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The Monash Health Strategy, Transformation & Major Projects Unit offers a number of tools, templates, and training to support quality improvement projects. Login with your Monash Health username and password when prompted.

Monash Health templates & tools

Safer Care Victoria's (SCV) Quality Improvement Toolkit includes fact sheets, templates, and other practical tools to plan and carry out your project.

SCV also facilitates access to QI training delivered via the Institute for Healthcare Improvement. Visit the Education & Training page of this guide for more information. 

SCV Quality Improvement Toolkit

The Institute for Healthcare Improvement (IHI) offers additional tools, including tools for patient safety and improving maternal outcomes. 

IHI Quality Improvement Essentials Toolkit

The NSW Health Clinical Excellence Commission (CEC) offers a number of free tools and templates via its website, including:

CEC Quality Improvement Tools

The CEC also has a clear and succinct step-by-step guide available as a PDF.

Improvement Science: Step-by-Step Guide

Is it quality improvement (QI), research, or something else?

Before planning a QI project, take a moment to confirm that your initial ideas align with the QI process.

See also the tab on Monash Health procedures, as some QI projects must be registered with the Research office.


The figure below by Backhouse (2020) explains the differences and similarities between QI, original research, clinical audit, and related projects.

Image: Backhouse, A. (2020). Quality improvement into practice. BMJ, 368. https://doi.org/10.1136/bmj.m865
Click the image to view it full-size. 

Additional resources

What's the difference between research and QI? (2 mins)

In this video from the IHI Open School, Dr James Moses -- Medical Director of Quality Improvement at Boston Medical Center -- discusses the difference between a research project and a quality improvement project.

Developing aim statements

What are you trying to accomplish? The aims of your project should be specific, measurable, achievable, relevant, and time-based (SMART goals). The Quality & Safety Unit's Improvement Workbook includes a worksheet to assist you in developing your aim statement. Below are examples from the IHI. 

Overarching aim    Example aim statement
Patient safety    

Achieve > 95 percent compliance with on-time prophylactic antibiotic administration within 1 year.
Clinic access

Reduce waiting time to see a urologist by 50 percent within 9 months.
Flow

Transfer every patient from the inpatient facility to a long-term care facility within 24 hours after the patient is deemed ready to transfer.
Critical care

Reduce incidence of ventilator-associated pneumonia by 25 percent.

Adapted from: IHI. (n.d.). Science of improvement: Setting aims. https://www.ihi.org/resources/Pages/HowtoImprove/ScienceofImprovementSettingAims.aspx

A good first step to any improvement project (4 mins)

If you are visiting this guide, chances are that you already have an improvement idea in mind. If not, Dr Don Goldmann, Chief Medical and Scientific Officer at the IHI, explains a good first step -- looking at "what ticks you off".

Additional resources

Developing a measurement strategy

"Measurement is a critical part of testing and implementing changes; measures tell a team whether the changes they are making actually lead to improvement." (Institute for Healthcare Improvement, n.d.)


A successful measurement strategy combines multiple measures from each of these categories:

  • Process measures -- Linked to the factors that your project changes to achieve the aim
  • Outcome measures -- Directly linked to the aim of the project
  • Balancing measures -- To watch for unintended consequences

Recommended resources

How do I measure my improvements work? (7 mins)

This video from the Institute for Healthcare Improvement (IHI) uses clinical examples to explain outcome measures, process measures, and balancing measures. See also the two IHI resources under Recommended resources above.

Mike Davidge on measurement for improvement (10 mins)

Mike Davidge, Head of Measurement at the NHS Institute for Innovation and Improvement, explains the seven steps to measurement for improvement.

Evaluating QI projects

While a measurement strategy focuses on monitoring specific indicators to track change and progress over time, evaluation seeks to assess the success of the overall project. Evaluating your QI project includes determining whether it led to improvements -- and if those improvements were sustained -- as well as understanding what worked, what didn't, and why. 

Planning evaluation

"Consider the following four questions to help you decide on the type of evaluation you need:
• will it assess the impact or outcome against stated goals, or will it identify impact through intended and unintended effects?
• will it assess whether outcomes are directly due to the improvement work, or will it explore how the outcomes are produced in your particular setting?
• will it judge success against a single stakeholder's aims, or judge success against the stated aims of a wide range of stakeholders?
• will it judge whether an improvement works, or will it gather information to inform improvement development and quality improvement?"
(NHS Institute for Innovation and Improvement, 2005, p. 13)


The NHS Institute for Innovation and Improvement (2005, pp. 13-15) also identifies 5 key areas which should be considered when designing an evaluation plan:

  1. Summative or formative evaluation -- i.e. did the project meet its objectives? vs. why did the project produce the results that it did?
  2. Outcome or process evaluations -- i.e. understanding the impact or the internal operations.
  3. Quantitative or qualitative data -- each have their strengths and often a mix is used.
  4. Unitary approach or pluralistic approach -- i.e. considering the project from a single perspective or multiple perspectives.
  5. Experimental approach or naturalistic approach -- i.e. using controls vs. naturally occurring activities and outcomes.

See the Recommended resources below for more information on how to plan an evaluation of your QI initiative.

Recommended resources

Evaluation for QI 

These three short clips, produced by Health Innovation West of England, provide an overview of evaluating QI projects.

What is evaluation and why is evaluation important for quality improvement? (2 mins 57 secs)

What should I consider when planning an evaluation? (4 mins 8 secs)

Evaluation tools and approaches (3 mins 38 secs)

You may need to submit a Quality Assurance Application to register your QI project with Research Support Services (RSS) at Monash Health. The RSS team then determines whether or not your project is exempt from Human Research Ethics review. 

For more information, visit the links below.

Quality Assurance and Negligible Risk Projects

Prompt - Quality Assurance/Negligible Risk Research Policy & Procedure

The RSS team also provides recordings of their Ethics and Governance Seminar Series. Session 1 of the series discusses Quality Assurance/QI projects.

Ethics and Governance Seminar Series

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