1. Quality Improvement Projects

2. Introduction What is QIP? Purpose? How is it different from audit?
What skills does it teach?
Future plans for QIP

3. Quality Improvement Projects (QIP)
Trainees identify an improvement, lead it and write up covering the following areas:
1. The Project: simple and SMART
2. The Background: how the need for improvement was identified.
3. Process Mapping: the steps needed with action plans
4. Stakeholder Analysis: identifies people or groups involved in the area to improve
5. The Intervention: collects, analyses and interprets data
6. Conclusions: describes the outcomes of interventions
7. Reflections: self-assessment
Timescale: it should take about 8-12 weeks to complete 1-2 cycles of a simple QIP

4. Ideas for QIP projects
Capture of important diagnoses from hospital discharge letters
Repeat prescription pathway
Improving DNA rate

5. Example
Recording of fractures from hospital discharge summaries with aim of identifying fragility fractures
Purpose :
Osteoporosis risk
Child protection
Good record keeping

6. Process mapping Letter arrives in surgery ( mail, fax or electronic)
Letter opened/accessed
Letter processed and allocated to Dr
Doctor highlights the readcode
Administrator adds it to computer

7. Stakeholder analysis Practice administrators doctors in the surgery
Care homes
Pharmacist
(Local osteoporosis clinic)
(Fracture clinic)
(A&E)
(CCG)

8. The intervention
Collect/analyse data eg looking at past 6 months worth of fragility fracture coding
Develop a guideline on which discharge summaries to escalate:
eg hip fractures, radial fractures, spinal wedge fractures, over 75s with fractures
doctor to identify the fragility fracture and code fragility fracture

9. monitor the intervention for a short period of time to check it is working
modify aspects of it if necessary
Implement the change
re-analyse data 6 months later

10. Conclusions Outcomes local vs wider impact
implications eg financial, workload, prescribing, referrals, readmission rate ( falls prevention, osteoporosis management)
plans for sustainability through potential further work
dissemination of best practice via CCG/commissioning

11. Reflections Barriers Leadership skills Practice factors
Impact on self/stakeholders
Any unexpected findings