A PRACTICAL GUIDE TO QUALITY IMPROVEMENT FOR BURN CARE in Low-Resourced Settings
SUMMARY You have seen the eight steps of a successful Quality Improvement project and what each step involves. To bring everything together we have taken Daniel’s project as an example to show all eight steps in order for a single project. Daniel worked on a project to improve the documentation of wound dressing changes in his ward. Despite little change in his first PDSA cycle, he was able to change the rate of correctly completed. documentation from 44% to 85% at the end of his project. IDENTIFY THE PROBLEM
STEP 01
Inadequate information was being documented about dressing changes for burn patients in a hospital in Malawi, compromising the continuity of care for the patient. BUILD A TEAM Nurses, doctors, patient attendants and ward clerks were all involved in the project. They helped develop the guideline to improve documentation. Twice weekly meetings were organised with all the stakeholders to evaluate the progress of documentation, isolate issues and suggest methods for improvement. UNDERSTAND/ASSESS THE PROBLEM A SWOT analysis was used to unpick the problem and understand it more holistically. (SWOT diagram on following page). Daniel also used a driver diagram at this stage. A checklist was created that identified 10 variables associated with documentation standards. This checklist demonstrated a gap in documentation quality, with only 44% of the dressing change notes completed correctly. The staff reported to have too little time for filling in the notes adequately and consistently. CREATING A SMART AIM Improve documentation after dressing changes for burn patients. Utilisation of a checklist to measure specific elements of
STEP 02
STEP 03
STEP 04
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documentation quality. Improve documentation from 44% to 90%. Project aimwas achievable as the work was within the remit of Daniel’s role within his unit, and the project was not too costly. The project was relevant as improving documentation will help improve patient care and treatment outcomes and thereby improve quality of care.
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The project timeframe was four months, fromNov 2019 - Feb 2020.
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