Quality Improvement Tools Process Improvement Tools (PIT) / Rapid improvement tools (RITs)

A Quick Introduction to Quality Improvement The use of tools on a regular basis forms part of the Quality Improvement Methodology, which considers; Systems – ensuring the environment and the processes within it are conducive to preventing errors and promoting safety in practice; Reliability – ensuring whatever is meant to happen, happens the right way every time. Testing change – all improvement will require change but not all change results in improvement therefore changes to a system or process must be tested using PDSA cycles (Plan, Do Study Act) Measurement – The Tools enable the application of effective Infection Prevention systems and processes to be measured. (Further information is available on the ’What is Quality Improvement Methodology' page).  Both Process Improvement Tools (PITs)  and Rapid Improvement Tools (RITs) are available for clinical practice and care settings. 1. Clinical Practice Improvement Tools measure specific clinical practices.  They can be used in any care setting where clinical practice is performed - for example, the ‘Asepsis’ clinical practice tool may be used in all care settings. 2. Care Setting Improvement Tools are specific to care settings such as Endoscopy, theatres, acute in-patient facilities and care homes.  Each Quality Improvement Tool can be printed out for use as a paper copy to record the outcomes in the practice Process Improvement Tools (PIT) These are tools designed for detailed measurement of all aspects of practice/environment. (E.g. ward, outpatient dept, operating theatre etc) or a specific clinical practice (e.g. hand hygiene, insertion and care of peripheral vascular devices etc). The tools can be used to measure baseline compliance with standards and identify areas for improvement work.  Guidance is provided against the criteria in each standard to ensure objective assessment.  They will identify the extent of overall compliance with evidence based criteria required to prevent/reduce the risk of infection.  The tools are very comprehensive and will give a good overall indication of how well the areas are doing and should not need repeating frequently. In care settings where there is a specialist Infection Prevention and Control Team, these tools may be used by the team but the guidance allows use by others without specialist knowledge, e.g. matrons, ward managers, home managers and link practitioners.  The tools are very detailed and therefore simultaneous use is not advised. Once a base line assessment has been made using a PIT, the PIT may be used infrequently, for instance bi-annually, frequency of use is for local determination.   The person using the improvement tools should provide verbal feedback immediately. Then: Plans should be made to achieve the improvement required, Realistic time frames should be set to achieve the improvement Regular assessment should be made to determine whether improvement work is successful, this could be done by using the Rapid Improvement Tools (RIT). Rapid Improvement Tools                                                                       Rapid improvement tools (RITs) cover clinical areas (e.g. ward, outpatient dept, operating theatre etc) and clinical practices (e.g. hand hygiene, insertion and care of peripheral vascular devices etc). These tools are shorter and intended to be used on a frequent basis. They are an effective means of identifying infection risks and areas for improvement and to assess whether planned changes have been implemented successfully to achieve improvement. Guidance is provided against the criteria in each standard to ensure objective assessment.  They will identify the extent of overall compliance with evidence based criteria required to prevent/reduce the risk of infection. In care settings where there is a specialist Infection Prevention and Control Team, these tools may be used by the team but the guidance allows use by others without specialist knowledge, e.g. matrons, ward managers, home managers and link practitioners.  The tools are very detailed and therefore simultaneous use is not advised. The person using the improvement tools should provide verbal feedback immediately. Then: Plans should be made to achieve the improvement required, Realistic time frames should be set to achieve the improvement Regular assessment should be made to determine whether improvement work is successful. Such improvement work may be undertaken using quality improvement tools and techniques such as the PDSA cycle (see methodology menu item).  It is recommended that if practice is persistently poor as measured by the RIT, despite improvement efforts, that a more detailed assessment using the PIT is undertaken.