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HiQuiPs: Implementation Part 2 – Which Strategy to Choose: PDSA, Lean, or Six Sigma?

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PDSA, Lean, and Six Sigma are three different frameworks that can be part of your quality improvement armamentarium. Each of them can often be applied to the same quality issue. Deciding on which one to use requires an understanding of their inherent strengths and weaknesses. In our last post, we briefly introduced the theory behind Lean, Six Sigma, and PDSA cycles. Here, we will practically apply each methodology to one quality problem to …

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HiQuiPs: Implementation Part 1 – QI Implementation Methodologies

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In this two-part series, we will take a deeper dive into several QI conceptual frameworks, or ways to approach QI projects. In our previous posts, we discussed preparation strategies for QI projects; but when it comes to implementing a change, how would a team go about choosing an approach? We will start with a discussion of the variable effectiveness of different change interventions, then we will delve into an overview of some common …

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HiQuiPs: Preparation Part 2 – Stakeholder Engagement and Behavior Change

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You have recently finished a review of incidents that have been flagged in your ED. You have chosen a pertinent issue to tackle, formed a core group to work on the project, and formulated a SMART aim statement after reading our last HiQuiPs post. The median time for obtaining 12-lead ECGs is 13 minutes, while guidelines recommend less than 10 minutes.1 Your aim is to decrease the initial 12-lead ECG acquisition time by …

QI Series Part 3 | Differentiating Quality Improvement and Clinical Epidemiology

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How do Quality Improvement methods differ from classical clinical research? This article is the last in a three-part series on Quality Improvement (QI) in health care. The first article, “What is Quality Improvement?”, defined this field of study and provided a brief history of its origins.  The second article defined “quality” and briefly described tools used to achieve improvement. This article seeks to differentiate QI methods and goals from those encountered in clinical …

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New CanadiEM Series – HiQuiPs

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Links to HiQuiPs Posts Quality of Care and the ED (August 1, 2018) Preparation Part 1 – General Considerations for a QI Project in the ED (August 29, 2018) Preparation Part 2 – Stakeholder Engagement and Behaviour Change (October 7, 2018) Preparation Part 3 – Root Cause Analysis (November 2, 2018) QI in the ED –  Implementation Part 1. QI Implementation Methodologies (December 7, 2018) QI in the ED – Implementation Part 2. Which …