Table 1

Taxonomy of Quality Improvement Strategies With Examples of Substrategies

QI StrategyExamples
Provider reminder systems
  • Reminders in charts for providers
  • Computer-based reminders for providers
  • Computer-based decision support
Facilitated relay of clinical data to providers
  • Transmission of clinical data from outpatient specialty clinic to primary care provider by means other than medical record (e.g., phone call or fax)
Audit and feedback
  • Feedback of performance to individual providers
  • Quality indicators and reports
  • National/State quality report cards
  • Publicly released performance data
  • Benchmarking – provision of outcomes data from top performers for comparison with provider’s own data
Provider education
  • Workshops and conferences
  • Educational outreach visits (e.g., academic detailing)
  • Distributed educational materials
Patient education
  • Classes
  • Parent and family education
  • Patient pamphlets
  • Intensive education strategies promoting self-management of chronic conditions
Patient reminder systems
  • Materials and devices promoting self-management
Promotion of self-management
  • Postcards or calls to patients
Organizational change
  • Case management, disease management
  • TQM, CQI techniques
  • Multidisciplinary teams
  • Change from paper to computer-based records
  • Increased staffing
  • Skill-mix changes
Financial incentives, regulation, and policyProvider directed:
  • Financial incentives based on achievement of performance goals
  • Alternative reimbursement systems (e.g., fee-for-service, capitated payments)
  • Licensure requirements
Patient directed:
  • Copayments for certain visit types
  • Health insurance premiums, user fees
Health system directed:
  • Initiatives by accreditation bodies (e.g., residency work hour limits)
  • Changes in reimbursement schemes (e.g., capitation, prospective payment, salaried providers)

Note: Reprinted with permission from AHRQ38 (pp. 17–18).

From: Chapter 44, Tools and Strategies for Quality Improvement and Patient Safety

Cover of Patient Safety and Quality
Patient Safety and Quality: An Evidence-Based Handbook for Nurses.
Hughes RG, editor.

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