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A method in a QI project is a structured approach used to identify problems, test changes, and measure improvements in healthcare. 

Why is it important?

Choosing an appropriate method for your project:

  • Help teams systematically identify problems, plan interventions, and measure outcomes.
  • Ensures changes are based on real data rather than assumptions.
  • Keeps all team members aligned and working towards common goals.
  • Encourage ongoing evaluation and refinement of interventions.
  • Improves the likelihood that changes will be sustained over time.

How to choose a method

  • For small, rapid tests: use PDSA Cycles.
  • For goal-driven improvement: use the Model for Improvement.
  • For process efficiency: use Lean Thinking.
  • For reducing errors and variation: use Six Sigma.
  • For investigating patient safety issues: use Human Factors.
Example
If a hospital wants to reduce patient wait times, they might use Lean Thinking to identify inefficiencies in patient flow. If they want to reduce medication errors, they might use Six Sigma to standardise prescribing practices.

Recommended resources:

Monash Health templates & tools

The Plan-Do-Study-Act (PDSA) cycle is a four-phase process used to test and implement changes in healthcare quality improvement projects.

Why is it important?

PDSA cycles can:

  • Help teams quickly evaluate small-scale changes before implementing them broadly
  • Ensure more effective and efficient improvements.

How to use PDSA Cycles

  1. Plan: Identify the change to be tested, establish objectives, and decide how to measure success.
  2. Do: Implement the change on a small scale, gathering data and observations.
  3. Study: Analyse the results to determine whether the change led to improvement.
  4. Act: Based on the analysis, refine the change, standardise it if successful, or plan further tests if needed.
Examples
Jaekel, C., et al. (2023). Use of PDSA Cycles to Increase Aspiration Risk and Swallow Screening Documentation in the Hospitalized General Medical Patient Care Population. Journal of nursing care quality, 38(1), 89–95. 
Williams, B., et al. (2023). Using PDSA cycles to improve oral care compliance. American journal of infection control, 51(1), 110–113. 

Recommended resources:

IHI Open School. (2012). The PDSA Cycle.

The Model for Improvement (MFI) is a widely used framework in QI. Developed by the Institute for Healthcare Improvement, it provides a structured approach for achieving measurable and sustainable improvements in patient care and healthcare processes.

Why is it important?

The Model for Improvement is:

  • Simple and adaptable
  • Data-driven
  • Encourages small scale testing
  • Promotes continuous learning

How to use the Model for Improvement

  1. Answer 3 key questions
    1. What are we trying to accomplish?
    2. How will we know that a change is an improvement?
    3. What changes can we make that will result in improvement?
  2. Use PDSA Cycles once your 3 questions have been answered.
Example
Nates, L.K.C., et al. (2020). Quality improvement model (IHI) as a strategy to implement a sepsis protocol in a public hospital in Brazil. BMJ open quality, 9(1), e000354. 

Recommended resources:

Lean Thinking is a systematic approach to improving processes by eliminating waste, increasing efficiency, and enhancing value for patients

Why is it important?

Lean Thinking can:

  • Reduce patient waiting times
  • Improve patient safety
  • Enhance staff efficiency
  • Save cost without compromising care

How to use Lean Thinking

  1. Identify value: focus on the patient
  2. Map the value stream: understand the process
  3. Identify and eliminate waste
  4. Create flow: make the process efficient
  5. Establish a pull system: provide services just in time
  6. Engage in continuous improvement
  7. Measure and sustain improvements
Example
Alzahrani, Z. (2021). Lean thinking: using 6S and visual management for efficient adverse event closure. BMJ open quality, 10(1), e001197. 

Recommended resources:

Six Sigma is a quality improvement methodology focused on reducing defects and minimising process variability. It employs statistical tools and analysis to identify and address root causes of variation.

Why is it important?

Six Sigma can: 

  • Reduce errors an improve patient safety
  • Enhance efficiency and reduce waste
  • Use data to inform decision making.

How to use Six Sigma

Six Sigma uses the DMAIC Process.

  1. Define
  2. Measure
  3. Analyse
  4. Improve
  5. Control

DMAIC Process

Image source: https://www.sixsigmaonline.org/six-sigma-decision-making/

Example
Inal, T. C., et al. (2018). Lean six sigma methodologies improve clinical laboratory efficiency and reduce turnaround times. Journal of clinical laboratory analysis, 32(1), e22180. 

Recommended resources:

Human Factors involves analysing tasks, the people performing them, and their physical and socio-cultural environments to improve workplace systems.

Why is it important?

In healthcare, human factors principles enhance quality improvement by:

  • Analysing errors, near misses, and adverse events to identify root causes.
  • Designing preventive interventions and optimizing work environments, processes, and equipment.
  • Preventing medical errors proactively.
  • Enhancing efficiency, timeliness, accuracy, and reducing stress in healthcare workflows.
  • Supporting best practices and managing change during quality improvement (QI) initiatives.

How to use Human Factors

  1. Understand human factors in healthcare
    1. Human factors can include the "Dirty Dozen"
  2. Identify human factor issues in your QI project
  3. Design human-centred solutions
  4. Test and implement changes
  5. Sustain improvements by embedding human factors thinking

Recommended resources:

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