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  • Writer's pictureAudrea Chen

Quality Improvement and Patient Safety

Quality Improvement (QI) is an area of study that healthcare organizations are using to make changes and sustain improvements to patient care. There are six pillars that QI initiatives aim to target: patient safety & experience, population health, equity & inclusion, quality of work and satisfaction of healthcare providers, cost reduction and environmental sustainability. 


Healthcare systems are quickly recognizing QI as an important tool that makes the system better and now require healthcare professionals to engage in QI projects as part of their job. Collaboration with patient partners is also an essential part of QI because the project ultimately affects patient experience. Patients provide the unique perspective that helps QI projects make an impact where it matters.


One framework that is used for QI projects is called the Model for Improvement.  The process uses rapid change cycles called the Plan, Do, Study, Act (PDSA) cycles to study and improve the problem of interest. 


An example of a QI project in rheumatology is the implementation of a formal transition program at SickKids. The problem is that the concept of transitioning from pediatric to adult healthcare was not being consistently introduced to patients with JIA before they turned 17/18. Literature shows that it’s important to prepare families for transition to optimize healthcare outcomes during this risky time. Therefore, the goal of the QI project was to develop transition resources and a plan to introduce transition to at least 50% of patients with JIA aged 12 and above coming through the clinic by the end of the year. The project involved patient partners, pediatric rheumatologists, trainees, allied health professionals and research team members. The project team created a transition introduction handout and developed a streamlined process to deliver the information to patients. After a series of small changes to the process, the group was ready to move to the next step – which is now to implement a formal transition curriculum for patients with JIA.


Other examples of projects include the introduction of Treat 2 Target in pediatric rheumatology clinics and the implementation of mental health screening in the childhood lupus clinic. 


QI projects are a great way for patients to be involved in improving care for themselves and other patients. Often because the change cycles are designed to be short, you can see the effects of the project pretty quickly. 


You might be invited to be involved in a QI project someday, but do not worry if you’re not familiar with QI methods. Your project team leader should help you get the orientation/training you need to contribute to the project. If you’re interested in reaching out to join QI work, you might consider your local patient engagement management department at the hospital or starting a project yourself! 


References:

  1. Six Domains of Healthcare Quality. Content last reviewed December 2022. Agency for Healthcare Research and Quality, Rockville, MD. https://www.ahrq.gov/talkingquality/measures/six-domains.html

  2. Chow S and Shojania KG. “Rheum to Improve”: Quality Improvement in Outpatient Rheumatology. J Rheum. Sep 2017, 44 (9) 1304-1310; DOI: 10.3899/jrheum.161053

  3. Chen A, AlBijadi A, Mwizerwa O, Goh YI, Marcuz J, Whitney K, O’Brien C, Lahiry P, Limenis E, Rheumatology Family Advisory Council, Murray O, Juneja N, Mariapen D, Convery H, Anderson M, Bell-Peter A, Mastrangelo G, Itzkovitz E, MacMahon JM, Wong SK, Dushnicky MJ, Laxer RM, Levy DM and Tse SM. Introduction of a Transition Policy to Improve the Transition of Youth with Juvenile Idiopathic Arthritis from Pediatric to Adult Healthcare. Poster presentation at Canadian Rheumatology Association (CRA) Annual Scientific Meeting. 2024 Mar; Winnipeg, MN.

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