IA_PSPA_19 · Implementation of formal quality improvement methods, practice changes, or other practice improvement processes

Subcategory: Patient Safety and Practice Assessment

Activity Description: Adopt a formal model for quality improvement and create a culture in which all staff, including leadership, actively participate in improvement activities. This could include one or more of:

• Participation in multisource feedback;
• Training all staff in quality improvement methods;
• Integrating practice change and quality improvement into staff duties;
• Engaging all staff in identifying and testing practice changes;
• Designating regular team meetings to review data and plan improvement cycles;
• Promoting transparency and accelerating improvement by sharing practice-level and panel-level quality of care, patient experience, and utilization data with staff;
• Promoting transparency and engaging patients and families by sharing practice-level data with them, including acting on patient experience data;
• Participation in Bridges to Excellence;
• Participation in the ABMS Multi-Specialty Portfolio Program.

Why we recommend it: A recurring departmental quality meeting where Graphium QCDR analytics are reviewed and improvement cycles are planned satisfies this. Keep meeting minutes with dates, attendees, the data reviewed, and the decisions made.