How to choose a QI topic

Not all quality improvement project ideas may be appropriate for trainees to implement as their very first project while still developing core competencies. Some problems may be more complex and difficult to resolve than others. This checklist may be used as a guide to assess whether the topic may or may not be appropriate.

Questions (Y/N)

• Can the problem be assessed, immediate improvements planned and implemented with at least 2 tests of change within 4-6 months?

• Can the project be achieved with the little spare time that is allocated for QI training? (8 hours per month in addition to teaching time).

• Is complexity of the problem and scale proportionate to the trainee’s current QI skills and abilities?

• Is the intervention/treatment performed frequently? High frequency usually means high impact and makes testing ideas/changes quicker and easier to measure.

• Is the topic focused on a targeted group of people and/or area? (1 clinical area vs. multiple)

• Is the trainee passionate about the topic?

• Will this ultimately improve patient care?

• Is there an indisputable need to make a change/improvement?

• Is the topic about improving the way the trainee’s current service is delivered rather than another department’s? (e.g. if the trainee works in the emergency department, is the topic about improving the work done in the emergency department?)

Reading material

• Doctors and quality improvement (pdf)

  • Purpose: Presents the big picture, why doctors need to develop QI skills.

• Quality improvement part 1: introduction and overview (pdf)

  • Purpose: Describes what quality improvement is, background about the field and examples of some methodologies.

• How to start a quality improvement project (pdf)

  • Purpose: An overview of the Model for Improvement methodology.

• Junior doctor-led quality improvement project to improve safety and visibility of an interspecialty referral system (pdf)

  • Purpose: Example of a published quality improvement project (BMJ, 2021).

• Quality improvement in nursing: Administrative mandate or professional responsibility? (pdf)

  • Purpose: Quality improvement from a nursing perspective.

• The SQUIRE (Standards for Quality Improvement Reporting Excellence) guidelines for quality improvement reporting: explanation and elaboration (pdf)

  • Purpose: Guidance and standards for reporting quality improvement work.

• Learning leadership skills in practice through quality improvement (pdf)

  • Purpose: To appreciate the broad range of skills that are developed during quality improvement training.

Training videos

QI tools and templates

• A3 project template (excel document)

• Fishbone analysis - Cause and Effect Diagram (pdf)

• PDSA tracker (word document)

• Run Chart Template

• Interpreting Run Charts

• More on Run Charts: Healthcare Improvement Scotland (pdf)

How to access data for your QI project

How to access data for your QI project (video)

Examples of quality improvements projects

• Improving labelling of PAP smear samples

  (Excel document) - Hulda Þorsteinsdóttir, Resident in gynaecology

• Mænuvökvataka á Minnismóttöku Landakot

  (Excel document) - Berglind Árnadóttir og Guðbjörg Erla Guðmundsdóttir, Residents in Internal Medicine

• Improvement of cardioversions for patients in Hjartagátt

  - Hrafnhildur Gunnarsdóttir, Ívar Sævarsson og Jóhanna Rúnarsdóttir, Residents in Internal Medicine

• Increase vital signs taken for children in the emergency department

  (Excel document) - Kristín Júlía Erlingsdóttir and Urður Jónsdóttir, Residents in paediatrics

• Reduce preparation time for pleural drain placement on internal medicine wards

  (Power Point document)

  - Gunnar Baldvin Björgvinsson, Resident in internal medicine

• Reduce unnecessary blood gas sampling in the ICU

  (Excel document) - Hallfriður Kristinsdottir, Resident in Anaesthetics

• Improving review and confirmation of daily instructions for paediatric inpatients

  (Excel document) - Hildigunnur Þórsdóttir and Elín Óla Klemenzdóttir, Residents in Paediatrics

• Reducing non-urgent phone calls and unnecessary interruptions for the on-call resident

  (Excel document)- Hrafn Hlíðdal Þorvaldsson and Helga Þórunn Óttarsdóttir, Residents in Paediatrics

• Increase the number of Parkinson’s Disease (PD) patients that receive their first PD medication dose </=1 hour from their schedule after being admitted acutely to cardiology

  (Excel documet) - Snædís Jónsdóttir, Postgraduate clinical nurse specialist trainee

• Improving the number of medication reconciliations by clinical pharmacists for admitted patients in the emergency department

  (Power Point document) - Ingibjörg Sigurðardóttir, Post-graduate trainee in clinical pharmacy

Glossary of quality improvement terminologies in Icelandic