Since the publication of the IOM's Crossing the Quality Chasm there has been an explosion of activity directed at improving the quality of healthcare delivery. With QI as the underpinning methodology there are thousands of examples of teams that have achieved real and sustained results improving both healthcare processes and patient and system outcomes.
But there are unfortunately more examples of QI initiatives that have failed, either in implementation or to maintain improved outcomes. There is a whole literature describing factors that influence QI project success. One of those factors....QI can actually make it harder to provide care!
Here are a few examples of studies showing that,
when measured, these well known QI or change
initiatives resulted in up to 2 hours of unallocated
additional nursing time, longer workdays and fewer
In addition, the changes associated with QI don't
always have high perceived value amongst those
that have to adopt the new work, further impacting
the likelihood of sustained project success
QI initiatives that do not add additional workload and have high perceived value are more likely to be adopted, cause less workplace burden and, achieve the intended outcomes...sustainably.
So...design for highly adoptable improvement