Curriculum standards
Entrustable Professional Activities
LG5: Quality improvement
Quality improvement
Identify and address opportunities to improve systems, investments, teams, and strategies to advance population health outcomes, including own practice
This activity requires the ability to:
- continuously improve public health strategies and programs to meet agreed objectives as monitored and measured, including health protection, population health, and health care access and provision
- contribute to the development, implementation, or evaluation of quality improvement initiatives designed to improve the health of patients and populations using methods and tools to measure and evaluate processes, impacts, and outcomes of policies and practices
- consider sustainability and climate change impacts of quality improvement activities
- monitor own practice as a public health physician, and develop individual improvement plans to continuously improve contribution to teams-based actions
- write reports on quality improvement activities for the workplace
Professional practice framework domain
Medical expertise
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- use population health outcomes to identify opportunities for improvement in health care
- use standardised protocols to adhere to best practice and prevent the occurrence of errors in health care and population health management
- monitor personal professional performance regularly
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- contribute to processes or identified opportunities for evaluation and improvement
- recognise the importance of prevention and early detection of errors and poorly functioning programs
- recognise the value of guidelines to direct decision making and actions
Communication
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- support individuals and communities to have access to, and use, easy-to-understand, high-quality information about their health
- engage communities to share decision making about their own health, to the extent they choose
- implement the organisation’s open disclosure policy
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- demonstrate awareness of the evidence for consumer engagement and its contribution to quality improvement in care
- apply knowledge of how health literacy might affect the way individuals and populations gain access to, understand, and use health information
- discuss with individuals and communities any safety and quality concerns they have relating to their health
- communicate systems and pathways for complaints and feedback
Quality and safety
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- participate in organisational quality and safety activities, including critical incident reviews, clinical practice improvement activities, root cause analyses, system analyses, and corrective and preventative action plans
- identify and report actual and potential ‘near miss’ errors
- undertake system improvement activities
- select performance indicators and develop ongoing monitoring processes
- be aware of and use tools to improve health care, including clinical audits, data on patients’ experiences and outcomes, feedback and complaints, and formal and informal program evaluations
- use statistical process control charts
- maintain personal physical and mental wellbeing
- use systems thinking and lean thinking methodologies to plan quality improvement
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- demonstrate understanding of a systems approach to improving the quality and safety of health care
- demonstrate safety skills, including infection control, adverse event reporting, and effective handovers
- use a quality framework
- keep accurate records of work
- use plan-do-study-act cycles
- be readily accessible when on duty, and arrange suitable cover
- participate in systems for surveillance and monitoring of adverse events and ‘near misses’, including reporting such events
- ensure that identified opportunities for improvement are raised and reported appropriately
Teaching and learning
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- translate quality improvement approaches and methods into practice
- supervise and manage the performance of junior colleagues in the delivery of high-quality, safe medical practice
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- work within organisational quality and safety systems for the delivery of high-quality medical practice
- use opportunities to learn about safety and quality theory and systems
- participate in professional training in quality and safety to ensure a contemporary approach to safety system strategies
Research
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- ensure that any protocol for human research is approved by an appropriate ethics committee in accordance with national standards
- ensure that any protocol involving Aboriginal and Torres Strait Islander peoples or Māori (tangata whenua) is approved by an appropriate Indigenous ethics committee
- make use of systems thinking and lean thinking methodologies
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- recognise that participation in research is voluntary and based on an appropriate understanding about the purpose, methods, demands, risks, and potential benefits of the research
Cultural safety
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- undertake professional development opportunities that address the impact of cultural bias, colonisation, and racism on health outcomes, guidelines, and policies
- demonstrate understanding of the role of racism and other types of discrimination in accessing and using preventive services
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- communicate effectively with patients and communities from a range of cultural backgrounds
Ethics and professional behaviour
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- align improvement goals with the priorities of the organisation
- contribute to developing an organisational culture that enables and prioritises safety and quality in health care for patients and communities
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- comply with professional regulatory requirements and codes of conduct
Judgement and decision making
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- use decision-making support tools, such as guidelines, protocols, pathways, and reminders
- analyse and evaluate current processes to improve care
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- access information and advice from other sources, including other healthcare practitioners, to identify, evaluate, and improve management of the health of patients and communities
Leadership, management, and teamwork
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- formulate and implement quality improvement strategies as a collaborative effort involving all key health professionals
- support multidisciplinary team activities to promote interdisciplinary programs of care that improve quality and reduce the risks of harm to patients and communities
- actively involve experts in other areas to reduce error and optimise care, such as emergency services personnel in responding to disasters
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- demonstrate attitudes of respect and cooperation among members of different professional teams
- partner with other professionals to ensure best practice healthcare and information for patients and communities
Health policy, systems, and advocacy
Ready to perform without supervision
Expected behaviours of a trainee who can routinely perform this activity without needing supervision
The trainee will:
- participate in all aspects of the development, implementation, evaluation, and monitoring of governance processes for:
- defining the scope of medical practice
- performance monitoring and management
- safety and quality education and training
- measure, analyse, and report a set of specialty-specific processes, impact and outcome indicators, and a set of generic safety indicators
- identify areas within the system where systemic privilege exists, and challenge this as part of a pro-equity approach within the health system
- identify opportunities for quality improvement in population health programs
Requires some supervision
Possible behaviours of a trainee who needs some supervision to perform this activity
The trainee may:
- maintain communication with service managers about issues that affect the health of individuals and communities
- contribute to relevant organisational policies and procedures
- demonstrate an understanding of governance, healthcare standards, and current guidelines for the management of public health issues
- participate regularly in multidisciplinary meetings where quality and safety issues are standing agenda items, and where innovative ideas and projects for improving practice are actively encouraged
- help shape an organisational culture that prioritises safety and quality through openness, honesty, learning, and quality improvement