How to Perform Quality Improvement Projects

Safety and efficiency remain salient concerns for the US health-care system, especially in the face of growing health-care costs and morbidity from low-quality care. Current estimates suggest that more than 20% of health-care costs in the United States represent waste and low-value care, presenting numerous improvement opportunities. Although current guidelines and standards aim to address these problems, system processes and clinician behavior must also change to fill care gaps in the health-care system. Quality improvement (QI) is a systematic approach to safety or value gaps in care that uses data measured over time and then makes sequential, small changes to achieve a measurable aim. The Model for Improvement provides a general framework for approaching QI. In this review article, we describe the general approach to conducting QI studies in the health-care setting using the Model for Improvement as a guide, including identifying a problem, performing testing, measuring change, and implementing successful ideas. We also summarize common issues that QI teams face and should consider if sharing their QI work through publication. By following a systematic approach, QI teams can develop and implement interventions aimed at addressing gaps in care, thereby improving overall health-care value and safety for their patients.