Important Quality Collaborative Components

Project RedDE! Quality Improvement Basics

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Assembling your Team

Quality improvement work varies greatly across systems and diagnostic errors.  It is important to assemble a diverse team from your practice to help carry out the improvement work.  In order to reduce diagnostic errors, we suggest that your team be comprised of:

  • Primary Care Physician* 

  • Nurse* 

  • Front Office Staff* 

  • An additional clinical staff person 

  • Staff member with understanding about your IT or electronic health record (EHR) system to help with data reporting and collection 

  • Patient or family member 

*You will need a champion to carry out this project. This person could be a primary care physician, nurse or front office staff. This person will be responsible for leading your practice improvement activities. It may also be important to identify resources within your community such as mental health specialists, cardiologists, nephrologists and other sub-specialists. 

The Model for Improvement (MFI) promotes the use of small tests of change to accelerate improvement and involves the three fundamental questions: 

  • What are we trying to accomplish? 

  • How will we know that a change is an improvement? 

  • What change can we make that will result in improvement?

Quality measurement is an essential piece of the MFI because it helps answer the question as to how a team knows that the changes have resulted in an improvement. Project RedDE! employed a combination of process and outcome measures which were measured monthly. Data was aggregated across practice teams to show improvement. Practice teams had access to a physician quality improvement coach who connected with them monthly to discuss successes, challenges, and review monthly data. Please click here to access the project measures across the adolescent depression, pediatric elevated blood pressure, and actionable laboratory results diagnostic errors.

Quality Improvement Toolbox - Mini RCA

Since Project RedDE! focused on diagnostic errors, the mini Root Cause Analysis (RCA) offered a method to allow practice to get the “root cause” of a problem.  Using this standard Mini RCA Form, RedDE! practices were able to: 

  1. Identify what caused them to have a diagnostic error 

  2. Understand the root causes of that problem 

  3. Conduct Immediate Action to implement temporary countermeasures in place of the problem 

  4. Think though corrective action to mitigate or eliminate the root cause 

  5. Generate accountability for putting solutions in place 

Through the collaborative, practices were able to share root cause sources, corrective actions and long- term solutions. 

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