The basic principles of Clinical Practice Improvement include the following:

• Health care is a process which can be analysed
• Both the process and the outcomes of clinical work can be measured
• Profound knowledge of the processes of care exist within individuals who work in the system, in particular 'microsystems'
• Multi disciplinary teamwork and the design of novel solutions are essential in effecting improvements in health process
• There is the will and leadership to implement change.

CPI methodology provides a framework whereby clinicians can undertake a comprehensive diagnostic of the causes of process failures which lead to inefficiencies and/or patient harm and design solutions to continuously improve care and outcomes for patients.

Basic principles of Clinical Practice Improvement

The above model for the Plan, Do, Study, Act cycle was based on the work of Nolan, James, Berwick and Shewart and many other proponents of quality improvement. The diagrammatic representation of the process was developed by G. Rubin and B. Harrison for NSW Health (for the Clinical Practice Improvement Steering Group) 2000.

The Clinical Excellence Commission provides Clinical Practice Improvement (CPI) training to front line clinicians in NSW Health organisations. The CEC works closely with Local Health Districts, Sydney Children's Hospitals' Network (Randwick and Westmead), Justice Health and Ambulance Service, Quality Managers, to build the capacity and capability for them to support healthcare improvement projects and teams within Public Health Organisations (PHOs).

The CEC has recently established a CPI Advisor Network, for more information contact - Cathy Vinters 02 9269 5509 .

CPI Program Objectives

The program aims to improve the safety and quality of care to patients through:

• Enhancing the knowledge of clinicians about quality Improvement theory
• Improve the ability of clinicians to identify causes of process failures within their clinical teams
• Enhancing clinicians' personal and professional leadership skills (teamwork)
• Equipping healthcare facilities with personnel who can apply improvement methodology to effect change; implement evidence based practice and address problems arising out of root cause analyses
• Designing effective solutions using plan, do, study, act (PDSA) tests of change
• Awareness of microsystem re-engineering, human factors and reliable design principles
• Foundation in measuring for quality using statistical process control charts
• Spreading and sustaining change and improvement.

How do staff get involved in CPI training?

The CEC offers CPI training as:

A one day workshop which is suitable for clinicians who are part of a project team and teaches the use of quality improvement tools - DOC ~900kb

A two day workshop which provides more in depth training for staff who are required to lead improvement teams - DOC ~325kb

Staff who are interested in undertaking face to face CPI training should contact their quality manager through the Clinical Governance Unit at their Local Health Districts. Alternatively staff can contact the CEC directly on 02 9269 5509.

In addition to face to face training, the CEC, in collaboration with NSW Health, Health Service Performance Improvement Branch (HSPIB), has developed E-Learning modules (on the GEM platform) in healthcare improvement methods including CPI methodology enabling CPI training to be undertaken online. These modules are freely available to staff working for NSW Health PHO's.