Initiating QI Program Activities

The activities that take place in the months leading to implementing program activities will prepare quality improvement (QI) project teams to begin testing interventions using Plan-Do-Study-Act (PDSA) Cycles, submitting monthly electronic health record (EHR) data extracts, and testing tools and resources.

Toolkit Resource 1 provides a detailed view of how to successfully launch a QI project from creating the Aim to developing the team, clarifying the goal, identifying measures, understanding the current process, determining the intervention, and launching PDSA cycles.

We recommend the following additional activities to get your practice started:

• Form a core QI team. Prior to starting project activities, gain leadership buy-in! Organizational support is critical to implementing an effective and sustainable quality improvement effort. Teams should be comprised of two practice champions, when possible (a key staff and a key provider champion), key institutional leaders, and supporting interdisciplinary team members such as a medical assistants, nurses, pharmacists, or community health workers. Smaller workgroups may be necessary to address specific Key Drivers, if working on more than one Key Driver at a time (See Key Driver Diagram).

• Extract EHR data. Your practice should establish a method for extracting and viewing EHR data elements in conjunction with the Project Leadership Team. The EHR data will be used to create run and control charts to inform your practice of progress on achieving SMART Aims over time.
  • Data Measures are listed in selected areas of the Key Driver sections where we will have data on our QI dashboard or as examples to share and discuss with your practice teams.
• Begin to examine how your practice currently assesses and addresses diabetes control overall and for key subgroups. In particular, begin to examine how your practice ensures patients have A1C tests done and follow-up visits are scheduled monthly until blood sugar is controlled using high level process maps with your assigned QI coaches. Set a disparities focused aim and begin to conduct PDSAs in areas with disparities.

• Review the treatment algorithm and standardized follow-up visit template and consider adapting for your practice to begin using as you work on timely follow-up.