Quality Improvement in General Practice

Western Victoria PHN (WVPHN) is committed to developing and enhancing the high performing primary care model across our region. This includes implementing its principles to build the capacity of the primary health care sector through continuous quality improvement.

What is quality improvement?

Quality improvement is a system of regularly reviewing and refining general practice processes to enhance patient health and quality of care. Quality improvement activities lead to positive change in practices, particularly when using a whole-of-team approach.

Quality improvement in general practice can address one or more of the following areas:

• Safety: avoiding harm to patients.
• Effectiveness: providing evidence-based care and only providing services that are likely to be of benefit.
• Patient-centricity: providing care that is responsive to each individual patient’s preferences, needs and values.
• Timeliness: reducing waiting times for care and avoiding harmful delays.
• Efficiency: avoiding waste.
• Equity: providing care of the same quality regardless of personal characteristics such as gender, ethnicity, location or socio-economic status.

Benefits and outcomes

Benefits and outcomes from quality improvement can be categorised as:

• Patient Experience: Improving patients’ access to care; quality and safety; and outcomes.
• Care Team Wellbeing: Improving staff satisfaction, morale, team-work, and workforce sustainability.
• Population Health: Reducing the burden of disease and health inequalities across your region.
• Reducing Costs: Reducing unnecessary hospital admissions; improving the return on innovative investments

By developing ideas for quality improvement in general practice that affect each of these four objectives, the improvements are said to have met the ‘quadruple aim’.

The model for improvement

The Model for Improvement (MFI) is a proven approach for developing, testing and implementing changes in general practices. It is also the preferred approach for many peak health bodies including the RACGP and Improvement Foundation.

The MFI helps break down changes into manageable steps. Each step is then tested to ensure the change results in measurable improvements with minimal waste of effort.

Plan Do Study Act

By using a Plan Do Study Act (PDSA) cycle, simple measurements are used to monitor the outcomes of multiple changes over time.

Improvements can be implemented on a smaller scale to begin with. This enables general practices to refine and build on learnings throughout each cycle.

PDSA Template

• PDSA template – General Practice (RTF 1MB)

Sample PDSAs

• PDSA – Improve Opioid Management and Reduce Risk (RTF 1MB)
• PDSA – Improve the cultural awareness of practice staff (RTF 1MB)
• PDSA – Improve the current process of asthma diagnosis and increase update of asthma cycle of care plans (RTF 1MB)
• PDSA – Data cleansing (RTF 1MB)
• PDSA – Clinical Coding (RTF 1MB)
• PDSA – Cervical Screening (RTF 1MB)
• PDSA – Improve demographic data for digital health platforms (RTF 1MB) This PDSA can support readiness in general practice for ePresciptions.

Further sample PDSAs will be uploaded shortly.

Methodologies and approaches

WVPHN recognises the following organisations as leaders in developing methodologies and approaches for quality improvement. Please contact them for further details:

• Improvement Foundation
• Institute of Healthcare Improvement
• Royal Australian College of General Practitioners

Further support

WVPHN practice facilitators are available to support general practices’ quality improvement activities.

Request support from your practice facilitator