Improving departmental Quality Improvement Plans through standardisation, structured peer-to-peer feedback and...

Quality Improvement Plans (QIPs) can improve healthcare quality by raising awareness and providing a focus for improvement efforts. The physician-led quality committee at our institution set out to improve the previously heterogenous quality and content of clinical department QIPs and increase alignment between clinical department and hospital quality improvement (QI) priorities. We describe these initiatives and assess their impact on the quality of departmental QIPs.

The Physician Quality Committee at our academic tertiary care hospital implemented a series of interventions, including a peer-to-peer feedback mechanism, longitudinal education and coaching, standardised QI project templates and efforts to facilitate culture change. The QIPs from 13 clinical departments were reviewed for the years before (2018-2019) and after the interventions (2022-2023) and scored according to a structured rubric, created by consensus among physician quality leads. Data are reported as means and medians (IQR). A Wilcoxon signed-rank test was used to evaluate for statistical significance. A Likert-scale survey was used to assess physician QI leads' perception of the impact of the initiatives.

The mean score on the structured rubric was 4.4/12 for the QIPs from 2018 to 2019 and 8.0/12 for the QIPs from 2022 to 2023 (Z=3.06, p=0.0005). The median score (25th, 75th percentile) in 2018-2019 was 4.5 (3.5, 5.13), which increased to 8.5 (7.0, 9.0) in 2022-2023. The survey response for physician QI leads was 10/13 (76.9%). The most positive response was the QI lead's knowledge and understanding of how to structure a QI project (mean score of 4.4/5); the least positive response was related to departmental focus and clarity regarding QI priorities (mean score of 3.9/5).

Multifaceted physician-led interventions resulted in improvements in the quality and content of clinical department QIPs, improved physician knowledge of QI methodology, enhanced focus and clarity around departmental QI priorities, and improved awareness of hospital-wide improvement efforts.