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Quality Improvement Tools

As mentioned in Week 2, it can be difficult to establish a programme in an institution and ensure that tasks are prioritised and carried through with.

You can use a Quality Improvement Project Tool, such as a PDSA Cycle, to help you start an ASP and improve antibiotic use in specific areas of your institution.

The Plan-Do-Check-Act (PDSA Cycle) is a quality improvement model aimed at making positive changes in health care processes to achieving favourable outcomes and has been used widely by the Institute for Healthcare Improvement for rapid cycle improvement. One of the unique features of this model is the cyclical nature of impacting and assessing change, accomplished through small and frequent PDSAs rather than big and slow ones.

Before starting, it is important to answer three questions:

  • What is the goal (SMART goal)?
  • How will we know when the goal is reached? – need to have metric/ measurement in mind
  • What will be done to reach the gone?

You can then apply FOCUS-PDSA

  • Find a problem/ process to improve
  • Organise team that knows the process
  • Clarify how the process works (map it)
  • Understand the root cause of the problem
  • Select an improvement strategy

Then do PDSA

  • Plan
  • Do
  • Study/ Check
  • Act (sustain or adjust and go again)

Graphic showing FOCUS-PDSA timeline

As mentioned previously, it is important to have a good team organised to carry out this improvement.

Then you must map your own process which you want to improve (from patient entry to leave) and identify gaps in procedure or areas of poor compliance. The improvement strategy will depend on what problems were identified.

Once you have established an improvement strategy, to ensure it is sustainable you must:

  • Strictly monitor compliance and adherence
  • Make it an institutional KPI – ensure the policy is adjusted
  • Continue education and awareness – teams constantly change (share data)
  • Carry out continuous audit and feedback
  • Scale it up across all surgery in the hospital

The next step provides a paper detailing some potential strategies, interventions and/or tools that can be used to drive stewardship improvement and how to tailor them to your specific setting.

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This article is from the free online course:

Antimicrobial Stewardship for the Gulf, Middle East and North Africa

BSAC