HOW-TO GUIDE: DESIGNING A STUDENT-RUN QUALITY IMPROVEMENT PROJECT PROPOSAL TMIT Student Projects QuickStart Package ™

Objectives  Create a concise vision and mission for your project  Set reasonable and attainable aims  Compose a comprehensive outline for your advisor that will encompass the project and its goals

Outline Project Proposal I. Vision/Mission II. Setting Aims III. Proposal Outline I. Background II. The Intervention III. Strategy for Implementation

I. Vision/Mission  Vision  Mission ExampleThe First Global Student Sprint to Improve Healthcare Vision Students across the world helping to disseminate the WHO Safe Surgery Checklist and partnering to improve healthcare quality Mission Engage health professions students to take part in at least one of the three sub-aims around using the checklist: Build Awareness Promote Implementation Collect Data

II. Setting Aims 1. State your aim clearly 2. Make sure that it identifies the population and system to be improved 3. Set numerical goals Allows for better outcome measures 4. Set Stretch Goals Give yourself a timeline ○ Ex: Reduce infections by 50% in 6 months 5. Avoid Aim Drift Focus on your goal and try not to steer away

III. Project Proposal: Outline 1. Background Setting ○ Where and when will you be instituting your intervention? Healthcare service ○ Describe the service that you are trying to improve. Problem ○ What type of protocols or resources are in place? ○ Describe the deficit in this particular area. Barriers to quality ○ What barriers to improving quality do you anticipate?

III. Project Proposal: Outline 2. The Intervention Process defect ○ Where in the current system is the problem? Aim ○ What are your goals of improvement? ○ What results do you expect after instituting your intervention?

III. Project Proposal: Outline 3. Strategy for Implementation Strategy ○ Process versus Outcome improvement ○ PDSA cycles Measures ○ How will you measure the change pre and post implementation? Barriers to change ○ How will your process or outcome intervention be hindered during its implementation? Costs vs. resources vs. culture Cost Implications ○ Will this be more costly to the hospital? ○ Will the benefit show itself?

III. Project Proposal Ex: Safe Surgery Student Sprint Case Study: Karachi, Pakistan  1. Background Setting- Karachi Pakistan Healthcare service- Prevention of post-operative infections Problem- surgical site infection rates 4-20% Barriers to quality- access to antibiotics, cultural change  2. The Intervention Process defect – no protocol in place Aim- reduce surgical site infections by 33% by 6 mos.  3. Strategy for Implementation Strategy- process improvement by implementation of checklist Measures- compliance of use of checklist, # infections Barriers to change-cultural change in practice Cost Implications- No costs

III. Project Proposal ex: Reduction in Emergency Dept. Handoff Errors 1. Background Setting- San Francisco Emergency Dept. Healthcare service- Inter-shift patient transfers Problem- adverse events associated with ED handoffs Barriers to quality- physical environment and social setting 2. The Intervention Process defect – no formal protocol in place Aim- 100% compliance with SBAR protocol in 18mos 3. Strategy for Implementation Strategy- Process improvement using SBAR technique, PDSA cycle Measures- compliance, provider satisfaction Barriers to change-cultural change in practice Cost Implications- No costs