The COVID-19 pandemic brings huge challenges to the delivery of health care in Aotearoa. This page provides useful information to support quality improvement activities during this time. We aim to share insights and initiatives from a variety of sources.
IHI’s quality improvement essentials toolkit includes the tools and templates you need to launch a successful quality improvement project and manage performance improvement: http://www.ihi.org/resources/Pages/Tools/Quality-Improvement-Essentials-Toolkit.aspx
A quality improvement chart developed by Lloyd Provost has been applied to new cases of COVID-19 by one of our country’s improvement advisors. Discussed with Lloyd, it demonstrates the value of identifying sustainable improvement through statistical charts. See the excel template with instructions on how to use this chart (209KB, xlsx) and the charted Ministry of Health data.
The driver diagram was built in partnership with staff across Bedfordshire Community Health Services to reflect what matters to the staff involved in the COVID-19 response: https://qi.elft.nhs.uk/co-production-and-co-creation-in-bedfordshire/?dm_i=1TXQ,6SY2C,WQ27HU,R8H8I,1
The article identifies a five-step strategy and actions through which patient safety and quality improvement staff can support organisations during the COVID-19 pandemic: https://academic.oup.com/intqhc/article/33/1/mzaa050/5836316?login=false
This webinar from the UK provides opportunities to learn from adaptions made during COVID-19 and to look at future models of care. A written summary of the webinar is also available on this website.
Professor Jason Leitch and Dr Dominique Allwood talk about the UK's national response to COVID-19. Key points include system thinking, pace of change in response to the pandemic, how we maintain quality systems and new and agile ways of thinking: https://isqua.org/resources-blog/blog/covid19-expert-q-a-with-prof-jason-leitch-and-dr-dominique-allwood.html
A quality improvement project from Australia which could be adapted for the New Zealand setting. The aim of the project described here is to determine the demographic and clinical predictors of being COVID‐19 positive and requiring intensive respiratory support among patients who present to the emergency department with acute symptoms and/or signs consistent with potential COVID‐19 and undergo testing: https://onlinelibrary.wiley.com/doi/10.1111/1742-6723.13513
This article sets out the principles of quality improvement and patient safety science, applying them in a selection of approaches, methods and tools, which may be useful in crisis situations such as the COVID-19 pandemic. The article makes reference to several resources which may be of use to those keen to advance their knowledge: https://academic.oup.com/intqhc/article/33/1/mzaa051/5836318?login=false
The article outlines how the East London NHS Trust had to rapidly adapt quality skill training using virtual technology; they hosted 'pocket QI' adapting the content and delivery for a virtual event: https://qi.elft.nhs.uk/webinar-pocket-qi/
A story from East London NHS Foundation Trust highlighting how a quality improvement approach supported a key service during COVID-19: https://qi.elft.nhs.uk/quality-improvement-during-covid-19-understanding-your-system-the-clozapine-clinics-story/
A good illustration of the psychology of change framework which, in this example, transformed all guided self-help therapy services from face-to-face to virtual sessions: https://qi.elft.nhs.uk/unleashing-the-power-of-people-in-iapt-to-advance-covid19-improvement/
Dr Michal Boyd talks about her experience in having to change the way that resident assessments are carried out in a COVID-19 environment. This has required a move from on site and face to face assessments of residents to virtual assessments, and has seen upskilling of the care team, in particular nurses, which she speaks very positively about. You can also watch this video on YouTube.
The purpose of this document is to provide health and social care teams with much-needed advice and guidance on the human-centred design of work procedures such as written instructions, checklists or flow charts during this period of 'crisis management' in response to COVID-19 and to support the design and re-design of care services and new ways of working: https://chfg.org/guidance-to-help-design-effective-and-usable-work-procedures-for-health-and-social-care-teams/
Quality improvement essentials toolkit (IHI: Institute for Healthcare Improvement) (2021)
IHI’s quality improvement essentials toolkit includes the tools and templates you need to launch a successful quality improvement project and manage performance improvement: http://www.ihi.org/resources/Pages/Tools/Quality-Improvement-Essentials-Toolkit.aspx
Blog: Shewhart works on coronavirus (Associates in Process Improvement) (2020)
A quality improvement chart developed by Lloyd Provost has been applied to new cases of COVID-19 by one of our country’s improvement advisors. Discussed with Lloyd, it demonstrates the value of identifying sustainable improvement through statistical charts. See the excel template with instructions on how to use this chart (209KB, xlsx) and the charted Ministry of Health data.
Co-production and co-creation in Bedfordshire (East London Foundation Trust) (2020)
The driver diagram was built in partnership with staff across Bedfordshire Community Health Services to reflect what matters to the staff involved in the COVID-19 response: https://qi.elft.nhs.uk/co-production-and-co-creation-in-bedfordshire/?dm_i=1TXQ,6SY2C,WQ27HU,R8H8I,1
COVID-19: Patient safety and quality improvement skills to deploy during the surge (International Journal for Quality in Health Care) (2020)
The article identifies a five-step strategy and actions through which patient safety and quality improvement staff can support organisations during the COVID-19 pandemic: https://academic.oup.com/intqhc/article/33/1/mzaa050/5836316?login=false
‘COVID-19: Safety-II in action’ – with Suzette Woodward, Simon Gill and Paul Stretton (Q) (2020)
This webinar from the UK provides opportunities to learn from adaptions made during COVID-19 and to look at future models of care. A written summary of the webinar is also available on this website.
Expert Q&A with Prof Jason Leitch and Dr Dominique Allwood (ISQua) (2020)
Professor Jason Leitch and Dr Dominique Allwood talk about the UK's national response to COVID-19. Key points include system thinking, pace of change in response to the pandemic, how we maintain quality systems and new and agile ways of thinking: https://isqua.org/resources-blog/blog/covid19-expert-q-a-with-prof-jason-leitch-and-dr-dominique-allwood.html
Informing Emergency Care for COVID-19 patients: The COVID-19 Emergency Department Quality Improvement Project Protocol (Emergency Medicine Australia) (2020)
A quality improvement project from Australia which could be adapted for the New Zealand setting. The aim of the project described here is to determine the demographic and clinical predictors of being COVID‐19 positive and requiring intensive respiratory support among patients who present to the emergency department with acute symptoms and/or signs consistent with potential COVID‐19 and undergo testing: https://onlinelibrary.wiley.com/doi/10.1111/1742-6723.13513
Quality and safety in the time of Coronavirus: design better, learn faster (International Society for Quality in Health Care) (2020)
This article sets out the principles of quality improvement and patient safety science, applying them in a selection of approaches, methods and tools, which may be useful in crisis situations such as the COVID-19 pandemic. The article makes reference to several resources which may be of use to those keen to advance their knowledge: https://academic.oup.com/intqhc/article/33/1/mzaa051/5836318?login=false
Quality improvement department ‘tests’ virtual pocket training (East London NHS Trust) (2020)
The article outlines how the East London NHS Trust had to rapidly adapt quality skill training using virtual technology; they hosted 'pocket QI' adapting the content and delivery for a virtual event: https://qi.elft.nhs.uk/webinar-pocket-qi/
Quality improvement during COVID 19: Understanding your system – the Clozapine Clinics story (East London Foundation Trust) (2020)
A story from East London NHS Foundation Trust highlighting how a quality improvement approach supported a key service during COVID-19: https://qi.elft.nhs.uk/quality-improvement-during-covid-19-understanding-your-system-the-clozapine-clinics-story/
Unleashing the power of people in IAPT to advance COVID-19 improvement (East London Foundation Trust) (2020)
A good illustration of the psychology of change framework which, in this example, transformed all guided self-help therapy services from face-to-face to virtual sessions: https://qi.elft.nhs.uk/unleashing-the-power-of-people-in-iapt-to-advance-covid19-improvement/
Virtual assessment of residents in aged residential care facilities (Dr Michal Boyd) (2020)
Dr Michal Boyd talks about her experience in having to change the way that resident assessments are carried out in a COVID-19 environment. This has required a move from on site and face to face assessments of residents to virtual assessments, and has seen upskilling of the care team, in particular nurses, which she speaks very positively about. You can also watch this video on YouTube.
Guidance to help design effective and usable work procedures for health and social care teams (Chartered Institute of Ergonomics and Human Factors)
The purpose of this document is to provide health and social care teams with much-needed advice and guidance on the human-centred design of work procedures such as written instructions, checklists or flow charts during this period of 'crisis management' in response to COVID-19 and to support the design and re-design of care services and new ways of working: https://chfg.org/guidance-to-help-design-effective-and-usable-work-procedures-for-health-and-social-care-teams/