Quality improvement consists of systematic and continuous actions that lead to measurable improvement in health care services and the health status of targeted patient groups.[1] It involves the combined efforts of health care professionals, patients and their families, researchers, payers, and educators to make the changes that will lead to better patient outcomes, improved system performance, and enhanced professional development.[2] Several methodologies are available that provide a framework for quality improvement, such as PDSA (Plan-Do-Study-Act), Six Sigma, or FADE (Focus-Analyze-Develop-Execute). Regardless of the model applied, a team approach is an essential element to any successful quality improvement project. As leaders and key stakeholders of clinical outcomes, OB/GYN hospitalists are in a prime position to engage in and lead quality improvement initiatives.

Knowledge

OB/GYN hospitalists should be able to:

• Discuss the Institute of Medicine’s framework for assessing quality in health care.
• Explain the concepts of quality assurance, quality improvement, performance improvement, patient safety, and risk management.
• Discuss why quality and performance improvement is important to the following 3 key stakeholders: patients, providers, and payers.
• Explain value-based purchasing.
• Describe the attributes of effective health care teams and teamwork.
• Describe practices and tools that high reliability organizations use to prevent error and promote safety.
• Describe the key principles essential to successful quality improvement work.
• Give examples of and explain the relationship between a health care system’s resources (inputs), activities (processes), and results (outcomes).
• Explain how quality and performance are measured and used by The Joint Commission and Centers for Medicare and Medicaid Services.
• List and describe common quality and performance improvement methodologies used in health care.

Skills

OB/GYN hospitalists should be able to:

• Identify quality and performance improvement resources in their practice setting.
• Interpret quality and patient satisfaction data to inform and improve patient care at the individual, group, and system levels.
• Use performance improvement methodologies and tools to design and carry out quality improvement projects in their clinical areas.
• Apply change management strategies to implement and sustain improvement.
• Identify system failures and root causes when errors and adverse outcomes occur.
• Identify best practices as per validated resources and incorporate them into tools such as policies, procedures, checklists, and guidelines.

Self-Awareness and Collaborative Attitudes

OB/GYN hospitalists should be able to:

• Practice evidence-based, patient-centered care that is consistent with established hospital policies and guidelines.
• Demonstrate attitudes and behaviors that cultivate a spirit of quality improvement within the organization and encourage continuous improvement.
• Demonstrate behaviors that support a just culture.

System Organization and Impovement

OB/GYN hospitalists should be able to:

• Identify opportunities for quality and performance improvement at the practice, unit, and system level.
• Collaborate with the hospital quality team to lead, coordinate, and/or participate in quality and performance improvement initiatives.

References