What is CQI? Facility Guide and Best Practices
The U.S. healthcare system continues to face increasing costs without delivering the consistency of care needed to justify these expenses. To help combat this, the federal government has made a commitment to promote better patient outcomes at lower costs by supporting continuous quality improvement (CQI). But what is CQI in healthcare and how do facilities partake in it?
It’s important for facility leaders to participate in CQI in order to support national agendas geared toward improving healthcare. This guide will walk you through everything you need to know about CQI and best practices for upholding it at your facility.
What Is CQI? Definition and Application to Healthcare
Continuous quality improvement in healthcare, or CQI, is a process whereby facilities make ongoing efforts to achieve incremental improvements in patient care. CQI initiatives focus on enhancing things like safety, health outcomes, workflow, or regulatory compliance. A general CQI framework is typically carried out using the following iterative steps.
| 1. Define | Identify a targeted problem. |
| 2. Analyze | Determine the root causes of the problem. |
| 3. Outline | List measurable goals to address the problem. |
| 4. Implement | Put your CQI initiative or action plan into motion. |
| 5. Assess | Review the results and tweak the plan as needed. |
| 6. Repeat | Follow the same steps for the next problem. |
Who Is Responsible for CQI?
CQI is a shared responsibility between all professionals in the healthcare industry. Federal health agencies outline CQI recommendations based on the most current evidence. In addition to applying these standards, healthcare leaders and staff must work together to identify and address more specific problems that are hindering patient care processes at their own facilities.
Why Is CQI Important in Healthcare?
The continuous quality improvement process is designed to improve patient outcomes and help facilities achieve excellence. It requires a commitment to upholding standards and values that are fundamental to high quality patient care. When conducted with the right intent and purpose, CQI initiatives can bring many benefits, such as:
- Improved health and safety outcomes
- Reduced medical errors and costs
- More cohesive teamwork and care delivery
- Increased efficiency in workflow
- Higher staff morale and accountability
5 Best Practices for Facilities
Now that we’ve answered the question, what is CQI? You may be wondering how to implement initiatives at your facility. Here are five best practices to follow as you construct your continuous quality improvement plan, along with some CQI examples.
1. Follow an Evidence-Based CQI Methodology
CQI is a structured process that’s been heavily researched by leading health experts. Before you implement any new initiatives, make sure you’re educated on established methods that can help inform the steps of your CQI process:
Following these methods will ensure your quality improvement projects set you up for success. It’s also important to understand that one method is not necessarily better than the other — what you decide to employ will largely depend on the unique needs of your facility. You can always try one method and switch to another if you don’t get the results you’re aiming for.
2. Assess Appropriate Quality Measures/Metrics
It’s important to clearly define care areas that need improvement and make your progress measurable. You can monitor specific care processes by assessing quality measures or metrics that allow you to reach tangible goals.
The Center for Medicare and Medicaid Services (CMS) provides a quality measure inventory that you can use to select from various evidence-based measures to quantify care outcomes. You can also create your own metrics if your goals aren’t captured by these existing measures.
Example: A facility notices that their patients are being frequently readmitted. To help prevent this, staff begin monitoring readmissions by using the CMS 30-Day All Cause Rehospitalization measure.
3. Engage Staff Across All Levels in CQI Initiatives
CQI is a collaborative effort, and it’s important for staff to be educated on what CQI is and how they play a role in unit-based initiatives. You can engage your staff in quality improvement by hosting training sessions or workshops for new CQI initiatives, or even incentivizing staff to spearhead their own CQI projects.
Example: As part of a department’s career development program, nurses receive financial rewards or honors when they take the lead in overseeing quality improvement projects that improve workflow.
4. Involve Patient and Families in CQI Planning
Since improving patient outcomes is a fundamental goal of CQI, healthcare leaders must get direct input and feedback from the patients themselves. Objectively, staff can only measure and observe so much of the care process. As such, checking in with your patients will allow you to grasp the non-clinical aspects of care that need improvement.
Example: A clinic sends out an online patient experience survey to assess how their recent patients have felt about the treatment from the care team.
5. Optimize the Use of Health Technology
Technology is rapidly changing the way healthcare is delivered, and it’s important for facilities to maximize the efficiency of new data tools. In particular, electronic health records (EHR) help streamline documentation while providing opportunities to inform large-scale quality improvement. Work with informaticists and IT staff to develop automated processes enabling meaningful use of EHR data.
Example: A facility integrates an EHR function that gives providers an automated snapshot of patients who are experiencing worsening symptoms. This allows providers to more quickly implement new care orders and get their patients’ symptoms under control.
Discover More Ways to Deliver High Quality Care
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