Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Quality Improvement Article
  • Published:

Introduction to quality improvement tools for the clinician

Abstract

As physicians continue search for ways to deliver high quality care to their patients and families, newer tools and methods are being introduced. Initially developed by manufacturing, quality improvement methods have been slowly adopted by healthcare and are now standard curriculum in medical schools. The IHI Model for Improvement allows for teams to create. model for change, test proposed changes in clinical situations, measure the results and then accept or modify the proposed changes. Additional tools such as process maps, Pareto charts, Ishikawa diagrams, and key driver diagrams provide structure and visual representation to the team during the creation and implementation of. quality improvement initiative. As participation in quality improvement is becoming an expectation for all health care providers, familiarity with these tools will assist teams with implementing improved processes in their local systems of care.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Swanson J, Pearlman S. Roadmap to. successful quality improvement project.. Perinatol. 2017;37:112–5.

    Article  CAS  Google Scholar 

  2. Lachman P, Jayadev A, Rahi M. The case for quality improvement in the neonatal intensive care unit. Early Hum Dev. 2014;90:719–23.

    Article  Google Scholar 

  3. Langley GJ, Nolan KM, Nolan TW. The foundation of improvement. Silver Spring, MD: API Publishing; 1992.

    Google Scholar 

  4. Doran GT. There’s. S.M.A.R.T. way to write management’s goals and objectives. Management Review. AMA FORUM. 1981;70:35–36.

    Google Scholar 

  5. Langley GL, Moen R, Nolan KM, Nolan TW, Norman CL, Provost LP. The improvement guide:. practical approach to enhancing organizational performance. 2nd ed. San Francisco: Jossey-Bass Publishers; 2009.

    Google Scholar 

  6. Agency for healthcare research and quality practice facilitation handbook. Health literacy universal precautions toolkit, 2nd ed. Plan-Do-Study-Act (PDSA) directions and examples. https://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/literacy-toolkit/healthlittoolkit2-tool2b.html Accessed 30 Oct 2017.

  7. Gillam S, Siriwardena AN. Frameworks for improvement: clinical audit, the plan-do-study-act cycle and significant event audit. Qual Prim Care. 2013;21:123–30.

    PubMed  Google Scholar 

  8. Dias S, Saraiva PM. Use basic quality tools to manage your processes. Qual Progress. 2004;37:47–53.

    Google Scholar 

  9. Trebble TM, Hansi N, Hydes T, Smith MA, Baker M. Process mapping the patient journey: an introduction. BMJ. 2010;341:c4078.

    Article  Google Scholar 

  10. Joosten T, Bongers I, Janssen R. Application of lean thinking to health care: issues and observations. Int. Qual Health Care. 2009;21:341–7.

    Article  Google Scholar 

  11. Juran JM, Godfrey AB. Juran’s quality handbook. 5th ed. New York City: McGraw-Hill; 1998.

    Google Scholar 

  12. Wilkinson L. Revising the Pareto Chart, The American Statistician. 2012;60:332-334, https://doi.org/10.1198/000313006X152243.

    Article  Google Scholar 

  13. American Society for Quality. Cause analysis tools: pareto chart. 2009. http://www.asq.org/learn-about-quality/cause-analysis-tools/overview/pareto.html Accessed. Sept. 2017.

  14. Tague NR. Seven Basic Quality Tools. In: The Quality Toolbox. Milwaukee, Wisconsin: American Society for Quality; 2004. p. 15.

  15. Provost L, Bennett B. What’s your theory? Driver diagram serves as tool for building and testing theories for improvement. Qual Prog. 2015;48:36–43.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Alan Peter Picarillo.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Picarillo, A.P. Introduction to quality improvement tools for the clinician. J Perinatol 38, 929–935 (2018). https://doi.org/10.1038/s41372-018-0100-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41372-018-0100-4

This article is cited by

Search

Quick links