COVID19: The Science of Improvement

Resources from the international QI community looking at the science of improvement during the COVID19 pandemic.

By meganpeng · April 23, 2020

The Science of Improvement is an applied science that aims to understand what changes in which contexts produce improvements. It draws on clinical science, systems theory, human factors theory, psychology, ergonomics and statistics to apply innovation and rapid-cycle testing on the frontline (more information from the Institute for Healthcare Improvement here).

The methodology is founded in the work of W. Edwards Deming with subsequent creation of the Model for Improvement by Associates for Process Improvement and Plan-Do-Study-Act cycles for small tests of change.

An evidence scan originally conducted by The Health Foundation on research into the concept and practice of improvement science is available here.

A new video series produced by the Royal College of Physicians of Ireland to support those working on the frontline with practical tools for applying the science of improvement to dealing with quality and safety in a time of crisis is available here.

Understanding Variation

How improvement science and data can be used to understand and manage the COVID-19 crisis was discussed in a recent webinar hosted by the International Society for Quality in Health Care.

Making informed decisions driven by data also requires understanding of variation and hereogeneity. A fundamental concept is variation in a measure has two potential origins – common causes and special causes. This involves:

  • Use of time-ordered data to detect special cause and improvement.
  • Understanding why results differ by location and environment.
  • Understanding what is different from what is the baseline or norm or random phenomena.

Shewhart Control Charts help identify where the focus of work should be to make a change and determines if a change is actually an improvement. It enables operational decisions to be made from analysis of healthcare data based on a wider understanding of the processes and their variation.

A discussion on the use of Shewhart Control Charts in COVID-19 and the I-Chart COVID-19 Shewhart Chart Template tool is available to download here.