Template for Quality Improvement Project Proposal with PDSA worksheet
Nursing 492: Integrative Seminar & Practicum
Template for Quality Improvement Project Proposal with PDSA worksheet
Assessment and Identification of the Problem/Need
- Quality Improvement Topic
- In one paragraph, discuss the issue(s) or problem(s) that led to the identification of your project topic or focus.
- Based on this, what is the main purpose of your project?
- In your assessment, is the current practice informed by current evidence? Why or why not?
Planning
- The Institute for Healthcare Improvement (IHI) Plan-Do-Study Act (PDSA) will be used as a framework to guide your project, please review: http://www.ihi.org/resources/Pages/HowtoImprove/default.aspx
Name:
Project Title:
| Personal Opportunity Statement Example: I’d like to become a really good runner. |
| Aim and Measures For further guidance on how to develop your aim statement and the family of measures, please reference the IHI open school module: QI 102: How to Improve with a Model of Improvement AND Model of Improvement: Measures Science of Improvement: Establishing Measures v Aim Statement(s) State what you are trying to accomplish, including: How good? By when? For whom? Example: 5 weeks from today, I will be able to run 5.3 miles in 50 minutes. |
v Measures
For the family of measures, please include the unit of measurement (e.g. The number of nurses that implement the proposed plan)
Example: The percent of nurses that attend the educational training
- Outcome Measure
List the measure(s) you ultimately want to affect and should directly relate to the above aim statement.
Examples: The number of miles I can run in 50 minutes
The percent of patients educated using the new protocol
- Process Measures
List the measures that will tell you if the parts or steps in the system are performing as planned to affect the outcome measure.
1.
2.
3.
Example: 1) Minutes runs per week 2) Minutes of strength training per week
- Balancing Measures
List the measures you will track to determine whether you are introducing problems in other parts of the system.
1.
2.
3.
Example: 1) Hours slept per night 2) Daily productivity at work on a scale of 1–5
| v Change to Test State how you will achieve your aim; i.e., what changes do you believe will lead to the improvement? What is at least ONE change you will implement to impact the aim and positively impact your outcome measure. 1. 2. 3. Example: Leave work by 5:30 PM. Example: Modify the standard bedside report form. |
- Specify activities/strategies to MEET you goal and aims (what are the steps)? What is your timeline for each of these strategies?
| Activity(what) | Site(where) | Participants(who) | Date |
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