Step 10 - What Next? + Final Thoughts

What Next?

Whether you saw improvement or not, there’s a few things you’ll want to consider doing:

– Handing over the project to someone else, who can continue where you left off without having to spend the time learning what you learned in the process.

– Make sure you have, in image format, a driver diagram with SMART aim, a run chart and documentation of your PDSA cycles. This makes putting together a presentation of your work easy. On that note, presenting your work to your colleagues should always happen. It is important in disseminating learning, as well as facilitating further constructive discussions about how to improve even more or identifying other areas to explore.

– Publishing your work. There are journals specifically tailored to QI work such as BMJ Open Quality or BMJ Quality & Safety. Note these will likely require you to complete the SQUIRE Guidelines for publishing QI reports.

– There are also many conferences targeted at QI work – locally, nationally and internationally. Regionally, the TIPS Showcase Evening in June each year exhibits junior doctor led QI work from the North West of England and we would strongly encourage you to consider submitting an abstract. For particularly impressive projects you may consider submitting an abstract to the ISQua International Conference or the IHI/BMJ International Forum on Quality and Safety in Healthcare.

Final Thoughts

We hope you have found this guide useful. The success of your project will very much depend on how well you apply the methods we have discussed. We realise they are very prescriptive but that is because, as proven internationally over the past 25 years, they work. If ever in doubt, return to the Model for Improvement and answer the questions in order.

It is probably worth speaking with your local QI department, as they will have knowledge of other ongoing projects and can ensure they don’t clash, or that work is not duplicated. They may also know of senior members of staff with QI experience, who may be able to give you useful assistance. Just be wary that the bread and butter of many QI departments is still the undertaking audit cycles, although this is slowly changing. Simply mention you are looking to base your project around the use of the Model for Improvement.

Finally there is lots of information out there if you would like to find out more about QI. At TIPSQI we want to present methods at a level that we believe can be effectively used by the vast majority of junior doctors, however there are further layers of depth to improving healthcare, if you are interested. If this is the case we would encourage you to explore the external resources in our More QI Resources page.

Political, economic and demographic pressures mean things will likely continue to get tougher for the NHS in the years ahead. However we can make the choice to commit to continuous improvement to make the our lives as professionals, and those of our patients, easier. We have found using the methods presented here to be the best way, and hope you do too.