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The 6 stages of the Quality Improvement Journey

Making improvements to your system involves a journey. The Quality Improvement Journey illustrates the stages of an improvement project. It maps out the 6 key steps you’ll need to take in order to create sustained improvement:

1. Creating Conditions
2. Understanding Systems
3. Developing Aims
4. Testing Changes
5. Implement
6. Spread

Learn more about each step below and see what tools and approaches will support you at each stage.

1 - Creating Conditions

At the start of an improvement project, the conditions must be right. There needs to a sense of urgency to highlight why the change is needed. You will need to seek organisational support, and involve the right people with a clear vision, shared purpose and values. Taking the time to create the right conditions for change will help you to build a strong foundation for sustained improvement.

A number of useful tools and information are available below to help you in the early stages of your improvement project.

2 - Understanding Systems

Systems can be complex, and often we’re unable to see all the different parts. It’s crucial we get to know the entire system rather than looking at parts in isolation before we make any changes. At this stage, it’s important to understand data to see how things are working, and to interact with those who use it. For example, listening to feedback and observing service users, as well as listening to the people working in the system.

There are key tools available to help you to understand a system. We’ve listed our recommendations below.

3 - Developing Aims

After you’ve completed step 2, you should have a clear picture of the system’s current performance. Now you need to decide what you’re actually going to improve, including what better looks like and how you will achieve this. With a clear aim, you will be able to develop ideas for change which can then be tested.

4 - Testing Changes

Testing is a critical stage as it helps you to understand what’s working and what’s not. It’s important to remember not all change results in an improvement. You will need to decide what to measure to be able to show that you have made an improvement.

There are a number of resources available below to support you to test changes.

5 - Implement

You are ready to implement a change once you have tested it in various situations and you’re confident that it is effective and will lead to an improvement. You can adopt different methods to implement your idea, including a ‘just do it’ approach or a step by step ‘sequential’ approach. Either way, you should consider creating standard policies and procedures, measuring to check you’re on track and educating your teams by building training into induction. Think about the impact your change will have on the people involved.

6 - Spread

Once you have successfully implemented a sustained change, you will want to spread your change where appropriate to benefit as many people as possible.

You will need to consider adjusting your change in a different context if needed. It will help if you’re able to share your improvement journey with others, explaining the benefits and encouraging buy-in.

3 key themes to consider throughout your journey

It is likely that your Quality Improvement Journey will move back as well as forward. At every stage of the journey, you’ll need to consider three themes:

1. Leadership and teams – how you lead your team and develop effective working relationships
2. Project management and communication – how you ensure everyone understands the vision and works together effectively to achieve it
3. Measurement – how you use data and understand if your changes are working

You will find further guidance and information on the Turas website.