Leveraging Lazomis QI for Structured Quality Improvement Projects

Why This Topic Matters

For many NHS clinicians, engaging with QI projects is an essential part of professional development, revalidation, and service improvement. However, managing these projects can often be challenging, particularly when juggling clinical duties. Common hurdles include maintaining project documentation, standardising data collection, ensuring team engagement, and demonstrating impact.

An effective digital tool can significantly mitigate these challenges. By providing a structured environment for project management, data analysis, and reporting, tools like Lazomis QI empower teams to focus more on the improvement itself and less on administrative overhead. This not only increases the likelihood of successful project completion but also enhances the capacity to sustain improvements and share learning across the organisation.

Practical Explanation: What is Lazomis QI and How Does it Support QI?

Lazomis QI is a dedicated platform designed to assist NHS teams in managing their quality improvement initiatives. It provides a structured framework that aligns with recognised QI methodologies, such as the Model for Improvement (Plan-Do-Study-Act or PDSA cycles), and supports the entire project lifecycle.

Key features that make Lazomis QI particularly useful for QI projects include:

• Project Centralisation: A single repository for all project information, including aims, team members, measures, and timelines.
• Data Collection Tools: Customisable forms and templates for consistent data capture, reducing variability and ensuring data integrity.
• Visualisation and Reporting: Integrated dashboards and charting capabilities to monitor progress, identify trends, and generate reports for stakeholders.
• PDSA Cycle Management: Tools to plan, execute, analyse, and document iterative cycles of change, crucial for testing interventions.
• Collaboration Features: Facilitates communication and task assignment among project team members.
• Resource Library Integration: Direct access to relevant guidelines, templates, and educational materials.

Common Pitfalls in QI Projects and How Lazomis QI Helps

Even with the best intentions, QI projects can encounter obstacles. Recognising these common pitfalls can help teams navigate them more effectively, and Lazomis QI offers specific functionalities to address many of them:

• Lack of Clear Aim: Without a specific, measurable, achievable, relevant, and time-bound (SMART) aim, projects can drift. Lazomis QI prompts you to define clear project aims and objectives at the outset.
• Inconsistent Data Collection: Variable methods of data collection lead to unreliable results. The platform allows for standardised data entry forms, reducing ambiguity and improving data quality.
• Poor Stakeholder Engagement: Failing to involve key personnel can hinder adoption. Lazomis QI's collaboration features allow for easy sharing of progress and findings, fostering transparency and engagement.
• "One-off" Improvement vs. Sustained Change: Improvements can revert without sustained effort. Lazomis QI supports ongoing monitoring and the documentation of spread and scale plans, helping embed changes.
• Inadequate Measurement: Not knowing what to measure, or how to measure it, leads to uncertainty about impact. The platform guides users in defining outcome, process, and balancing measures, and visualises them for clear impact assessment.
• "Project Creep": The scope of a project expanding beyond its initial aims. By clearly documenting initial aims and scope, Lazomis QI helps teams stay focused.
• Lack of Documentation: Critical learning and decisions can be lost without proper records. Lazomis QI serves as a centralised hub for all project documentation, from meeting notes to PDSA summaries.

Step-by-Step Approach to Using Lazomis QI for Your Project

This framework outlines how to effectively integrate Lazomis QI into your QI project workflow, broadly following the Model for Improvement:

Step 1: Project Initiation and Setup

1. Define Your Problem and Aim: Clearly articulate the problem you wish to solve and set a SMART aim. Use Lazomis QI's project setup module to document this, including your rationale and initial hypothesis.
2. Assemble Your Team: Identify key stakeholders and team members. Add them to your Lazomis QI project, assigning roles and responsibilities.
3. Establish Measures: Determine your outcome, process, and balancing measures. Input these into Lazomis QI, specifying data sources, frequency of collection, and responsible individuals. This ensures everyone understands how success will be measured.

Step 2: Understanding the System and Baseline Data

1. Process Mapping: Before making changes, map the current process (the 'as-is'). While Lazomis QI doesn't directly create flowcharts, you can upload diagrams and link to external tools, ensuring this critical documentation is accessible within your project.
2. Baseline Data Collection: Use Lazomis QI's data collection tools to gather initial data for your chosen measures. This establishes your starting point and helps you understand current performance.
3. Data Visualisation: Utilise Lazomis QI's charting capabilities to visualise your baseline data. Run charts and control charts can be invaluable here to understand variation before intervention.

Step 3: Developing and Testing Changes (PDSA Cycles)

1. Generate Ideas for Change: Brainstorm potential interventions. Document these ideas within your project notes.
2. Plan Your First PDSA Cycle: For a chosen intervention, use the PDSA module in Lazomis QI to outline: what you will Plan (specific change, predictions, data to collect), how you will Do it (who, what, when, where), how you will Study the results (analysis method), and what you will Act on (adapt, adopt, abandon).
3. Execute and Collect Data: Carry out the 'Do' phase of your PDSA. Input the new data into Lazomis QI, ensuring consistency with your established measures.
4. Analyse and Reflect: Use Lazomis QI's analytical tools to 'Study' the impact of your change. Compare it to your predictions and baseline data. Document your findings and reflections directly within the PDSA module.
5. Act and Plan Next Steps: Based on your 'Study' phase, decide on your 'Act'. This might involve refining the change, testing it on a larger scale, or trying a different intervention. Document this decision and link it to your next PDSA cycle within Lazomis QI.

Step 4: Implementing and Sustaining Change

1. Scaling Up: Once a change has been successfully tested through multiple PDSA cycles, begin to implement it more widely. Continue to monitor key measures using Lazomis QI to ensure the change is embedded.
2. Documentation of Spread and Scale: Document your strategy for spreading the improvement to other areas or scaling it up within your department. Lazomis QI can store these plans and track their progress.
3. Sustaining the Gain: Develop a plan to maintain the improvement. This might include updating policies, integrating the change into routine practice, or setting up ongoing audits. Use Lazomis QI to record these sustainability plans and any associated monitoring schedules.

Step 5: Reporting and Sharing Learning

1. Generate Reports: Use Lazomis QI's reporting features to create summaries of your project's journey, impact, and lessons learned. These can be tailored for different audiences, such as clinical governance committees, departmental meetings, or professional portfolios.
2. Share Your Success: Disseminate your findings within and outside your organisation. Lazomis QI provides a structured way to present your project, which can be invaluable for presentations, posters, or even publications.

Example in Clinical Practice: Reducing Delayed Discharge in an Acute Ward

Consider a QI project aimed at reducing delayed discharges from an acute medical ward. The team identifies that a significant proportion of patients face delays due to late completion of discharge summaries or lack of timely transport arrangements.

How Lazomis QI Helps:

• Project Setup: The QI lead creates a new project in Lazomis QI, clearly stating the aim: "To reduce the mean time from 'medically fit for discharge' to actual discharge by 20% within 3 months, for patients on Ward X, by improving the timeliness of discharge summary completion and transport booking."
• Measures: Outcome measure: Mean time (hours) from medical fitness for discharge to actual discharge. Process measure: Percentage of discharge summaries completed within 4 hours of medical fitness. Balancing measure: Readmission rates within 30 days.
• Baseline Data: The team uses Lazomis QI's custom forms to collect retrospective data for 4 weeks on current discharge times and summary completion. Run charts generated in Lazomis QI immediately highlight the current average delay and significant variation.
• PDSA Cycle 1 (Discharge Summaries):
  • Plan: Introduce a ward-based 'discharge facilitator' role to prompt doctors for early summary completion and chase necessary information.
  • Do: Implement the facilitator role for 2 weeks, collecting data daily on summary completion times via Lazomis QI's mobile interface.
  • Study: Lazomis QI dashboards show an improvement in summary completion rates, but delays still occur due to junior doctor workload. The mean discharge time has slightly reduced.
  • Act: Adapt the change – propose a protected hour for discharge summaries for junior doctors and test again.
• PDSA Cycle 2 (Protected Time & Transport):
  • Plan: Implement protected time for discharge summaries, and concurrently introduce a 'transport readiness' checklist to be completed 24 hours before anticipated discharge.
  • Do: Run this for 3 weeks, continuing data collection in Lazomis QI for all measures.
  • Study: Lazomis QI shows a significant drop in both discharge summary delays and overall discharge times. The balancing measure (readmissions) remains stable, indicating no unintended harm.
  • Act: Adopt both changes and begin to scale them across the medical division, with ongoing monitoring.
• Reporting: The QI lead generates a comprehensive report from Lazomis QI, highlighting the project's impact, the PDSA cycles undertaken, and recommendations for sustaining the change. This report is shared with clinical governance and presented at departmental meetings, demonstrating tangible improvements in patient flow and staff efficiency.

How Lazomis Can Help

Lazomis is designed to be your trusted partner in quality improvement. Our Lazomis QI tool specifically offers the framework and functionalities to manage your projects efficiently and effectively. From the initial project setup, through iterative PDSA cycles, to final reporting, Lazomis QI centralises your efforts, standardises your data, and visualises your progress.

By providing a secure and intuitive platform, Lazomis helps reduce the administrative burden of QI, allowing you and your team to focus on the impactful work of improving patient care. Our support resources and templates are aligned with best practices in QI, ensuring you have the guidance you need at every step.

This resource supports, but does not replace, clinical judgement. Local policy, formulary and specialist advice should be followed.

Key Takeaways