Basics of Quality Improvement

Basics of Quality Improvement
AAFP TIPS™
Transform your practice with AAFP TIPS™, providing ready-to-use resources to help you make
small changes that yield big results.
MIPS: Explaining the Quality Performance Category
The Merit-based Incentive Payment System includes a category on quality performance. Read
more to learn about how to report and how the category is scored.
Quality improvement (QI) is a systematic, formal approach to the analysis of practice

performance and efforts to improve performance.
A variety of approaches—or QI models—exist to help you collect and analyze data and test
change. While it’s important to choose a reputable QI model to guide your efforts, it’s more
important that you fully commit to using the QI process and good QI practices.
Benefits of QI
Understanding and properly implementing QI is essential to a well-functioning practice, and is

necessary for any practice interested in improving efficiency, patient safety, or clinical outcomes.
In addition, good QI practices and improved patient outcomes position your practice for success
by:
 Helping you prepare for the transition to value-based payment models.

 Allowing you to participate in the public reporting of physician-quality data.
 Giving you the opportunity to participate in the federal Quality Payment Program (QPP)
following one of two tracks: the Merit-based Incentive Payment System (MIPS) or the
Alternative Payment Model (APM).
 Equipping you with the skills necessary to apply for and complete national recognition
programs, such as National Committee for Quality Assurance’s (NCQA) Diabetes,
Heart/Stroke, and patient-centered medical home (PCMH)-recognition programs.
 Helping you earn Family Medicine Certification-Performance Improvement activity
credit (formerly Maintenance of Certification) requirements.
AAFP Office Champions Projects
The AAFP’s Office Champions Project are an example of QI demonstration projects in which
participating family physician practices select staff and physician office champions to lead the
implementation of an intervention. Read the results:
 Child and Adult Immunization(794 KB PDF)

 Treating Tobacco Dependence Practice Manual
 Tobacco Cessation 2013(15 page PDF)
See Also
 FPM Journal: Editor's Choice of Best Available Content on Quality and Safety
 Continuing Medical Education (CME) Opportunities: Performance in Practice
 Patient-Centered Medical Home (PCMH)
Related Links
 Centers for Medicare & Medicaid Services (CMS) Quality Payment Program (QPP)
(qpp.cms.gov)
 Agency for Healthcare Research and Quality (AHRQ)(www.ahrq.gov)
 Institute for Healthcare Improvement (IHI)(www.ihi.org)
Quality Improvement Basics
The QI process is grounded in the following basic concepts:
 Establish a culture of quality in your practice. Your practice’s organization, processes,

and procedures should support and be integrated with your QI efforts. The culture of a
practice—attitudes, behaviors, and actions—reflect how passionately the practice team
embraces quality. The QI culture looks different for every practice, but may include
establishing dedicated QI teams, holding regular QI meetings, or creating policies around
your QI goals.
 Determine and prioritize potential areas for improvement. You will need to identify
and understand the ways in which your practice could improve. Examine your patient
population (e.g., to identify barriers to care, frequently diagnosed chronic conditions, or
groups of high-risk patients) and your practice operations (e.g., to identify management
issues such as low morale, long patient wait times, or poor communication). Use
established quality measures, such as those from the National Quality
Forum(www.qualityforum.org), Agency for Healthcare Research and
Quality(www.qualitymeasures.ahrq.gov), and the Quality Payment
Program(qpp.cms.gov) to guide your efforts.
 Collect and analyze data. Data collection and analysis lie at the heart of quality
improvement. Your data will help you understand how well your systems work, identify
potential areas for improvement, set measurable goals, and monitor the effectiveness of
change. It’s important to collect baseline data before you begin a QI project, commit to
regular data collection, carefully analyze your results throughout the project, and make
decisions based on your analysis.
 Communicate your results. Quality improvement efforts should be transparent to your
staff, physicians, and patients. Include the entire practice team and patients when
planning and implementating QI projects, and communicate your project needs,
priorities, actions, and results to everyone (patients included). When a project is
successful, celebrate and acknowledge that success.
 Commit to ongoing evaluation. Quality improvement is an ongoing process. A high-
functioning practice will strive to continually improve performance, revisit the
effectiveness of interventions, and regularly solicit patient and staff feedback.
 Spread your successes. Share lessons learned with others to support wide-scale, rapid
improvement that benefits all patients and the health care industry as a whole.
Quality Improvement Models and Tools
Quality improvement models present a systematic, formal framework for establishing QI

processes in your practice. Examples of common QI models include the following:
 Model for Improvement (Plan-Do-Study-Act [PDSA] cycles)(www.ihi.org): The Institute

for Healthcare Improvement’s Model for Improvement combines two popular QI models:
Total Quality Management (TQM) and Rapid-Cycle Improvement (RCI). The result is a
framework that uses PDSA cycles to test interventions on a small scale.
 Six Sigma(asq.org): Six Sigma is a method of improvement that strives to decrease
variation and defects.
 Lean(www.ihi.org) is an approach that drives out waste and improves efficiency in work
processes so that all work adds value.
Quality improvement tools are standalone strategies or processes that can help you better
understand, analyze, or communicate your QI efforts. Examples of QI tools(www.ihi.org)
include run charts, process maps, and fishbone diagrams (ihi.org(www.ihi.org)).

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Basics of Quality Improvement

MIPS: Explaining the Quality Performance Category

Quality improvement (QI) is a systematic, formal approach to the analysis of practice

Understanding and properly implementing QI is essential to a well-functioning practice, and is

 Helping you prepare for the transition to value-based payment models.

AAFP Office Champions Projects

 Child and Adult Immunization(794 KB PDF)

Quality Improvement Basics

The QI process is grounded in the following basic concepts:

 Establish a culture of quality in your practice. Your practice’s organization, processes,

Quality Improvement Models and Tools

Quality improvement models present a systematic, formal framework for establishing QI

 Model for Improvement (Plan-Do-Study-Act [PDSA] cycles)(www.ihi.org): The Institute

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