Key points
- A QI project follows the <strong>PDSA cycle</strong>: Plan → Do → Study → Act.
- The minimum viable QI project can be designed in <strong>one weekend</strong> and executed over 4–8 weeks alongside clinical work.
- What matters for appraisal: <strong>clear aim, measurable outcome, evidence of change, and documented reflection</strong>.
Step 1 — Pick a problem you see every week
Step 2 — Write a SMART aim statement
Step 3 — PLAN: design the intervention
Step 4 — DO: implement and collect data
Step 5 — STUDY: analyse what happened
Step 6 — ACT: decide what to do next
Step 7 — Document for portfolio/appraisal
QI vs Clinical Audit — what's the difference?
Scope creep kills QI projects
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The best QI projects start with frustration: a process that wastes time, a common error you keep seeing, or a gap in care that patients experience. Examples: incomplete discharge summaries, delayed referrals for a specific pathway, inconsistent safety-netting documentation, or poor compliance with a prescribing guideline. If you care about the problem, the project will sustain itself.
Return to this sectionYour aim should be: Specific (what exactly will improve?), Measurable (what metric will you track?), Achievable (can you influence this?), Relevant (does it matter clinically?), Time-bound (over what period?). Example: 'Increase the proportion of discharge summaries completed within 24 hours from 60% to 85% over 6 weeks.'
Return to this sectionWhat single change will you test? Keep it small — one change per PDSA cycle. Examples: a checklist, a template, a reminder system, a brief training session, or a process redesign. Define: what you will do, who is involved, when you will measure, and what data you will collect.
Return to this sectionRun the intervention for a defined period (2–6 weeks). Collect your outcome data consistently. Keep a brief log of what happened — including any unexpected barriers or adaptations. You do not need a massive dataset; 20–50 data points is often sufficient for a practice-level QI project.
Return to this sectionCompare your outcome data to your baseline. Did the metric improve? By how much? What worked and what didn't? Were there unintended consequences? A simple before/after comparison with a chart or table is usually sufficient. You do not need statistical testing for most QI projects.
Return to this sectionThree options: (1) Adopt — the change worked, make it permanent. (2) Adapt — the change partly worked, modify and run another PDSA cycle. (3) Abandon — the change didn't work, try a different intervention. Document your decision and the reasoning. This is the 'closing the loop' that appraisers want to see.
Return to this sectionWrite up: aim, baseline data, intervention, results, reflection, and next steps. Include at least one chart showing the change. Add a reflection paragraph covering: what you learned about improvement methodology, what you would do differently, and how this informs your future practice. Total write-up: 1–2 pages.
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Portfolios and governance · Article 12 of 12