Practice facilitators can convey the roles and responsibilities of a high-functioning quality improvement team, and can educate the practice on what that could look like and the benefits to be found in a structured approaches. Explain the advantages of a quality improvement team and how it functions, which can remove anxiety about workload. Sharing examples of organizational structures, sample agendas from meetings that have worked well, and successful approaches from similar practices. As they engage in a project, lead a workflow mapping activity to show them which roles they need to include when forming their team. Help structure a well-functioning quality improvement team with a quality improvement lead, physician champion, reporting/IT representative, nursing staff, and other staff relative to priority initiatives.
Celebrate the team’s early successes! Highlight how the work is improving patient care, which is essential to clinical staff. If a team is still resistant to regular meetings, or practice leadership doesn’t see the value in protecting staff time for quality improvement monitoring, help them see an example of the return on investment during a quick successful intervention even outside of the main project. This can be very effective to sustaining the team and realizing the value added by this work, even though it will take staff time.
Help the practice find an improvement model, such as the Institute for Healthcare Improvement (IHI’s) Model for Improvement, with which they are comfortable. Coach them on how to use this model to identify positive changes and track their effectiveness. Encourage the practice to be consistent in their quality improvement approach, guiding them in selecting a manageable set of improvement initiatives with clear goals, timelines, and staff time and resources. Many practices are finding success with the IHI Model for Improvement project approach using AIM statements (What are we trying to accomplish), and structuring Plan Do Study Act (PDSA) cycles with Specific, Measurable, Attainable, Realistic, and Timely (SMART) goals and project timelines.
Emphasize the importance of getting ancillary staff who touch the process involved in the quality improvement project, such as billers, front desk, and nursing staff; the best ideas come from the people who are doing the work. This will help them with the issue at hand and will also reinforce that quality improvement teams and process testing should involve the entire practice.
If nothing you share resonates with the practice, keep offering options and discussing successful examples of practices until they find something that works for them. Ask them to complete a PDSA worksheet together with you, using a change that they have already made in the past or something that they want to change in the present. Help the team understand improvement science. Communicate that PDSAs that do not show improvement are just as important as those that do and will be implemented. Convey that practices often stick with changes that have added no value, consuming additional staff time and resources, because of a lack of rigor in how improvements are tested and implemented.