When a patient presents to a hospital, clinical staff ask patients questions to help them understand the causes of the problem for the patient and assist them in making a diagnosis. This means the patient is likely to get an accurate diagnosis and the cause of problem can be addressed.
When there is a process failure which might lead to patient harm, Clinical Practice Improvement (CPI) methodology provides a framework for clinicians to review, identify and understand causes of the failure and design solutions to continuously improve processes of patient care.
The Clinical Excellence Commission (CEC) provides CPI training to participants of the Clinical Leadership Program and as well as front line clinicians in NSW Health Facilities.
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.
The basic principles of Clinical Practice Improvement are:
- 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.
|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 CEC 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, email us.
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.
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
Applications for the next RACP CPI program for advanced trainees will open in January 2017 for the course commencing April 2017.
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 district. Alternatively staff can contact us.
- Cathy Vinters PDF ~25KB
- Cheat sheet for quality tools PDF ~312KB
- PDSA - A template to keep track of PDSA cycles DOC ~375KB
- Project team groundwork - A worksheet to keep the team on track with their outcomes and expectations DOC ~40KB
- Quality measurement data collection tools - Pre formatted Excel worksheets to enable entering of data and graphs etc will populate from entered data XLS ~265KB
- Project Gantt chart - a timeline for team to enter projects into to keep on track XLS ~28KB
Gem Workstar - LinkGEM has been designed to provide access to learning opportunities for all staff working within the NSW Health system.
Innovation Exchange - Link
Institute for Healthcare Improvement - Link
Intermountain Healthcare - Link
The Agency for Healthcare Research and Quality (AHRQ) - Link
The Improvement Hub (Scotland) - Link