Write an analysis of the key principles and elements of quality improvement.
- Describe the purpose of QI in healthcare.
- What methods or models are often used for QI?
This analysis should be 2 pages (double spaced) and utilize APA format and style (title page, in-text citations, reference page) and should include at least one reference outside of what is used in the course.
Document Type/Template
- Word Document
Purpose of Quality Improvement in Healthcare
Quality Improvement (QI) in healthcare refers to systematic and continuous efforts aimed at enhancing the efficiency, effectiveness, safety, and equity of healthcare services (CDC as cited by Johns Hopkins Medicine, n.d.; U.S. Department of Health and Human Services as cited by Johns Hopkins Medicine, n.d.; AHRQ as cited by Johns Hopkins Medicine, n.d.) Johns Hopkins Medicine. The overarching goal is to improve patient outcomes, deliver value-based care, and reduce variability and errors (StatPearls, 2025) NCBIJohns Hopkins Medicine. QI is inherently iterative, recognizing that healthcare systems are complex and continuously evolving; it relies on ongoing cycles of testing, learning, and adaptation (AHRQ, n.d.) AHRQ.
Key Principles of Quality Improvement
Several foundational principles guide QI:
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Iterative Approach: QI employs cyclical methods—most notably the Plan‑Do‑Study‑Act (PDSA) cycle—to test changes, learn from results, and refine interventions continuously (Russ et al., 2023) SAGE Journals.
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Data-Driven Decision Making: Reliable, valid, and sequential data collection is essential to track baseline performance, monitor interventions over time, and distinguish true improvement from random variation (Russ et al., 2023) SAGE Journals.
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Engagement and Teamwork: Effective QI often hinges on teamwork, communication, and stakeholder engagement—for example, TeamSTEPPS improves collaboration among healthcare teams to enhance safety and performance (AHRQ, n.d.) AHRQ.
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System Understanding and Adaptation: QI efforts are predicated on understanding the healthcare system’s structure and dynamics—understanding root causes, system bottlenecks, and unintended consequences ensures sustainable change (Donabedian model; StatPearls, 2025) WikipediaNCBI.
Common Models and Methods
Several models and methodologies are widely deployed in healthcare QI:
Model for Improvement and PDSA
The Model for Improvement, developed by the Institute for Healthcare Improvement (IHI), builds on three fundamental questions—“What are we trying to accomplish?”, “How will we know a change is an improvement?”, “What changes can we make?”—and uses rapid-cycle testing through PDSA cycles (AHRQ, n.d.) AHRQPubMed Central. The PDSA cycle itself—Plan, Do, Study, Act—is central to testing small changes, observing impact, and iterating to refine interventions (AHRQ, n.d.; UNC, n.d.) AHRQUNC School of Medicine.
Lean and Six Sigma (and Lean Six Sigma)
Lean focuses on eliminating waste and optimizing process flow, originally from Toyota’s manufacturing system, and has been adapted to healthcare to reduce inefficiencies such as waiting times and errors (StatPearls, 2025; Monash Health, n.d.) NCBImonashhealth.libguides.com.
Six Sigma targets reduction of process variability and defects through the structured DMAIC approach (Define, Measure, Analyze, Improve, Control) (Johns Hopkins Medicine, n.d.; StatPearls, 2025) Johns Hopkins MedicineNCBIWikipedia.
Lean Six Sigma merges Lean’s value-driven waste elimination with Six Sigma’s focus on variability reduction for more comprehensive improvement (Johns Hopkins Medicine, n.d.; StatPearls, 2025) Johns Hopkins MedicineNCBI.
FOCUS‑PDSA
FOCUS‑PDSA is a healthcare‑adapted method combining a problem‑identification FOCUS framework (Find, Organize, Clarify, Understand, Select) with PDSA cycles for structured, iterative improvement particularly suited to complex adaptive systems (NCBI, n.d.) NCBI.
Donabedian Model
The Donabedian model offers a conceptual foundation for assessing quality through three domains: structure, process, and outcomes, emphasizing how organizational context and care activities impact patient outcomes (Wikipedia, 1966) Wikipedia.
Co‑design and Design Thinking
Emerging methodologies such as co-design, which involves healthcare providers, patients, and stakeholders in designing solutions, and design thinking, which emphasizes desirability, feasibility, and viability in solution development, provide human-centered approaches to QI (Monash Health, n.d.) monashhealth.libguides.com.
Body (Page 2 – Continued)
Purpose of These Models
Each of the models and methods serves a distinct yet complementary role:
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The Model for Improvement and PDSA enable rapid, small-scale testing that can be quickly refined based on results.
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Lean optimizes workflow by reducing non-value activities, while Six Sigma reduces variation and errors through data‑driven analysis and control.
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FOCUS‑PDSA merges systematic problem identification with iterative testing, making it especially suited for complex healthcare environments.
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Donabedian’s framework ensures that QI addresses not only outcomes but also the context (structure) and delivery (process) of care.
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Co‑design and design thinking bring in user-centered innovation, ensuring improvements are aligned with patient and provider needs.
Together, these methods promote effective, sustainable improvements by integrating system awareness, stakeholder engagement, structured testing, and data-informed decision-making.
Conclusion
Quality Improvement in healthcare aims to enhance patient outcomes, efficiency, equity, and safety through structured, continuous efforts. Core principles include iterative cycles, data-driven decisions, team involvement, and systems thinking. Widely used approaches—Model for Improvement (PDSA), Lean, Six Sigma, FOCUS‑PDSA, the Donabedian model, and co-design/design thinking—offer frameworks for diagnosing issues and implementing meaningful change. By combining these methods thoughtfully, healthcare organizations can achieve lasting, measurable improvement in care quality.
References (Page 2)
Agency for Healthcare Research and Quality. (n.d.). The model for improvement. In Improvement guide. Retrieved August 16, 2025, from AHRQ website AHRQ.
AHRQ. (n.d.). Understanding and implementing the improvement cycle. In Improvement guide AHRQ.
Johns Hopkins Medicine. (n.d.). Quality improvement: Definition, history, and models. Retrieved August 16, 2025, from Johns Hopkins Medicine website Johns Hopkins Medicine.
Monash Health. (n.d.). Methods & models: Co‑design, Lean, Six Sigma. Monash Health Quality Improvement Guide monashhealth.libguides.com.
NCBI Bookshelf. (2025, January 11). Quality improvement methods (Lean, PDSA, Six Sigma). In StatPearls. Retrieved from NCBI NCBI.
NCBI PMC. (n.d.). Using FOCUS‑PDSA quality improvement methodology model in healthcare. Retrieved August 16, 2025, from NCBI PMC NCBI.
Wikipedia. (2025). Donabedian model. Wikipedia. Retrieved August 16, 2025, from Wikipedia Wikipedia.
Russ, S. J., Green, J., de Winter, L., Herrington, E., Hughes‑Hallett, A., Taylor, J. M., & Sevdalis, N. (2023). An introduction to quality improvement: Underlying QI principles. Journal of Integrated Care, …
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