Patient safety and good care is reliant upon continuous quality improvement.
Key requirements for quality improvement:
- The improvement is informed by data, so the impact of changes can be measured. Data can be drawn from a variety of sources, including feedback from patients, team members in the practice, and clinical data analysis.
- All members of the team are involved on a routine basis.
The Quadruple Aim is a term to describe four domains to consider when improving something:
- Patients' experience of care
- Clinicians' experience of work
- Improved health outcomes for patients
- Sustainable cost
If you're struggling to decide what to do, narrow your options down to those that fit within all four of these dimensions, because anything that fits in all four is more likely to get everyone engaged and motivated.
A model for quality improvement is available and comprises three essential questions as well as an overview of Plan, Do, Study, Action (PDSA) cycles to help structure your approach.
Find a SEMPHN PDSA template.
What to measure: outputs vs outcomes
You can measure outputs (e.g. the number of Type 2 Diabetes patients who have had a recent HbA1C).
Or you can measure outcomes (e.g. more Type 2 Diabetes patients who are controlled, which could be measured by counting, over time, those with a recent HbA1C in target range).
Measuring outcomes is the recommended choice. It's more meaningful to everyone, and it's more important because it's measuring what you're trying to achieve.
Here is an example of some outcome measures you might want to track:
- % patients with Type 2 Diabetes who are controlled (HbA1c < n)
- % patients with IHD/CHD who are on anti-platelets
- % [at-risk patient cohort] who have had a flu vaccine
- trend in eGFR of patients with CKD (i.e. how many maintained renal function)
Tracking measures and data analysis
Once you've picked an important outcome measure, how do you track it?
Practice Incentive Payment Quality Improvement (PIP QI)
The Practice Incentive Payment Quality Improvement (or PIP QI) is for general practices that participate in quality improvement activities to improve patient outcomes and deliver best practice care.
There are two requirements that practices must comply with in order to receive payment:
- Participate in continuous quality improvement each quarter (such as PDSA activities), in partnership with their local PHN. The measure for the activity must be from clinical data.
- Submit the PIP Eligible Data Set on a quarterly basis to their local PHN.
More information and the Guidelines for PIP QI are on the
Department of Health webpage for PIP QI Incentive guidance.
Workforce Incentive Program Practice Stream (WIP PS)
The Workforce Incentive Program (WIP) Practice Stream provides financial incentives to help general practices with the cost of engaging nurses, midwives, allied health professionals, and/or Aboriginal and Torres Strait Islander health workers and practitioners.
The incentive payable is based on the practice Standardised Whole Patient Equivalent (SWPE), health professional types and average hours worked.
Learn more about the WIP Practice Stream and how to apply by reviewing our fact sheet.
