Note: We will provide feedback only on student projects. Professionals are welcome to participate in the Practicum, but at this time, we aren’t able to offer direct feedback.) Feedback at this stage is critical to make sure your project is aimed at helping patients (not just helping providers, for example) and that your planned tests of change are scoped appropriately. Then, at the end, after you turn in your summary report, we will provide more feedback about your project and the lessons learned. At that point, we’ll also discuss potential ways to share your learning with others.
If I am the faculty advisor of multiple projects, can I see which documents have been submitted?
Yes. As long as you and your participants are all registered under the same organization on IHI.org, there is an option available for you to see which documents have been submitted. Send an email to the IHI Open School to have this administrator role set up. Be sure to include your organization's name and your participants' names.