Quality Improvement Tools and Resources
Explore the resources below to learn about the science behind quality improvement (QI), how to form a QI team, and how to manage change within your unit, department, or organization.
You will develop your problem statement as you go through the process of understanding the problem. Ensure your problem is clearly defined and root causes are understood before you move on to identifying change ideas in the next step of the QI process.
Designing and testing change ideas is an iterative process. You may need to revisit many of the tools you used in Planning for Change. For example, you will likely need to return to the measurement guide and your measurement plan to ensure that you are correcting appropriate measures to test your change ideas.
Implementing and sustaining changes is one of the most challenging steps of the QI process, and requires active change management and frequent monitoring. Refer to the Implementing and Sustaining Change guide, communication plan, and measurement guide and plan to help you implement and sustain your changes.
- Step 1 - Planning
- Step 2 - Implementing
- Step 3 - Sustaining
Step 1 - Planning for Change
The QI process begins with identifying and understanding the problem you are trying to solve. Your QI team will partner with patients and providers to identify a problem, understand the current state of the process, and identify the root causes of the problem.
Key activities include:
- Writing a problem statement summarizing the problem you are trying to solve
- Mapping the current state of relevant processes and patient journeys with staff and patients
- Identifying the root causes of the problem with input from staff and patients and by observing processes in real time
- Generating a measurement plan to determine what data you will collect to further understand root causes and track improvement
- Collecting data and displaying it visually using run charts and control charts to understand variations in performance
Tools and Resources for Planning for Change
- QI Science Guide - Learn about approaches to QI: the Model for Improvement, Plan-Do-Study-Act-Cycles, Lean, and more.
- QI Charter Tool - Outline the purpose, scope, team, measures, and targets necessary to achieve success.
- Communication Plan Tool - Plan how to communicate about your QI project at each step to optimize stakeholder awareness and buy-in.
- Problem Statement Tool - Summarize the problem that your QI team is trying to address.
- Fishbone Tool - Reflect on the different components of a system and brainstorm how they may contribute to a problem.
- 5 Why's Tool - Continuously ask "Why is this happening?" to identify how components of a system may contribute to a problem.
- Measurement Guide - Learn about the importance of collecting data for QI, how to select indicators, collect data, and analyze results.
- Measurement Plan Tool - Plan the measurement of the performance of processes surrounding the problem to identify and understand contributing factors.
- Pareto Chart Tool - Determine which causes have the most impact on your problem to help you decide which to address first.
- Run Charts Tool - Learn how to interpret your data using run charts.
Step 2 - Implementing Change
At this point, you have an understanding of the problem you are trying to solve and why it is happening. Now you will begin to design and test change ideas to address these root causes. The Plan-Do-Study-Act (PDSA) cycle is a way to test and adjust change ideas.
Key activities include:
- Identifying change ideas that address the root causes of the problem
- Carrying out a test by implementing the change idea on a small scale and collecting data to track improvement
- Analyzing results to determine whether the change idea resulted in improvement
- Determining if and how the change idea needs to be tweaked, and preparing for another cycle of testing
Tools and Resources for Implementing Change
- Change Concepts and Ideas Guide
Learn about the different types of change concepts and how to generate change ideas to address them. - Driver Diagram Tool
Document the goal of the QI project and identify primary drivers (change concepts) and secondary drivers (change ideas). - PDSA Tool
Learn how to test and improve your change ideas by following the PDSA approach. Document your test plan, observations, analysis, and decision to continue to revise and evaluate your change ideas. - Implementing and Sustaining Changes Guide
Learn about stakeholder engagement, how to communicate change, standardize change, provide training, and more. - Implementation Tool
List how you will support the standardization, documentation, training, measurement, and resourcing to implement the change.
Step 3 - Sustaining Change
At this point, you have tested change ideas through your PDSA cycles and determined which were successful. Now you will formally implement these changes into practice in your unit or department, and once implemented, you will spread the change to other units or departments.
Key activities include:
- Formalizing and standardizing the changes, and documenting the new processes
- Communicating the new processes widely among staff
- Generating buy-in by sharing the improvement story and the impact on patients and staff
- Using your measurement plan to monitor adoption and improvement
- Collecting data and displaying it visually using run charts and control charts to understand variations in performance
- Creating a spread plan
- Using your measurement plan to monitor adoption and improvement
Tools and Resources for Sustaining Change
- Implementing and Sustaining Changes Guide - Learn about stakeholder engagement, how to communicate change, standardize change, provide training, and more.
- Sustainability Planner - Identify how you will support the seven key factors that will help sustain the change.
- Spread Guide - Learn about spread in QI, the “seven spreadly sins,” and a framework for spreading change.
- Spread Tool - Outline what change is being spread and how, the resources required, and how progress will be communicated.
Step 2 - Implementing Change
At this point, you have an understanding of the problem you are trying to solve and why it is happening. Now you will begin to design and test change ideas to address these root causes. The Plan-Do-Study-Act (PDSA) cycle is a way to test and adjust change ideas.
Key activities include:
- Identifying change ideas that address the root causes of the problem
- Carrying out a test by implementing the change idea on a small scale and collecting data to track improvement
- Analyzing results to determine whether the change idea resulted in improvement
- Determining if and how the change idea needs to be tweaked, and preparing for another cycle of testing
Tools and Resources for Implementing Change
- Change Concepts and Ideas Guide
Learn about the different types of change concepts and how to generate change ideas to address them. - Driver Diagram Tool
Document the goal of the QI project and identify primary drivers (change concepts) and secondary drivers (change ideas). - PDSA Tool
Learn how to test and improve your change ideas by following the PDSA approach. Document your test plan, observations, analysis, and decision to continue to revise and evaluate your change ideas. - Implementing and Sustaining Changes Guide
Learn about stakeholder engagement, how to communicate change, standardize change, provide training, and more. - Implementation Tool
List how you will support the standardization, documentation, training, measurement, and resourcing to implement the change.
Step 3 - Sustaining Change
At this point, you have tested change ideas through your PDSA cycles and determined which were successful. Now you will formally implement these changes into practice in your unit or department, and once implemented, you will spread the change to other units or departments.
Key activities include:
- Formalizing and standardizing the changes, and documenting the new processes
- Communicating the new processes widely among staff
- Generating buy-in by sharing the improvement story and the impact on patients and staff
- Using your measurement plan to monitor adoption and improvement
- Collecting data and displaying it visually using run charts and control charts to understand variations in performance
- Creating a spread plan
- Using your measurement plan to monitor adoption and improvement
Tools and Resources for Sustaining Change
- Implementing and Sustaining Changes Guide - Learn about stakeholder engagement, how to communicate change, standardize change, provide training, and more.
- Sustainability Planner - Identify how you will support the seven key factors that will help sustain the change.
- Spread Guide - Learn about spread in QI, the “seven spreadly sins,” and a framework for spreading change.
- Spread Tool - Outline what change is being spread and how, the resources required, and how progress will be communicated.
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Last Updated: August 25, 2026
