Dermatology toolkit

Quality Improvement (QI) is an evidence-based approach to continuously improve the quality of healthcare by embedding new approaches more effectively and efficiently into practice.

The RCGP have produced a pragmatic Quality Improvement Guideline for General Practice (PDF)

The West of England Academic Health Science Network have a range of downloadable QI tools for us in QI projects.

QI is undertaken using the QI cycle.

• Step 1: Diagnose
• Step 2: Plan and test
• Step 3: Implement and embed
• Step 4: Sustain and spread

QI cycle. RCGP QI Guide, p10 (PDF).

For the plan and test stage (step 2) of the QI cycle, it can be helpful to use the Model for Improvement approach to clarify the aim and measure of success⁽¹⁾. One approach to identify which changes result in an improvement or not is to undertake the Plan- Do-Study-Act (PDSA) cycle of change The advantage of the PDSA cycle is that it allows us to test out ideas for change in a controlled way, on a small scale. The RCGP has developed practical guidance to this methodology (PDF).

1. What are we trying to accomplish?
2. How will we know that a change is an improvement?
3. What changes can we make that will result in improvement?

• Plan
• Do
• Study
• Act

Model for Improvement Diagram p1 of RCGP A practical guide to Model for Improvement and PDSA (PDF)

There is plenty of QI activity that can be undertaken within primary care for patients affected by skin conditions. Many of the chronic inflammatory skin conditions, which require high levels of self-management and have associated co-morbidities, could benefit from a QI approach to healthcare.

1. Psoriasis Example (PDF)
2. Atopic Eczema in Children Example (PDF)
3. Acne Example (PDF)

References

1. Langley GJ, Moen RD, Nolan KM, Nolan TW, Norman CL, Provost LP. The improvement guide: a practical approach to enhancing organizational performance: John Wiley & Sons. 2009