Developing the Capacity for Rapid-Cycle Improvement at a Large Freestanding Children's Hospital

Area of Science:

• Healthcare Management
• Quality Improvement Science
• Pediatric Healthcare Delivery

Background:

• Established two pilot
• Innovation Units
• in a children's hospital to foster unit-level rapid-cycle improvement capacity.

Purpose of the Study:

• To train frontline staff to lead rigorous improvement portfolios.
• To develop a sustainable system for managing quality improvement initiatives at the unit level.

Main Methods:

• Frontline staff received comprehensive improvement training.
• Interdisciplinary teams brainstormed and prioritized tests of change using impact-effort evaluations and goal alignment.
• A standardized template documented each test of change, including metrics, baseline data, and results.

Main Results:

• Over 40 plan-do-study-act cycles were conducted, generating 150 improvement ideas.
• Elements from all 10 distinct improvement projects were successfully implemented, with 8 spreading to other units.
• Successful interventions remained in practice over three years later, with ongoing testing of new ideas.

Conclusions:

• The Innovation Unit model effectively engaged frontline staff in quality improvement.
• A sustainable framework for managing improvement portfolios was established at the unit level.
• This approach offers a valuable model for other healthcare settings, rooted in the microsystem of care.