PQI

Definition

Performance and Quality Improvement (PQI) is a process for achieving desired institutional and individual health care provider performance. Quality improvement methods typically follow the Plan-Do-Study-Act (PDSA or Deeming Wheel) process. The PQI process considers the institutional context, describes desired performance, identifies gaps between desired and actual performance, identifies causes for the gaps, selects and implements interventions to close the gap, and measures changes in performance. A successful PQI process requires staff and resource allocation that may hinder implementation. Through our clinical staff and the application of technology, Profiles & Interventions (PI) provides the resources and expertise to ensure a successful program.

Defining Desired Performance

The PI staff works with healthcare providers to define desired performance based on national policies and priorities, evidence-based clinical guidelines and standards set fourth by regulatory agencies. Clients are encouraged to contribute their view of quality and "real world" application of the selected performance standards. Once PI and providers have reached a consensus on the operational and performance criteria the PI staff develop a custom assessment tool for measurement and benchmarking.

Conducting a Cause Analysis

Once the PI team has measured performance using the assessment tools, they work with healthcare personnel to determine the reasons for any performance gaps. Rather than serving as a punitive measure for poor performance, this cause analysis is intended to motivate healthcare staff to identify their own weaknesses and offer solutions to improve performance and quality. There are many common causes of poor performance, including unclear job expectations, lack of performance feedback, lack of motivation motivation, weak leadership, deficient knowledge and skills, and inadequate facilities, equipment or supplies.

Selecting Interventions

An intervention is an activity, process, event or system that is designed to improve performance by closing the gap between desired and actual performance. The PI staff use a variety of behavioral change interventions depending on the need identified by the cause analysis. Given the wide range of possible interventions and the likelihood that problems will exist in more than one area, the most urgently needed interventions and those that will have the greatest impact are given the highest priority.

Implementing Interventions

The staff at PI have a wide range of expertise in designing, developing and implementing various interventions. Our staff can provide the guiding framework that allows our clients and supportive staff to work toward a common goal of quality, ensuring pull-through of the designed intervention.

Measuring Changes in Performance

Monitoring change is an ongoing task that allows clients to provide feedback on the results of interventions. The PI staff works with clients to measure changes in the performance of different facilities. To evaluate whether interventions are closing the performance gap, PI typically uses the same assessment tool that was used to establish their performance baseline. Information from these evaluations is used to guide further analysis of performance gaps and causes for those gaps, and it can also signal healthcare providers and clients that services are getting closer to the desired level of quality.

Improving Performance and Quality

Through implementing a PQI process, the PI staff helps health personnel and communities work together to improve performance and quality. Through our expertise and resources we empower our clients to solve weaknesses and devise solutions at their facilities that ensures state of the art healthcare delivery.