Follow a Framework for Improvement

Use a structured framework for improvement to plan and guide progress

For team members (and as a communication aide for stakeholders), there is great value in knowing how each of the team’s activities contributes to the overall progress of the improvement effort. A coherent framework is as important to quality improvement as an understanding of aeronautics is for building an aircraft.

The team will advance the quality improvement project along several fronts simultaneously. A logical flow for a QI project, summarized below.

A Framework for Improvement

1. Lay out the evidence / identify best practice. Determine what needs to be done for whom, and then draft a VTE protocol to standardize it.
2. Analyze care delivery. Highlight the steps in the clinical workflow where interventions will have the highest yield.      
3. Create performance tracking. Set up regular data collection and charting that is reliable, inexpensive, and directly relevant to the aim.
4. Integrate the VTE protocol into the clinical workflow and then layer other QI strategies that use high reliability mechanisms
5. Perform cycles of PDSA (Plan-Do-Study-Act) to perfect #3 and #4

The diagram below presents the 5 steps graphically to depict inter-relationships.