Traditionally, hospital teams have performed quality improvement efforts with very little time and energy left from their actual jobs. Unfortunately, the COVID-19 pandemic has furthered those stresses on everyone from nurse trainees and medical residents to directors of nursing, physicians, and disciplines and departments across the hospital and system.
In the United States, the burdens of COVID-19 led the Center for Medicare & Medicaid Services (CMS) to relax data collection and reporting requirements related to the Health Insurance Exchange Quality Rating System, QHP Enrollee Experience Survey (QHP Enrollee Survey), and Quality Improvement Strategy Programs. As a result, CMS is not calculating quality for 2020 under its Quality Rating System. But quality improvement could not stop amid COVID-19; in fact, the virus necessitated QI initiatives focused on issues such as infection prevention and telemedicine, among many others.
With the pandemic not going away anytime soon, hospitals will need to continue their QI programs despite patient surges and staff shortages. However, there’s a way to reduce the pain of lengthy and inefficient quality improvement amid all the organized chaos.
The push to improve quality care never stopped
According to an article in The BMJ, quality improvement has indeed been impactful during the pandemic. A survey of 225 people involved in improving health and care across the UK revealed that more than half of them said quality improvement had been influential during COVID-19. The article describes five ways in which QI was applied during the pandemic:
- Creating a common theory about how to tackle complex problems
- Understanding and improving processes
- Using measurement to inform decision making
- Employing plan-do-study-act (PDSA) cycles to test and scale rapidly
- Supporting learning and redesign for the future
The writers concluded that certain quality improvement approaches are valuable in dealing with complex problems, even in high-stress situations such as the pandemic. They also wrote that to sustain success, hospitals needed to commit to a chosen improvement method and embrace tools as part of continuous improvement discipline.
There were COVID-driven quality improvements in US hospitals as well. Cleveland Clinic’s QI teams initiated numerous measures to direct the care of patients with suspected or confirmed COVID-19 while also protecting caregivers. They concluded that, “Quality improvement during a pandemic requires a dynamic, rapid cycle, plan-do-check-act cycle approach. Leadership at all levels is key to coordinate, develop protocols, and implement change to sustain quality improvement during disasters such as pandemics.”
In Pediatric Quality and Safety, Ashley A. Foster, MD and Anne M. Stack, MD of Boston Children’s Hospital Emergency Department explained that at the outset of the pandemic, their hospital’s robust QI program — including multiple ongoing efforts — was disrupted by the need to safely treat patients with the virus while continuing to provide high-quality care to all patients. As a result, the hospital developed a new QI framework that enables it to adapt to COVID-19 and still maintain and further its important QI work.
QI projects don’t have to be stressful
Knowing that COVID-19 will factor into hospital care (and quality) for the foreseeable future, facilities must find ways to reduce the burden of QI projects while increasing their successful implementation. First, take a look at what complicates your quality improvement program:
- Do all your QI projects rely on manual processes?
- Do your project teams lack standardized workflows?
- Do project team members have difficulty collaborating and communicating?
- Is there an easy way for teams to see previous QI projects?
- Are QI teams accessing irrelevant or dated research?
- Do teams struggle to summarize and present their findings?
- Do QI recommendations end up going nowhere?
None of these situations is necessary if you use the right solution to organize your quality improvement efforts. Look for an application that includes standardized yet configurable workflow templates and encourages team discussion right within the app. Integrated search will help your team members find the highest quality and most current research — and an appraisal tool will help accelerate data extraction. Find a platform that enables each QI project team to synthesize its evidence and report findings in a way that builds the case for implementation.
Manage both COVID-19 and quality improvement
It’s challenging to put a QI project team together or to rally its members’ enthusiasm when everything about the process adds to its degree of difficulty. An unproductive program is also demoralizing to the staff (“nothing ever changes here”), making it tough to engage, retain, and hire employees. But suppose you use the right technology to make QI projects more efficient. In that case — both during the pandemic and afterward — your quality improvement program, your employees, your patients, and your bottom line all will reap the benefits.
Learn how Ovid Synthesis can relieve the stress of quality improvement projects through integrated workflows, advanced AI-powered search, and collaboration tools.
