Quality Improvement: It Takes a Team

By Jim Miller

“Even though nurses, physicians, and administrators work together daily, it’s interesting to learn how group members often have little or no perspective of the challenges faced in the daily clinical work processes of their colleagues,” notes Johns Hopkins University School of Nursing faculty member Jo Walrath, PhD, RN. She adds, “This lack of perspective is all too often at the heart of quality improvement (QI) problems in hospital settings.”

In a recent Academic Medicine article, Walrath describes how the “Hopkins Experience” in ACT II, the second phase of the Achieving Competence Today (ACT) program funded by the Robert Wood Johnson Foundation, set out to change these perspectives. Through a structured and interdisciplinary approach to learning QI that was piloted at Hopkins and other sites around the United States, teams of graduate medical, nursing, and health administration students focused on the core competencies of inter-disciplinary teamwork and quality improvement techniques.

According to Walrath and her colleagues, the importance of interdisciplinary participation in planning QI projects, the value of the patient’s perspective on systems issues, and the value of a system’s perspective in crafting solutions to issues all proved to be valuable lessons among the teams. She and other team leaders found the “Hopkins Experience” offered a key strategy for improving quality of care in hospital settings and for reforming health care education.

Walrath notes, “Educating key members of the health care team—when they are students—can only help in the long run to improve teamwork, communications and clinical outcomes for patients.”

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