Division of Pediatric Hospital Medicine.
Division of Pediatric Hematology and Oncology.
Hosp Pediatr. 2022 Oct 1;12(10):e359-e363. doi: 10.1542/hpeds.2022-006717.
Successful publication of quality improvement (QI) work is predicated on the use of established QI frameworks and rigorous analytical methods that allow teams to understand the impact of interventions over time. This article is meant to help QI teams disseminate their work more broadly through publication by providing tangible methods that many journals desire in QI articles with specific examples of published works referenced throughout the article. We introduce improvement frameworks that teams should identify early and use as a foundation throughout their projects. We review vital aspects of QI projects, such as team formation, creation of a succinct and clear aim statement, defining primary, process, and balancing measures, as well as QI tools like key driver diagrams, Ishikawa (fishbone) diagrams, and Pareto charts. Finally, we highlight the importance of analyzing data over time to understand the impacts of plan-do-study-act cycles on data. Annotated run charts or, more preferably, annotated statistical process control (or Shewhart) charts are both statistically sound methods to identify significant changes over time. Deliberate planning and execution of QI projects using these concepts will lead to improved chances of QI teams finding success in their project and eventual article acceptance.
成功发表高质量改进（QI）工作的前提是使用既定的 QI 框架和严格的分析方法，使团队能够随着时间的推移了解干预措施的影响。本文旨在通过提供许多期刊在 QI 文章中所期望的切实方法，帮助 QI 团队更广泛地发表他们的工作，文章中还引用了已发表作品的具体示例。我们介绍了团队应该尽早确定并在整个项目中用作基础的改进框架。我们回顾了 QI 项目的重要方面，例如团队组建、创建简洁明了的目标陈述、定义主要、过程和平衡措施，以及关键驱动因素图、石川（鱼骨）图和帕累托图等 QI 工具。最后，我们强调了随着时间的推移分析数据以了解计划-执行-研究-行动（PDCA）循环对数据影响的重要性。带注释的运行图或更优选的带注释的统计过程控制（或休哈特）图都是识别随时间显著变化的统计上合理的方法。使用这些概念精心规划和执行 QI 项目将提高 QI 团队在项目和最终文章接受方面取得成功的机会。
