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Why the Heck Should I Care About QI?

Jennifer Volberding PhD, LAT, ATC, NREMT

Professor

Department Chair Athletic Training

Athletic Training Program Director

Oklahoma State University Center for Health Sciences

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Conflict of Interest

No Disclosures

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Learning Objectives

Define Quality Improvement

Identify Strategies to Implement QI into Clinical Practice

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How Do We Define Quality in Healthcare?^1,2

STEEEP
Safe
Timely
Effective
Efficient
Equitable
Patient-Centered

Safe: avoiding harm to patients from the care that is intended to help them

Timely: reducing waits and sometimes harmful delays for both those who receive and those who give care

Effective: providing services based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit (avoiding underuse and misuse)

Efficient: avoiding waste, including waste of equipment, supplies, ideas, and energy

Equitable: providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status

Patient-centered: care that is respectful and responsive to individual patient preferences, needs, and values and ensuring that all patient values guide all clinical decisions

It all comes down to doing the right thing, at the right time, in the right way, for the right person and having the best possible results

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What is Quality Improvement (QI)?^3,4,5

A process of approaching systemic problems in healthcare
Combined and ongoing efforts of everyone on the healthcare team
Continuous activity

There is always an opportunity for improvement

Part of the BOC’s upcoming Continuing Professional Certification

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What QI is Not^5,6

RESEARCH

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From: Looking to Improve Your Practice? Consider the Science of Quality Improvement to Get Started

J Athl Train. 2020;55(11):1137-1141. doi:10.4085/1062-6050-0342.19

The Model for Improvement. Reprinted with permission. Langley GJ, Moen RD, Nolan KM, Nolan TW, Norman CL, Provost LP. The Improvement Guide: A Practical Approach to Enhancing Organizational Performance. 2nd ed. San Francisco, CA: JosseyBass. Copyright 2009; 23–24. All rights reserved.^4,17�

Figure Legend:

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Identify the Goal⁶

Address a frustration
Narrow a quality gap
Eliminate a safety concern
correct a problem within the local system

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QI Process^5,6,7

Focus on patients
Value teams
Emphasize systems and processes of care

Structural
Process
Outcomes

Appreciate the power of variability
Requires data

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From: Looking to Improve Your Practice? Consider the Science of Quality Improvement to Get Started

J Athl Train. 2020;55(11):1137-1141. doi:10.4085/1062-6050-0342.19

Example of a fishbone diagram. Abbreviations: EMR, electronic medical record; PROs, patient-reported outcomes.�

Figure Legend:

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Data, What Data?^5,6

Essential to evaluate the effects of change
Start with baseline when identifying the problem or gap
Can be simple or complicated data

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QI Process⁸

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So where can you use QI in Your Clinical Practice?

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QI Resources

BOC

Continuing Professional Certification
https://bocatc.org/athletic-trainer-credentials-and-tools/#t2

NATA Professional Development Center

Using Quality Improvement in Athletic Training
https://educate.nata.org/

NATA Foundation

https://www.natafoundation.org/wp-content/uploads/Quality-Improvement-RTCP.pdfAthletic Training Practice-Based Research Network
Quality Improvement in Healthcare (1.0 CEUs – FREE)
https://www.coreat.org/online-courses.html

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References

Agency for Healthcare Research and Quality. Six Domains of Healthcare Quality. Accessed May 15, 2024. https://www.ahrq.gov/talkingquality/measures/six-domains.html
Patient Safety & Quality Healthcare. Improvement Interventions and the IOM Aims for Quality: STEEP-7. Access May 15, 2024. https://www.psqh.com/analysis/improvement-interventions-and-the-iom-aims-for-quality-steep-7/
Varkey P, Reller MK, Resar RK. Basics of quality improvement in health care. Mayo Clin Proc. 2007;82(6):735-739.
Riley WJ, Moran JW, Corso LC, Beitsch LM, Bialek R, Cofsky A. Defining quality improvement in public health. J Public Health Manag Pract. 2010;16(1):5-7.
Lopes Sauers AD, Sauers EL, Snyder Valier. Quality improvement in athletic healthcare. J Athl Train. 2017;52(11):1070.1078.
Snyder Valier AR. Looking to improve your practice? Consider the science of quality improvement to get started. J Athl Train. 2020;55(11):1137-1141.
Agency for Healthcare Research and Quality. Types of Health Care Quality Measures. Accessed May 15, 2024. https://www.ahrq.gov/talkingquality/measures/types.html
NATA Foundation. Quality Improvement. Accessed May 15, 2024. https://www.natafoundation.org/wp-content/uploads/Quality-Improvement-RTCP.pdf

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Questions?

Jennifer.volberding@okstate.edu