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What is Quality Improvement?

Quality Improvement in healthcare is the process of continuously striving to improve services, processes and experiences within health services. It is a systematic and coordinated process that includes:

• the identification of problems;
• the systematic use of data, methods and tools to design and select solutions; and
• real-time measurement of baseline data and improvements.

It includes the combined efforts of everyone – health and care professionals, patients and carers, partners, advocacy groups and more – in making changes that will improve patient outcomes, system performance and effectiveness, as well as patient and workforce experience. 

The linked aims of improvement:  What is QI and how can it transform healthcare?

The process is a cycle and does not end. Quality Improvement, and indeed healthcare, cannot reach its full potential unless change-making becomes an intrinsic part of everyone’s job, every day; and unless those closest to the issues affecting care are given the time, permission and resources to speak up and share solutions to the challenges faced.

As The Health Foundation points out in QI Made Simple, “Done well, Quality Improvement can deliver sustained improvements not only in the quality, experience, productivity and outcomes of care, but also in the lives of the people working in healthcare.”

There are a range of different methods and tools in Quality Improvement, from Lean Six Sigma to The Institute for Healthcare Improvement (IHI)’s Model for Improvement, but as The King’s Fund states, “There is no clear evidence that one approach is superior to others. Rather, it is the process of having a systematic approach to Quality Improvement and applying this consistently that is important.”

As much as a set of tools and a methodology, Quality Improvement can also be thought of as a mindset. In addition to technical skills, there are behavioural ones whereby stakeholders (health and care professionals and patients alike) resist the inertia and safety net of thinking, “that’s the way we’ve always done things,” and are humble and curious to look for opportunities to learn and improve. The IHI talks more about this here.

Why Quality Improvement matters now

In today’s healthcare landscape, Quality Improvement matters more than ever. Increasing patient demands, workforce challenges and financial pressures are driving the need for innovation and efficiency. Quality Improvement offers a framework to continuously improve.

Extending beyond traditional problem-solving, Quality Improvement in healthcare is important for solving complex problems where an immediate solution is not known and where the nature of the problem is not fully understood. A focus on Quality Improvement in health and care has many benefits. It can:

• improve patient safety, care delivery and patient outcomes;
• enhance patient experience;
• enhance staff engagement, giving them a sense of ownership and collaboration;
• improve systems and processes, reducing inefficiencies and waste to make best use of resources (across time, finance, assets and equipment, and people);
• reduce errors;
• better prepare a team or organisation to handle large-scale emergencies or events, as illustrated during the COVID-19 pandemic;
• provide a systematic and scalable way of tackling the challenges (both large and small) faced by a team, department, or organisation;
• ensure data is used to both uncover problems and effect solutions;
• build participatory change, by using the expertise and contributions of those closest to the issues – service providers and service users – to identify issues and solutions; and
• release the creativity and innovation necessary to tackle complex issues which may have remained unsolved for many years.  

All methodologies for Quality Improvement in health and care share a systematic approach that is both inclusive and scalable. But Quality Improvement is more than a set of tools and a methodology: it is a mindset that feeds organisational culture.

What you’ll learn in this guide

This comprehensive guide explores the critical elements of Quality Improvement and provides actionable insights for healthcare professionals. Whether you’re new to Quality Improvement or looking to enhance your existing initiatives, you’ll find valuable resources, tools and strategies.

Here’s what we’ll cover:

1. Quality Improvement Tools to structure your projects;
2. Real-world Examples of Quality Improvement Initiatives in healthcare;
3. Techniques and examples for Scaling and Sustaining Quality Improvement Efforts across organisations;
4. Strategies for Engaging Teams to drive impactful change; and
5. How platforms like ImproveWell can simplify and amplify your Quality Improvement efforts.

If you’re looking for an all-in-one solution to engage your teams in continuous improvement, discover how ImproveWell can help.

👉 Book a demo today and take the first step towards transforming your Quality Improvement efforts

Key components of Quality Improvement in healthcare

Effective Quality Improvement in healthcare relies on several core components that help organisations identify areas for improvement, implement changes and measure success. By following these steps, healthcare professionals can create a structured approach to achieving better outcomes for patients and staff alike.

But first, let’s consider what quality in healthcare is.

How do we define quality?

In England, a single definition of quality for the NHS was first set out in High Quality Care for All in 2008, following the NHS Next Stage Review led by Lord Darzi. This definition sets out three dimensions to quality:

• clinical effectiveness: quality care is care which is delivered according to the best evidence as to what is clinically effective in improving an individual’s health outcomes;
• safety: quality care is care which is delivered so as to avoid all avoidable harm and risks to the individual’s safety; and
• patient experience: quality care is care which looks to give the individual as positive an experience of receiving and recovering from the care as possible, including being treated according to what that individual wants or needs, and with compassion, dignity and respect.

High-quality care requires all three dimensions to be present.

Definition of quality, Quality in the New Health System

The definition also states that those providing services should be:

• well-led: open (collaborating internally and externally) and committed to learning and improvement;
• sustainable: using resources sensibly and efficiently, providing fair access to all according to the needs of the population; and
• equitable: providing care that does not vary in quality because of a person’s characteristics.

In Crossing the Quality Chasm, the US Institute of Medicine defines six domains of healthcare quality – or six areas for healthcare to improve on:

• Safe: avoiding harm to patients, reducing the hazards and risk from the care itself;
• Effective: providing evidence-based care and refraining from providing services that are unlikely to be of benefit;
• Patient-centred: putting people in control of their own care and ensuring that care is responsive to individual patient preferences, needs and values;
• Timely: reducing waiting times for care and avoiding needless, harmful delays;
• Efficient: avoiding waste – from duplication to lost records, and even lost ideas; and
• Equitable: ensuring that care is of the same quality regardless of patient characteristics such as gender, ethnicity, location or socio-economic status.

Core components of Quality Improvement in healthcare

Understanding the problem

Before embarking on any Quality Improvement initiative, it’s crucial to fully understand the problem you’re trying to solve. Without a clear grasp of the underlying issues, your Quality Improvement efforts may not address the right factors or lead to lasting improvements.000

• Root cause analysis: start by conducting a root cause analysis to identify the root of the issue rather than just addressing symptoms;
• Data collection: collect quantitative and qualitative data to understand the scope, impact, and nuances of the problem; and
• Stakeholder involvement: engage relevant stakeholders, including frontline staff, patients and leadership to gather diverse perspectives on the problem.

Example: If patient wait times are a concern, first determine whether the delays are caused by staffing shortages, inefficient workflows, or other systemic factors before jumping to solutions.

Setting measurable goals

Every Quality Improvement initiative begins with a clear objective. Goals should be specific, measurable, achievable, relevant, and time-bound (SMART) to ensure progress can be tracked and evaluated.

For example:

• Clinical goal: reduce hospital-acquired infections by 25% within six months; and
• Operational goal: decrease patient wait times in the emergency department by 15% in the six months.

When teams align their efforts around well-defined goals, it becomes easier to identify priorities and maintain focus throughout the project.

Collecting and analysing data

Data is the foundation of every Quality Improvement initiative. By collecting accurate and timely data, teams can uncover trends, measure performance and evaluate the impact of their interventions. Common approaches to data collection include:

• Patient and staff feedback and surveys; and
• System-recorded metrics, such as bed capacity, length of stay etc.

Implementing change using proven methods

Implementing changes effectively requires structured methodologies to test and refine improvements before scaling them across an organisation. Some of the most widely used methods include:

• Plan-Do-Study-Act (PDSA) Cycles: Test small-scale changes, evaluate their effectiveness and refine the approach; and
• Lean Methodology: Focus on reducing waste and improving efficiency in workflows.
• Six Sigma: Use data-driven techniques to minimise errors and improve quality.

By adopting these structured approaches, healthcare teams can ensure that changes are evidence-based and impactful.

Monitoring progress and measuring impact

Continuous monitoring is essential for understanding the success of Quality Improvement efforts and identifying areas that require further adjustment. Metrics should align with the original goals and could include:

• Process metrics: how well is the intervention being implemented?
• Outcome metrics: what measurable benefits are being achieved (e.g. decreased patient wait times)?
• Balancing metrics: are there any unintended consequences of the changes (e.g. increased staff workload)?

Healthcare teams can use dashboards, reports and regular team reviews to stay informed and make data-driven decisions.

Related resources

Explore these detailed guides to build on these components:

• Quality Improvement Tools in Healthcare
• Examples of Quality Improvement in Healthcare

Ready to drive change in your organisation?

When Quality Improvement initiatives are executed with clear goals, robust data and proven methods, they can deliver transformative results. If your organisation is looking for a comprehensive solution to gather frontline feedback, discover ideas and solutions, and monitor change, ImproveWell is here to help.

👉 Book a demo and empower your team with the tools they need to drive continuous improvement.

Engaging teams in Quality Improvement initiatives

Involving teams effectively is one of the most critical factors for the success of Quality Improvement initiatives in healthcare. Frontline staff are uniquely positioned to identify inefficiencies and propose practical solutions, but without their buy-in, even the best-planned initiatives risk falling short. This section explores why team engagement matters and how organisations can empower their people to drive sustainable change.

Why engaging teams is critical for Quality Improvement success

1. Frontline staff have unique insights
   Frontline healthcare workers are closest to the day-to-day processes and patient interactions. Their firsthand experiences provide invaluable insights into areas for improvement and potential solutions.
2. Fostering ownership and accountability
   When staff are actively involved in Quality Improvement initiatives, they feel a greater sense of ownership and responsibility for the outcomes. This shared accountability creates a culture of collaboration and continuous improvement.
3. Sparking innovation
   Engaged teams are more likely to contribute innovative ideas and think creatively about problem-solving. This leads to solutions that are not only effective but also practical to implement.

Strategies for engaging teams in Quality Improvement initiatives

1. Build a collaborative culture

Encourage open communication and collaboration across all levels of the organisation. Teams need a safe space to share ideas, discuss challenges and provide feedback without fear of judgment.

💡 Example: Hold regular “improvement huddles” where staff can discuss ongoing Quality Improvement projects and propose new ideas.

2. Use feedback as a catalyst for change

Actively seek input from staff about what’s working and what’s not. Whether through surveys, suggestion boxes or digital platforms, creating formal channels for feedback ensures that all voices are heard.

💡 How ImproveWell can help: ImproveWell’s feedback tool enables frontline staff to share ideas and sentiment in real time, empowering them to foster continuous improvement.

3. Recognise and celebrate contributions

Acknowledging the contributions of staff can go a long way in maintaining motivation and engagement. Highlight successful projects, reward innovative ideas, and create opportunities for staff to take ownership of initiatives.

💡 Example: Feature a “Improvement spotlight” in newsletters or meetings to celebrate achievements and inspire others to get involved.

4. Provide training and resources

Equip teams with the knowledge and tools they need to participate effectively in Quality Improvement initiatives. Training in methodologies like Plan-Do-Study-Act (PDSA), data collection and root cause analysis helps build confidence and competence.

💡 Example: Conduct workshops or provide online resources on using Quality Improvement tools such as process maps and fishbone diagrams.

5. Involve multidisciplinary teams

Quality Improvement is most effective when it involves diverse perspectives. Including clinicians, administrators and support staff ensures that all aspects of a process are considered and improvements are holistic.

💡 Example: Create cross-functional Quality Improvement teams that include a mix of roles to address complex challenges like reducing patient waiting times or improving care transitions.

Overcoming common barriers to engagement

Despite its importance, engaging teams in Quality Improvement initiatives can be challenging. Here are a few common barriers and tips for overcoming them:

• Barrier: Lack of time or competing priorities

Solution: Incorporate Quality Improvement activities into existing workflows, such as discussing progress during shift handovers

• Barrier: Resistance to change
  Solution: Involve staff early in the planning process and clearly communicate the benefits of the proposed changes
• Barrier: Lack of understanding or confidence
  Solution: Provide targeted training and mentorship opportunities for staff new to Quality Improvement.

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Related Resources

Dive deeper into strategies for engaging teams and building a culture of improvement:

• Engaging Teams in Quality Improvement Initiatives
• Why involvement at all levels matters for NHS improvement

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Empower Your Teams with ImproveWell

Engaging teams is easy with the right tools. ImproveWell provides health and care organisations with a platform to:

• Collect feedback from frontline staff
• Gather ideas for improvement
• Monitor workforce sentiment
• Measure progress and change.

By empowering your people, you can drive meaningful and lasting improvements across your organisation.

👉 Book a demo today and see how ImproveWell can support your Quality Improvement initiatives.

Scaling and sustaining Quality Improvement efforts in healthcare

Implementing successful Quality Improvement initiatives is sometimes just the first step. The next challenge lies in scaling these improvements across an organisation and sustaining them over the long term. Without a structured approach, even the most effective projects can lose momentum. This section explores strategies to scale Quality Improvement efforts effectively and ensure their long-term success.

The importance of scaling and sustaining Quality Improvement

1. Maximising Impact: scaling ensures that improvements are implemented beyond the pilot phase, benefiting more patients, teams and processes.
2. Embedding change: sustaining Quality Improvement efforts ensures that changes become part of standard practice rather than one-off projects.
3. Building a culture of continuous improvement: organisations that sustain improvements demonstrate a commitment to innovation and quality, creating a ripple effect that inspires further initiatives.

Strategies for scaling Quality Improvement efforts

1. Start small, then expand

Begin by testing changes on a small scale to refine the intervention and gather evidence of its effectiveness. Once validated, gradually expand the initiative across other departments, sites or teams.

💡 Example: If a new protocol reduces emergency care waiting times in one location, adapt and roll it out to other sites, ensuring local context is considered.

2. Create standardised processes

To ensure consistency during scaling, document successful workflows, tools and practices. Clear guidelines help different teams replicate the improvement effort with minimal variation.

💡 Example: Develop toolkits, templates or checklists that teams can use to implement the initiative.

3. Invest in leadership support

Strong leadership is key to driving organisation-wide adoption. Leaders play a critical role in championing initiatives, allocating resources, and reinforcing the importance of sustained improvements.

💡 Tip: Establish a Quality Improvement steering committee to oversee scaling efforts and address challenges as they arise.

4. Leverage technology for scalability

Digital platforms and tools can streamline the scaling process by providing a centralised hub for data collection, reporting and communication.

💡 How ImproveWell can help: ImproveWell’s platform enables organisations to track the progress of Quality Improvement initiatives, share best practices and monitor outcomes across multiple teams and locations.

Strategies for sustaining Quality Improvement efforts

1. Embed Quality Improvement into everyday practice

For improvements to last, they must become part of routine operations. Integrate Quality Improvement activities into existing processes such as shift handovers, staff meetings or huddles.

💡 Example: Schedule regular check-ins to review progress on Quality Improvement initiatives and address emerging challenges.

2. Monitor and adjust regularly

Sustainable improvement requires ongoing measurement and the ability to adapt to changing circumstances. Continuously monitor key metrics and adjust strategies as needed to maintain improvements.

💡 Tip: Use dashboards to provide real-time visibility into performance and progress.

3. Maintain staff engagement

Keeping teams engaged is essential to sustaining improvements. Regularly seek feedback, recognise contributions and ensure staff understand how their efforts are making a difference.

💡 Example: Celebrate milestones and share success stories to keep morale high and reinforce the value of Quality Improvement efforts.

4. Plan for leadership transitions

Sustained improvement relies on strong leadership, but team changes can disrupt progress. Prepare for transitions by documenting knowledge and ensuring incoming leaders are equipped to continue driving Quality Improvement efforts.

💡 Tip: Develop a succession plan for key Quality Improvement leadership roles to preserve institutional knowledge.

Barriers to scaling and sustaining Quality Improvement efforts

Even with the best intentions, challenges can arise. Here are some common barriers and how to overcome them:

• Barrier: Lack of resources
  Solution: Identify scalable solutions that require minimal additional investment
• Barrier: Resistance to change
  Solution: Engage teams early, communicate benefits clearly, and involve them in the process
• Barrier: Loss of momentum
  Solution: Establish regular progress reviews and celebrate successes to keep energy high

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Related Resources

Learn more about scaling and sustaining your Quality Improvement  efforts:

• Scaling Quality Improvement in Healthcare
• Spread and Sustainability of QI in Healthcare

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Achieve sustainable Quality Improvement with ImproveWell

ImproveWell supports healthcare organisations in scaling and sustaining Quality Improvement efforts. With tools for tracking, collaboration and monitoring, we make it easy to implement and maintain meaningful change across teams and locations.

👉 Book a demo today to see how ImproveWell can help your organisation create a culture of continuous improvement.

How ImproveWell supports Quality Improvement

At ImproveWell, we understand the challenges healthcare organisations face in driving Quality Improvement. Our platform makes change simple: creating cultures of continuous improvement, empowering teams, and enabling organisations to achieve measurable results.

Key benefits of the ImproveWell solution

1. Gather real-time feedback

Encourage frontline staff to share insights, ideas, and perspectives in real time.

• Capture actionable suggestions directly from the people closest to care delivery – the staff;
• Track sentiment on a daily basis;
• Understand what matters to staff and key stakeholders and where improvements are needed with surveys; and
• Empower teams to drive change and take ownership of Quality Improvement efforts.

💡 Example: Use ImproveWell Pulse Surveys to gather feedback on reducing waste, invite staff to submit ideas for change. Discuss and refine ideas with staff within the platform, adopt new initiatives, measure change and close the feedback loop.

2. Monitor improvement initiatives from start to finish

Track the progress of improvement initiatives:

• Gather ideas from frontline staff, key stakeholders and expert patient groups;
• Refine and discuss together;
• Enable staff to encourage ideas with “likes”;
• Use AI-powered insights to enhance decision making;
• Prioritise high-impact initiatives to ensure resources are focused where they matter most;
• Share the status on projects and close the feedback loop with customisable reports; and
• Visualise shifts in staff feedback and sentiment through customisable dashboards.

💡 How It Helps: Organisations can quickly identify what’s working, adapt strategies, and celebrate successes.

3. Promote and build a culture of collaboration

Embed continuous improvement into the fabric of your organisation by making it easy and accessible for everyone to participate.

• Recognise and reward staff contributions to maintain engagement and morale;
• Foster collaboration and camaraderie with a shared repository of ideas;
• Access a wider community of improvers; and
• Provide leadership teams with real-time insights to drive strategic decisions.

💡 Example: Use ImproveWell’s reporting tools to showcase organisation-wide progress and highlight individual achievements.

Transforming improvement with ImproveWell

Whether you’re at the start of your Quality Improvement journey, or already using sophisticated methods, ImproveWell is your partner in bringing everyone on your improvement journey.

👉 Ready to take the next step? Book a demo to see how ImproveWell can transform Quality Improvement in your department or organisation.

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