Improvement Teams
Healthcare Systems
Early Health Professional Training
Residency Programs
Board Certification & Re-Certification Programs
Particular Linguistic & Cultural Settings

To Introduce QI to Staff
As a QI Refresher
To Facilitate Cross Disciplinary Communication
To Support Specialty Association QI Training

Members of improvement teams can be asked to go through some or all of the six modules prior to the team's first meeting. In that way, team members can approach their work together with a similar understanding of some basic improvement science concepts and tools, an appreciation of key questions that need to be asked, common language, and an appreciation for some of the challenges they are likely to face. This approach makes it possible for new improvement teams to hit the ground running at their first meeting.

Instead of spending limited resources running live QI training programs, organizational energy and resources can be focused on other important tasks, such as providing improvement teams with experienced coaches to guide them in their work.

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It is possible to incorporate this resource into routine new staff orientation and/or job induction training. This could be combined with the request that all existing personnel also go through the six modules during a set period of time. Eventually, all staff will possess the core skill set necessary to participate meaningfully in improvement efforts, whether as members of improvement teams or by supporting the work of such teams.

Some organizations have asked personnel who have gone through the HISC modules to demonstrate what they have learned in a specific improvement effort, which they plan and undertake themselves, as a required piece of the new staff orientation/induction process or another established process.

A different sort of example comes from the Veterans Health Administration. VHA made the HISC improvement skills modules directly available through its Intranet to 2,000 personnel in the system with special responsibility for improving the quality of healthcare delivered by the VHA.

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Asking health professionals in training to go through a pair of these modules at the beginning of each of the first few clinical experiences in which they participate should make it possible for them to begin to assist with the improvement efforts they encounter along the way. Once they have completed all six HISC modules and have supported and written reports analyzing two or more improvement efforts, students should be in a position to make enhanced contributions to and take increased responsibility for subsequent improvement efforts throughout the rest of their training.

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All residency programs are now faced with the requirement to explicitly address the development of competence in practice-based learning and improvement and systems based practice in their curricula. The HISC modules can be incorporated into a residency program, from the outset, along with such things as routine improvement support group/journal club meetings and individualized coaching for residents involved in improvement efforts.

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Many board certification and maintenance of certification programs are requiring or planning to require demonstration of competence in practice-based learning and improvement, and systems-based practice. As a consequence, a growing number of professional associations and boards are looking for efficient, cost effective, practice focused ways to introduce the majority of their members and diplomates to this essential aspect of the contemporary healthcare scene.

Since most healthcare professionals in practice have not been introduced to the concepts and tools of improvement science to any great degree, the need for resources of this kind is now quite substantial. The HISC modules offer associations and boards a way to rapidly mount authoritative, engaging, easily accessible programs of their own.

• When charts have been pulled, data have been extracted and compared with national norms, and the results analyzed, the need and motivation to learn about improvement science can be particularly high.

  Options to consider:

  • A direct link to this site and its six engaging modules.
  • A direct link to a version of the six HISC modules which we have helped you adapt so as to emphasize and respond well to the special needs and high priority concerns of your particular healthcare constituency.
    • For example cases can relate to the sorts of problems that are of great interest and concern to a given group of health professionals.
    • Choice of practice settings is another variable to consider.
    • Choice of conditions to feature is yet another.
• When health care professionals are not currently responsible for the direct care of patients, other ways to learn how to apply improvement science are needed.
  • For example, the American Board of Internal Medicine (ABIM) worked with us to fashion the six HISC modules into a special option for those seeking to gain experience with the application of improvement science concepts and methods to their current circumstances (whether medical school or association professionals, researchers, or new parents), the Essentials of Quality Improvement.

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It would be highly desirable to make the content of these modules available to healthcare professionals in other linguistic and cultural settings. For example, a version of the six modules crafted for healthcare professionals throughout Latin America might be a helpful addition.

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To introduce the staff of your practice or clinic to improvement work, one strategy might be a six part, once a week, lunch time in-service program, where you and your colleagues discuss each of the six modules in turn. Ask your colleagues if they would be willing to go through a different module each week, on their own, prior to each session.

As a variation, instead of using each weekly session to discuss issues raised within or questions about this week's module, you could use the session to work on a small improvement project together, focusing on application of what was learned rather than talking about what was learned in the abstract. It is still possible to wrap up each session devoting a few minutes to outstanding questions.

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Many users of this site who have had prior training in and experience with healthcare improvement have indicated that they found running through these modules at a pretty fast clip to be an excellent refresher just prior to starting work with a new improvement team on a new improvement project, particularly if they haven't done any improvement work in many months or within the past year.

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The concepts, tools and skills or improvement science turn out to be fairly generic. That is, they can be successfully applied in a wide variety of settings and be used by healthcare professionals in almost any healthcare specialty or subspecialty. Used for interdisciplinary team problem solving the concepts, processes, language, tools and skills of healthcare improvement tend rather consistently to facilitate communication between professionals who work in different health professions and roles and who in other settings tend to find it rather difficult to collaborate.

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The HISC modules can be used in tandem with targeted health professional specialty association improvement programs, whether local, regional, or national. Here, as elsewhere, asking participants to spend individual time on line can do a lot to cut down the face time required and many other expenses associated with a given program.

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