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NURS 7303 - Knowledge Translation I

Quality Improvement

This course requires students to lead a Quality Improvement (QI) project, QI:

  • Differs from other projects completed by clinicians and medical researchers in purpose and evidence.
  • Represents a systematic approach to understanding processes that leads to desired patient outcomes (i.e., the result of care).
  • Focus on improving processes and outcomes for a specific population once a problem is identified.

QI is not always evidence-based:

  • QI initiatives often focus on internal/local evidence and lack thorough review and synthesis of the overall (external) body of evidence. These are not evidence-based.
  • Evidence-based QI (EBQI) begins with internal evidence and includes external evidence in decision making about identifying the process changes that will impact the practice change to improve a clinical outcome.

Check out the additional tabs above to see how QI questions compare to research and clinical questions.

From Evidence-Based Practice in Nursing & Healthcare, Melnyk, B. M., & Fineout-Overholt, E. (2022).

 

Quality Improvement

Clinical

Research

Purpose

To identify and fix the processes leading to a problem that is internal to the clinical setting

To guide the systematic search for evidence to determine the best intervention to affect the outcome

To generate new knowledge / external
evidence

Evidence Type

Internal evidence

Best available evidence

 External evidence

Example

Why is hospital readmission rate in the population of patients who have had kidney transplants so high?

On our Press Ganey reports, why are our patient satisfaction scores not meeting benchmarks for our patients who have had kidney transplants?

In postoperative kidney transplant patients (P), how does a health coach (I) compared to no health coach (i.e., current practice) (C) affect hospital readmission rates (01) and patient satisfaction ( 02) within within days of discharge ( T)?
PICOT format required

What is the effect of a health coach on patients' satisfaction with hospitalization following kidney transplant?

What is the effect of health coaching on patients' readmission rates following kidney transplant?

 

Adapted from Evidence-Based Practice in Nursing & Healthcare, Melnyk, B. M., & Fineout-Overholt, E. (2022).

Similarities

Differences

Both:

  • Involve a systematic investigation that is carefully designed to achieve reliable and valid results.

  • Involve analysis of data.

  • May involve the implementation of a new intervention.

  • May result in a presentation or publication.

QI projects:

  • Are often flexible and incremental in design, employing strategies such as a plan-do-study-act cycle.

  • Use data analysis to find out whether or not the workforce is following best practices and professional guidelines.

  • Implement a new practice or process to improve (for example) workflow, patient safety, staff expertise, cost effectiveness, etc.

  • Often have been proven to be successful elsewhere and are widely accepted in the profession/discipline.

  • Evaluates the best strategies to implement these interventions locally.

  • Can help us characterize our population in order to better serve their needs or improve their care.

  • Aim to directly benefit existing patients by implementing immediate local improvements.

  • Do not increase risk to patients beyond the risks that are involved in care they are already receiving.

  • Are applicable primarily to the unique characteristics of our local setting.

  • Results are typically evaluated by an internal committee or executives who decide whether or not to permanently adopt the new practice.

From KU Medical Center Determination of Quality Improvement versus Research