Our model for improvement is a method for change that’s universal for all Medway Innovation Institute projects. It’s simple, it’s intuitive, and it makes sure we’re always prioritising patient outcomes and quality of care.
The model for improvement
The model for improvement is built on the belief that sustainable improvement is created through incremental changes that are supported by accurate information and collaboration. This approach is taken by many successful tech companies and innovative start-ups. It’s known as the PDSA (Plan, Do, Study, Act) cycle. It involves testing ideas for change on a small scale to uncover a clear cause and effect link. The cyclical nature of the model allows the changes to be refined and improved through repeated rounds of testing and learning.
Setting a goal
We ask everybody working on a quality issue to turn it into an aim. Something that is ‘SMART’ (Specific, Measurable, Achievable, Realistic, Time bound). If we know where we want a quality improvement area to be and by when, we’ll be able to show whether the project is working.
Every project will need between 5-8 measures of success. There are 3 types of measures we use in improvement projects:
1. Outcome measures
This is often directly linked to your aim. For example, if your project focuses on falls reduction, then your outcome measure could be the number of falls occurring. We aim for a tangible link between the outcome measure and the patient. How does the system impact the values of patients, their health and wellbeing? What are impacts on other stakeholders such as the community?
2. Process measures
Your improvement project will likely involve changing or modifying different processes or systems to improve the quality issue you’ve identified. It’s important to measure the reliability of these processes so you can track them back against your aim. Are the steps in the system performing as planned? Are we on track in our efforts to improve the system?
3. Balancing measures
These can help show whether there are unintended consequences elsewhere in the system. Are changes designed to improve one part of the system causing new problems in other parts of the system?
The PDSA cycle
Not every change results in improvement. Using PDSA cycles enables you to test out changes on a small scale, building on the learning from these test cycles in a structured way. It’s a powerful tool for learning from ideas that do and don’t work.
The four stages of the PDSA cycle are:
- Plan – The change to be tested or implemented.
- Do – Carry out the test or change.
- Study – Based on the measurable outcomes agreed before starting out, collect data before and after the change and reflect on the impact of the change and what was learned.
- Act – Plan the next change cycle or full implementation.
Tools for change
We’ve developed a range of tools to accelerate improvement work. These simple resources are fast and easy to use. They really help with the development of ideas and create change through different stages of your project.