Emerging Methods in QI
Research and Evaluation
Lori Melichar, Ph.D.
AcademyHealth, 2009
3 ways to talk about Quality Improvement:
QI is a process-based data-driven approach to improving the
quality of a product or service through iterative actionevaluation cycles.
QI is the combined and unceasing efforts of everyone—…..—
to make changes that will lead to better patient outcomes,
better system performance and better professional
development
QI is an approach to quality that emphasizes the organization
and systems that focuses on "process" rather than the
individual; recognizes both internal and external
"customers"; promotes the need for objective data to
analyze and improve processes
QI programs at RWJF
• Programs that use QI as a strategy for
Improvement
•Pursuing Perfection
•Transforming Care at the Bedside
•Aligning Forces for Quality
• QI strategies
•Collaborative learning
•PDSA
•Frequent Measurement
QI evaluations at RWJF
• Evaluation – 10% of Authorizations
• Learn and share
• Guide future investments
• Evaluations of QI program especially challenging
• Some old problems newly problematic
• Some new problems associated with complexity and
limitations of the field
• Others in the field echoed our needs
• VA
• IOM
• AHRQ
Advancing the Science of QI research and
evaluation sought projects to
• develop methods, tools and standards for the design, conduct
and reporting of CQI research and evaluations,
• demonstrate how the paradigms, methods and approaches from
other disciplines can advance the science of CQI research;
• develop and test new theoretical models, conceptual frameworks
and logic models to explain CQI initiatives;
• demonstrate how rapid-cycle “run-chart” or “PDSA-cycle” data
can be used to rigorously evaluate the effectiveness of CQI
interventions
• develop methods to systematically capture implementation
context information.
Projects to develop new measures
• QI team characteristics
• Systems Thinking
• Capacity for change
• Context
Data collection and analysis
• Review of SPC data analytic techniques
• Using IT for QI data analysis
• Events per risk exposure time
Criteria to identify and assess QI
research and evaluation
• Checklist of key features of QI lit
Panelists
• Jack Needleman
• Martin Charns
• Heather Kaplan
• Shirley Moore
Be thinking
• Guidance about focus?
• Guidance about measurement?
• Guidance about methods?