Why It Matters
We know many Chapters are looking for advice on how to start project work, so we asked leaders to share their advice for successfully planning and running a QI project.
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Taking Quality Improvement Beyond the Classroom

By Zoe Mahoney | Tuesday, April 17, 2018
OS-leaders

The Open School’s strategy rests on a three-pronged approach – teaching the basics of QI and patient safety through our core courses; offering inspiration, support, and momentum for your work through local Chapters; and then providing practical experience with improvement in local settings through project-based initiatives.

We know many Chapters are looking for advice on how to start project work, so we brought together a group of leaders on the last Global Chapter Network Call to share their advice for successfully planning and running a project. Here’s what they had to say (download the guide as a handout here):

Getting Started

Before starting, it’s important to assess if your Chapter is ready to get involved in project work.

  • Is your Chapter well-established? You don’t need 100 Chapter members to launch project work, but you do want a strong leadership team and structure in place, regular attendance at your events from committed members, and, if possible, a Faculty Advisor who can help guide your efforts and build connections for your Chapter. Need help getting your Chapter off the ground? Reach out to one of our Global Chapter Leaders!
  • Have Chapter members learned basic skills in quality improvement and patient safety? Set a benchmark for how much Chapter members should know. Often, Chapters require that all members, especially those interested in taking on project work, complete a set of the Open School courses or the Basic Certificate in Quality & Safety. This can help to make sure everyone involved has the same foundation of QI knowledge.
  • Does the Chapter have dedicated time to implement projects and QI teams? Your Chapter should have at least three months to set up, run, and support a project — one year is even better. And be sure to time your launch so that it works with the academic calendar. For example, starting a QI project in April soon before students leave for break won’t set teams up for success.

Establishing a Motivating Team Vision

Presenters from Brock University and the Icahn School of Medicine at Mt. Sinai both had QI programs in place when they started, and Faculty Advisors have helped create a platform that connects Chapter members with existing projects at a local organization. For other Chapters, it’s more reasonable to partner with an organization first and then work with them to identify an area for improvement.

Sara Pasik, a medical student from the Icahn School, encouraged her Chapter to set a systems-oriented goal, and give their project work a broader focus. Not only will this create opportunities to have a larger impact, she said, but it will also help maintain the project’s long-term momentum.

Presenters suggested you figure out which approach works best for your Chapter based on the resources available to you. If you have the flexibility to do so, try to ground your program and projects in a topic area that members are passionate about. Take the time to surface the issues about which people feel the most excited. A sense of ownership in the decision-making process can go a long way, and you’ll have designed work they’ve already expressed they want to be a part of.

Building Partnerships

Forming partnerships in your local community is a great way to get connected to potential QI projects. By partnering with a local organization, you not only become a familiar face, but you also get an insider’s view into the systems utilized within that organization. That allows for an accurate view of the needs of that organization, and may provide inspiration for your next QI project. Taking advantage of these relationships not only provides an opportunity for you, but also provides the organization a chance to improve in areas that will help them to function better.

Ask your Faculty Advisor or professors to help connect you to an organization that would be receptive to forming relationships with students, or that would be open to hosting QI projects. After becoming more familiar with the organization, you may start to notice areas for improvement, or hear from organizational stakeholders on the key impediments and inefficiencies they see in their day to day work. Use these observations to create new QI projects and start to form your teams based on interest.

Julie Finnegan, Chapter President at Brock University, shared how a clear, strong, call to action helped her build relationships and recruit others to join her. “The more [the organization] saw how genuine I was and how much I really wanted to better this process,” she said, “the more willing they were to help me out.”

Work with your partnering organization to become familiar with their current processes, what employees there most want to change, and what a positive outcome looks like to them.

Setting norms and clearly defining leadership and team roles will do wonders for creating a clear line of internal communication and mutual understanding. Not to mention that clear roles can help teams manage the projects more efficiently and provide points of contact for your team and the partner organizations.

Interested in crafting a narrative to inspire a team? Check out Leadership and Organizing for Change, one of the Open School’s project-based courses.

Embracing a “Fail Forward” Mindset:

Feeling like your QI Project isn’t as successful as you’d like it to be? Don’t get discouraged! Instead, embrace “failing forward” — key to any improver’s approach! This growth mindset will help you and your team see failures as sources of inspiration, learning, and reflection.

One Chapter Leader shared how her Project team didn’t set roles at the start of their project. This led to miscommunication and much more work for everyone involved. Setting team roles allowed for less overlap of work and smoother communication between team members.

Another experienced tension between teams at the organization she partnered with. It took months of hard work for her to organize focus groups to help improve collaboration between floors, but focusing on repairing the relationships and bringing people together in person paid off and they saw morale improve dramatically.

Owning Your Role as a Change Agent

As a student or resident, it can feel intimidating to launch a project, or work with a new organization. Julie admitted that at first, she felt underqualified and let doubts creep in about the contributions she should and could make a student. She didn’t feel it was her place to make changes. However, she quickly recognized that this didn’t reflect the views of the organization she was working with. In fact, the organization was thrilled to have someone so focused on helping them to improve as a part of their team, and they’ve since partnered together to achieve exciting results.

In one of the Mt. Sinai Chapter’s projects, a systems review revealed that most doctors were not even aware that they had ordered certain tests since they were an automatic request attached to a computer program. This discovery led to the reduction of Amylase tests ordered from about 100 per week to five or fewer per week. Not only did this save the organization precious time, it also added up savings of close to $60,000 for the year — the equivalent of hiring a new employee!

A project through the Brock University Chapter aimed to optimize the patient transition process from acute care hospitals to long-term care facilities. Since the project started so broad, the team realized they needed to focus their goals and create many smaller QI projects targeting different parts of the transition process. Having open communication with the frontline nurses allowed Julie and her team to get an up-close and accurate view of the current processes to better evaluate what needed to change to qualify as an improvement.

There are plenty of tools from the Open School and IHI to support you along the way, too. Once teams start their project work, they can continue to get guidance on their approach through the Open School’s Quality Improvement Practicum and through resources like our Quality Improvement Essentials Toolkit.

Zoe Mahoney is a Project Assistant for the IHI Open School. Interested in learning more about how Chapters are leading QI projects? Check out this blog post. 

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