Quality is a big word. It’s commonly used to signify excellence. Simply placing the connotation of quality in front of a product or service is easy. Anyone can make the statement, “we deliver quality patient care to the communities we serve.” It’s a word often taken for granted. We like to toss quality into our marketing flyers and communications to bolster our EMS programs. It’s a crowd pleaser and a feel-good statement. It’s what we all want….. but are we delivering quality? How do we know? Are there benchmarks? What’s the standard and how did we arrive at that standard? Does your organization measure operational or clinical quality? Do you have a culture that promotes quality improvement?

Starting a quality improvement project can be daunting, especially if you’ve never embarked on one. There are many misconceptions about what it takes to construct and execute a quality improvement project. Many feel that the time and cost required will not benefit the organization. Contrary to that belief, a well-constructed quality improvement project can benefit an organization in my areas. For example, improving ambulance operations can improve clinical care and increase revenue. While quality improvement projects can be met with opposition, the reality is, certain clinical and operational issues need oversight and continuous quality improvement. As an industry, keeping our eye on efficiencies and improvements can build excellence and have an impact on the patients we serve. Quality is an investment and if done thoughtfully, can accomplish many things for an organization including: producing revenue, increasing safety and compliance, creating efficiencies, and engaging and retaining talent.

Here are a few tips for getting a quality improvement project started within your own organization:

1. Confirm there is support for a QI project within your organization before investing time in developing a QI project proposal.

2. Find an organizational weakness to improve and pinpoint a metric you can focus on and measure.

3. Find your why. Why is this project important? How will this QI project better the organization and impact patient care delivery? If you know your why, the struggle will be worthwhile.

4. Present your QI project proposal to your team and stakeholders. Be sure to include: The why behind the initiative, how you will accomplish your goal, the timeline, budget projections, and expected deliverables.

5. Once approved, gather your baseline data.

6. Involve your personnel in the initiative. Share the project with staff and ask them for help in achieving the organizational goal. Involve your field training officers and supervisors as champions and consultants on the project.

7. Design and deliver training and education to personnel to address the organizational weakness. Deliver your expectation clearly and focus on accountability.

8. Design a one on one process to address individual weaknesses if needed. For example, Bob is consistently not utilizing capnography with his intubated patients. This can be addressed with Bob individually.

9. Remeasure your metrics in alignment with your timeline. Adjust your tactics according to your progress. Don’t be afraid to innovate and try new approaches.

10. Communicate your progress with personnel. Be transparent. Celebrate your victories no matter how small they are.

11. Depending on your project results and/or budget you can choose to continue or wrap up your project.

12. Never stop striving for improvement. Organizational changes take time.

Last, here are few tips for accomplishing an organizational quality improvement project with a less desirable budget:

1. Tap into free resources in your community. EMS sustainability grants and resources are available in most states.

2. Hire a quality improvement project manager part-time as a consultant.

3. Utilize a field supervisor by splitting their role and allocating a certain number of hours to QI project work for the organization.

4. Utilize operations, billing, and education by having them work through a project as a team.

5. Bring on a part-time employee as a project manager, cap the hours worked to eliminate over-time.

6. Offer staff a stipend for clinical chart review and quality improvement initiatives that involve repetitive data entry and/or review.

In closing, what’s more costly, not investing in a structured quality improvement program or managing a program with fiscal responsibility? The rewards of quality improvement are multifaceted and can result in better quality and savings long term. One way or another quality improvement will cost you.