About quality improvement
Quality improvement is a system of regularly reviewing and refining processes to improve them. It uses specific methods and tools to achieve a measurable improvement in care quality and outcomes.
Why it’s important
Quality improvement in residential aged care improves the delivery of safe and effective care for residents.
Quality improvement:
- improves care provided to residents
- encourages person-centred care that is responsive to residents’ needs and choices
- encourages aged care providers to be collaborative and committed to feedback, learning and improvement
- enhances systems to monitor and track change.
Community of practice case studies
A community of practice has been created to support providers to continuously improve the quality of care they deliver. See real examples of exemplar services who have successfully integrated quality improvement logic into their practice:
- Residency by Dillons Fremantle have worked on identifying and cultivating residents’ strengths and abilities, enabling them to lead independent and fulfilling lives.
- Cooinda Coonabarabran have worked on improving the food and dining experience of residents.
Plan, Do, Check, Act
‘Plan, Do, Check, Act’ is an approach to continuous improvement where changes are tested in small cycles that involve planning, doing, checking, and acting, before returning to planning, and so on.
Plan
Planning is an important first step in quality improvement:
- Gather information to understand the current situation and identify what is causing the quality issue. This includes reviewing data, feedback and incident information.
- Establish goals for your quality improvement activity. Goals should be measurable and have a set timeframe to be achieved.
- Make a plan for how the quality improvement activity will be done. This process should be collaborative and include different levels of staff, and residents, where possible. The plan should be detailed, define who is affected by the activity, and outline the tasks required and who is required to deliver them.
Do
Doing focuses on implementing and delivering the quality improvement activities you have planned:
- Allocate resources to deliver the quality improvement activity.
- Test the activity at a small scale and adjust as needed.
- Inform stakeholders.
- Document observations, including any decisions made while delivering the activity and if any changes are made to the plan.
- Collect data based on the measures agreed in the planning phase.
Check
Checking involves evaluating what you are doing to check whether it is working using qualitative and quantitative information:
- Qualitative information involves asking questions to understand what did and did not work well, and how to further improve.
- Quantitative information involves collecting data to measure outcomes. A validated quality improvement tool is a helpful way to collect this data.
Once the data has been collected, the results should be analysed to understand whether to make any changes to your plan.
Act
Acting involves deciding whether a quality improvement activity has been successful:
- If the activity is successful, organisations should work to embed the new activity at a larger scale. This includes training and educating staff, updating policies and procedures, and informing stakeholders.
- If the activity is not successful, organisations should identify why this might be and what can be done differently. The Plan‑Do‑Check‑Act tool should be used again, but this time with a different quality improvement activity.
Plan, Do, Check, Act Tool
Enablers for success
An improvement culture – by creating momentum and enthusiasm to try new things – is critical for success. One way to achieve this is to embed champions for change in the organisation. These staff members share ownership and create the right conditions for the Plan, Do, Check, Act approach to address areas of concern.
The support of senior organisational leaders is vital to success. Senior staff:
- ensure governance arrangements and processes provide the opportunity to identify issues
- enable improvement teams to undertake Plan, Do, Check, Act activities through endorsement and resourcing.
Building capability and skills across the workforce, through training, practice and exposure will create an environment where people can prioritise quality improvement.
Using data to support quality improvement
Data can be used during different stages of the Plan, Do, Check, Act quality improvement cycle.
Before change can occur, providers must identify the areas of concern that need improving. Data can help to identify areas of concern and the problems to solve. To do this, providers can use data from the Aged Care Mandatory Quality Indicator Program and Star Ratings results.
You can then use the Government Provider Management System (GPMS) to analyse your data. GPMS allows you to:
- set up quality indicator targets to monitor your performance against your own quality improvement targets for each indicator
- display data trends and patterns over time to provide high-level insights
- display data for a service in a line and bar chart format, tabular and targets, to help you analyse and interpret the results, identify patterns, spot anomalies, and understand the overall trajectory of data.
The Australian Institute of Health and Welfare (AIHW) conduct a trend analysis to examine variation over time in quality indicator performance. The AIHW also produce other aged care reports and fact sheets on these trends and more.
Learn more
For more information:
- search Star Ratings through the ‘Find a provider’ tool
- watch the Quality improvement in aged care webinar recording, view the slides and read the question and answer document
- see our Star Ratings resources
- find tools and resources in the National Aged Care Mandatory Quality Indicator Program manual – Part B to support quality improvement for each of the quality indicators.
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