This document provides an introduction to quality improvement in healthcare. It discusses several definitions of quality, including the six dimensions defined by the US Institute of Medicine: healthcare must be safe, effective, patient-centered, timely, efficient and equitable. It also discusses the importance of measuring outcomes and reducing unwarranted variation. Quality improvement requires assessing the impact of changes, sustaining improvements through repeated measurement, and recognizing that meaningful change requires collaboration rather than working alone.

1. An introduction to
Quality
(for Improvement)
Dr. Damian Roland
@damian_roland

2. Have YOU
experienced
Quality Care?

3. What does the Hippocratic
Oath say about quality
Improvement?

4. What is Quality?

5. OUTCOME

6. VARIATION
From: NHS QIPP Right Care. NHS Atlas of Variation in Healthcare for
Children and Young People March 2012. 2012; London.

7. EXCELLENCE

8. Six Dimensions/Definitions
United States Institute of Medicine (IoM)
SAFE EFFECTIVE
PERSON
CENTERED
TIMELY EFFECIENT EQUITABLE

9. Or…
No Needless
Deaths
No Needless
Pain or
Suffering
No
Helplessness
in those
served or
serving
No Unwanted
Waiting
No Waste
No one left
out
US Institute for Healthcare Improvement

10. Where have we gone wrong?

11. Where have we gone wrong?
Roland D, Haden S, Pryde K and Lachman P. Paediatric trainees and the Quality
Improvement Agenda: don't just do another audit. J R Soc Med 2011; 104:344-345

12. Assessing the impact of your last
audit
What change resulted from the audit?
Have these changes been sustained?
Has the audit been repeated since the
changes?
If not, is there a review date set for repeat
audit?
Klaber R and Roland D. Delivering quality improvement: the need to
believe it is necessary. Arch Dis Child 2014;99:175-179

15. PDSA

16. Measurement

18. Think of something you would
like to improve?
http://bit.ly/lonenut

19. Does that video change your
approach?
http://bit.ly/bronzeagechange

20. And now….?

21. Impossible to do alone

22. The Reality…

23. How do we use Quality
Improvement to change
outcomes
We ACT
We MEASURE
We IMPROVE

24. Thank you for
your time
Dr. Damian roland
@damian_roland
rolobotrambles.com