Quality improvement primer part 3: Evaluating and sustaining a quality improvement project in the emergency department

Quality improvement (QI) and patient safety are two areas that have grown into important operational and academic fields in recent years in health care, including in emergency medicine (EM). This is the third and final article in a series designed as a QI primer for EM clinicians. In the first two articles we used a fictional case study of a team trying to decrease the time to antibiotic therapy for patients with sepsis who were admitted through their emergency department. We introduced concepts of strategic planning, including stakeholder engagement and root cause analysis tools, and presented the Model for Improvement and Plan-Do-Study-Act (PDSA) cycles as the backbone of the execution of a QI project. This article will focus on the measurement and evaluation of QI projects, including run charts, as well as methods that can be used to ensure the sustainability of change management projects.