GP · core-skills
Quality improvement and practice systems
Also known as Quality improvement · QI · Clinical audit · PDSA cycle
GP-fellowship guide to quality improvement and practice systems: the Model for Improvement and PDSA cycles, audit and feedback evidence from Cochrane reviews, quality improvement collaboratives and their success determinants, the Triple Aim framework, and practical QI in general practice.
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Red flags
- A QI project that measures nothing has already failed - every cycle needs a baseline, a target, and a re-measure
- Audit and feedback is a widely used strategy to improve professional practice - plan the feedback step, not just the audit
- QI collaborative teams that do not remain intact and stop gathering data lower their chances of long-term success
Overview
Quality improvement is the systematic effort to close the gap between what we know works and what we actually deliver. Every GP already does informal QI — reflecting on a missed diagnosis, changing a recall system. Formal QI adds structure: baseline measurement, planned change, re-measurement, and spread. [3]
References5ShowHide
- [1]Ivers N, Jamtvedt G, Flottorp S, et al. Audit and feedback: effects on professional practice and healthcare outcomes Cochrane Database Syst Rev, 2012.PMID 22696318
- [2]Ivers N, Yogasingam S, Lacroix M, et al. Audit and feedback: effects on professional practice Cochrane Database Syst Rev, 2025.PMID 40130784
- [3]Hulscher ME, Schouten LM, Grol RP, et al. Determinants of success of quality improvement collaboratives: what does the literature show? BMJ Qual Saf, 2013.PMID 22879447
- [4]Schouten LM, Hulscher ME, van Everdingen JJ, et al. Evidence for the impact of quality improvement collaboratives: systematic review BMJ, 2008.PMID 18577559
- [5]Berwick DM, Nolan TW, Whittington J The triple aim: care, health, and cost Health Aff (Millwood), 2008.PMID 18474969