Implementing a 4C Approach to Quality Improvement. 2017

Michelle McGonigal
Allegheny General Hospital, Allegheny Health Network, Pittsburgh, Pennsylvania.

Designing a quality improvement activity can be labor intensive and intimidating to facilitators who have not been specially trained in process improvement methodologies. To simplify the process, a team was formed with the specific task of developing a basic model that addresses key concepts in change theory. The 2010 Institute of Medicine report stresses the importance of health care professionals working together, collaboratively, to use data to improve patient outcomes and improve care nationally. In addition, as noted in Quality and Safety Education for Nurses (2013), competencies have been developed to promote frontline problem solving including using data for quality improvement, providing safe care, functioning in collaborative teams, respecting and addressing patient and family concerns, applying evidence-based practice, and using informatics to make decisions. The team completed a search of the literature on change theory to identify the factors that are imperative to address when initiating a process improvement cycle. Kotter's Model of Change provided direction and guidance on the creation of the 4C model, which involves centering on issue, collaborating with team members, using the change process, and celebrating successes. This model has been implemented in a multihospital system as a framework for process improvement with such initiatives as preventing hospital-acquired infections, implementing patient safety initiatives, and addressing human resource concerns such as turnover and patient satisfaction.

UI MeSH Term Description Entries
D009936 Organizational Innovation Introduction of changes which are new to the organization and are created by management. Organizational Change,Change, Organizational,Innovation, Organizational,Changes, Organizational,Innovations, Organizational,Organizational Changes,Organizational Innovations
D010348 Patient Care Team Care of patients by a multidisciplinary team usually organized under the leadership of a physician; each member of the team has specific responsibilities and the whole team contributes to the care of the patient. Health Care Team,Interdisciplinary Health Team,Medical Care Team,Multidisciplinary Care Team,Multidisciplinary Health Team,Healthcare Team,Care Team, Health,Care Team, Medical,Care Team, Multidisciplinary,Care Team, Patient,Care Teams, Health,Care Teams, Patient,Health Care Teams,Health Team, Interdisciplinary,Health Team, Multidisciplinary,Healthcare Teams,Interdisciplinary Health Teams,Medical Care Teams,Multidisciplinary Care Teams,Multidisciplinary Health Teams,Patient Care Teams,Team, Health Care,Team, Healthcare,Team, Interdisciplinary Health,Team, Medical Care,Team, Multidisciplinary Care,Team, Multidisciplinary Health,Team, Patient Care,Teams, Interdisciplinary Health
D003299 Cooperative Behavior The interaction of two or more persons or organizations directed toward a common goal which is mutually beneficial. An act or instance of working or acting together for a common purpose or benefit, i.e., joint action. (From Random House Dictionary Unabridged, 2d ed) Compliant Behavior,Behavior, Compliant,Behavior, Cooperative,Compliant Behaviors,Cooperative Behaviors
D006284 Health Plan Implementation Those actions designed to carry out recommendations pertaining to health plans or programs. Health Plan Implementations,Implementation, Health Plan,Implementations, Health Plan,Plan Implementation, Health,Plan Implementations, Health
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D017060 Patient Satisfaction The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial. Satisfaction, Patient
D055317 Evidence-Based Practice A way of providing health care that is guided by a thoughtful integration of the best available scientific knowledge with clinical expertise. This approach allows the practitioner to critically assess research data, clinical guidelines, and other information resources in order to correctly identify the clinical problem, apply the most high-quality intervention, and re-evaluate the outcome for future improvement. Evidence-Based Health Care,Evidence Based Health Care Management,Evidence Based Healthcare Management,Evidence Based Management, Health Care,Evidence Based Management, Healthcare,Evidence-Based Healthcare,Evidence Based Health Care,Evidence Based Healthcare,Evidence Based Practice,Evidence-Based Health Cares,Evidence-Based Healthcares,Health Care, Evidence-Based,Health Cares, Evidence-Based,Healthcare, Evidence-Based,Healthcares, Evidence-Based
D058996 Quality Improvement The attainment or process of attaining a new level of performance or quality. Improvement, Quality,Improvements, Quality,Quality Improvements
D024802 Nurse's Role The expected function of a member of the nursing profession. Nurse's Scope of Practice,Nurses Role,Nurses' Role,Nurse Role,Nurse Scope, Practice,Nurse's Roles,Nurses Roles,Nurses Scope, Practice,Nurses' Roles,Practice Nurse's Scope,Practice Nurse's Scopes,Role, Nurse's,Role, Nurses,Role, Nurses',Roles, Nurse's,Roles, Nurses,Roles, Nurses'

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