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Catalyzing System Change: 100 Quality Improvement Projects in 1000 Days
Amelia Sattler1, Anuradha Phadke2, Jake Mickelsen3
1Stanford University School of Medicine, Palo Alto, CA, USA. amelia2@stanford.edu.
Journal of General Internal Medicine
|November 20, 2023
Summary
Scalable quality improvement (QI) training empowers frontline staff in academic medical centers to implement innovations. The Stanford PC-PEP program demonstrated feasibility and improved QI self-efficacy among diverse care teams.
Area of Science:
- Healthcare Management
- Quality Improvement Science
- Primary Care Innovation
Background:
- Effective health system change necessitates robust quality improvement (QI) infrastructure to support frontline staff in implementing sustainable innovations.
- The Stanford Primary Care-Project Engagement Platform (PC-PEP) is an 8-week rapid-cycle QI training program designed for patient-facing primary care clinicians and staff.
Purpose of the Study:
- To evaluate the feasibility and outcomes of a scalable QI program tailored for busy practicing providers and staff within an academic medical center.
- To assess the impact of the PC-PEP program on QI self-efficacy and project progression across diverse healthcare teams.
Main Methods:
- Program evaluation of the Stanford PC-PEP training.
- 172 participants (providers, staff, medical learners) from Stanford's Primary Care and Population Health (PCPH) clinics (2018-2021) engaged in QI projects.
- Projects were categorized using the Institute for Healthcare Improvement's Quintuple Aim (QA), and progress was tracked using a modified innovation framework; QI self-efficacy was measured post-participation.
Main Results:
- 104 projects were completed by 172 participants within 1000 days, primarily focused on improving patient health (55%) and care team experience (23%).
- Project progression varied, with 20% reaching spread to different settings (step 5B); learner involvement correlated with scholarly products (47% vs 10%).
- 98% of respondents reported improved QI self-efficacy, with medical assistants showing higher acknowledgment for QI efforts (100% vs 61% for physicians).
Conclusions:
- Scalable QI training models, such as Stanford PC-PEP, can effectively empower frontline healthcare workers to drive meaningful improvements.
- With adequate QI infrastructure, these programs facilitate progress across the Institute for Healthcare Improvement's Quintuple Aim domains.
- The PC-PEP program demonstrates a feasible and impactful approach to enhancing QI capacity and fostering innovation within primary care settings.
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