Residency and Fellowship

Define the problem you are trying to solve and why it is important. Choose a project that you are passionate about and where you can have a strong influence to make effective change. Whenever possible, choose a project whose goals also align with your institution. Start with a clear, focused SMART (Specific, Measurable, Achievable, Relevant, Time-bound) Aim Statement. When defining your project, consider sustainability from the start. Please refer to Step #7 for more on recommendations for Sustainability. Please visit our resources section for more on SMART AIM statements. .

Engage a group of key stakeholders early. Including multidisciplinary team members will offer different areas of expertise, knowledge, and experience within the system. Leadership support will help drive improvement and promote sustainability. Please reference the “QI Project charter” In resources for more details on team members.

Use a set of measures to track change and learn across different areas of the system (or processes). These include outcome, process, and balancing measures. When measuring your process changes and your outcomes, stick to a simple and consistent methodology to collect this data. Inconsistencies in your measurement methodology will lead to inaccurate, unreliable, and inconclusive data. Please visit our resources section for more on measures.

Baseline data: What is the current source of your baseline data? Is it adequate to indicate that improvement is needed? Will it assist in showing a change moving forward?

When measuring your process changes and your outcomes, stick to a simple and consistent methodology to collect this data. Inconsistencies in your measurement methodology will always lead to inaccurate, unreliable, and inconclusive data.

Once you’ve started your project, keep all the team members as well as other key stakeholders informed of the project’s goals and outcomes. Your project may also undergo several changes and variations throughout your journey. These changes will need to be communicated effectively and efficiently. Your team will need to see how their efforts are resulting in the outcomes that you initially intended for. Without this acknowledgement, their efforts at making and sustaining a change will inevitably wane. Check in with front-line providers to appreciate what they understand about the project, what they see as persistent obstacles and how you can help them work smarter, not harder for better patient outcomes. .

When choosing interventions, differentiate between tasks and tests. “Tasks” are “low hanging fruit” or actionable steps that can be taken to achieve a goal and don’t require conducting a test. “Tests” are using systematic methods to evaluate the effectiveness of a change. At CHAM, we use Plan-Do-Study-Act (PDSA) cycles to test. It is important to mention, once you have come up with your ideas for potential interventions, it is imperative to conduct a PDSA cycle first before immediately putting into practice.

Once you’ve started your project, keep all the team members as well as other key stakeholders informed of the project’s goals and outcomes. Your project may also undergo several changes and variations throughout your journey. These changes will need to be communicated effectively and efficiently. Your team will need to see how their efforts are resulting in the outcomes that you initially intended for. Without this acknowledgement, their efforts at making and sustaining a change will inevitably wane. Check in with front-line providers to appreciate what they understand about the project, what they see as persistent obstacles and how you can help them work smarter, not harder for better patient outcomes.

Getting “buy-in” requires a complete understanding and belief that what you are doing (your interventions) is having a clear impact on the outcomes for your patients, families, and the healthcare delivery system. Understand the WIFM (What’s In It For Me) for each participant. Encouragement, perseverance, and determination all play a vital role in achieving this “buy-in”. Don’t forget, celebrate your success. Sustainability includes ensuring gains are maintained beyond the life of the project. Find out what motivates people, design effective control systems, create a sustainability plan.