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5 best practices for engaging staff during clinical quality improvement initiatives

Building and sustaining engagement during quality improvement activities isn’t easy, but AHRQ can help pave the way to success.
By admin
Aug 3, 2022, 7:00 AM

In an industry suffering from rising staffing shortages, widespread burnout, and the ongoing stresses of the COVID-19 pandemic, it can be extremely difficult to keep staff engaged and motivated during quality improvement activities.

However, it’s vital that healthcare leaders do everything they can to keep their quality moving on an upward trajectory, especially when financial incentives are thrown into the mix. Not only do patients depend on affordable access to safe and effective healthcare, but it’s much easier to attract and retain staff to an organization that fully embraces a culture of continuous improvement.

To support providers as they work toward their quality goals, the Agency for Healthcare Research and Quality (AHRQ) has released a new handbook, titled Obtaining and Using Data in Practice Improvement, that contains helpful information about how to fine-tune workflows and adopt data-driven strategies to foster high-quality care.

Related story: Surgeon General expresses concern, provides suggestions on burnout and resignations in healthcare

Starting with the fundamentals of staff education and engagement is crucial, the document explains. Innovation cannot take root if the improvements are not deployed into an environment that embraces the changes.

These five high-impact strategies can successfully prime the ground for alterations to health IT workflows or infrastructure, says AHRQ, while helping staff and leaders collaborate more effectively to build a learning health system.

Use the 3 percent rule to set goals and create perspective 

The 3 percent rule of thumb says that a successful quality improvement project should produce a sustained, absolute 3 percent improvement in a specific clinical outcome measure over the course of 12 months, explains AHRQ. The guideline is “a quick and easy way to put a practice’s QI achievements into perspective” and set future expectations for improvement activities.

The guide does note, however, that the 3 percent rule is only an estimate. Some metrics may improve more quickly if they are being given attention for the first time, while others may level out after a period of rapid improvement. Practices shouldn’t rely too heavily on the rule but instead use the number as a way to set initial goals, level expectations, and compare outcomes retrospectively.

Leverage the natural urge to compete to build quality improvements

Healthcare should be a collaborative endeavor. But injecting a little element of competition with other practices can be a healthy and helpful motivator. Many regional and national quality improvement programs already use rankings, ratings, and percentiles to encourage practices to outperform their peers, and leaders can do the same internally – to a degree.

When providing performance data or feedback, consider adding reference ranges from other practices or national benchmarks to add context, the guide suggests. Comparing data between individual providers can be just as motivating, the agency says.

Leaders should be careful not to pit colleagues against each other, denigrate external practices for their performance outcomes, or punish teams for falling short. Instead, comparisons should be framed positively and include incentives instead of penalties, where applicable.

Build on the intrinsic motivation of patient success stories

Healthcare providers are mission-driven to improve the lives of their patients.  Using patient stories and personal connections can be incredibly motivating and help bring abstract process changes to life.

Graphs, charts, and hard data can motivate some, but other staff will need a more personalized perspective to truly absorb information. AHRQ urges practices to integrate real-world patient situations into their improvement programs and share patient success stories to clearly illustrate the purpose behind a specific adaptation or new requirement.

Provide regular feedback and open the door for collaboration

Two-way communication is vital for creating sustained progress. QI leaders should use a combination of analytics skills, data storytelling, and organization-wide debriefs to provide feedback and keep projects on track.

Leaders should also openly welcome feedback from their staff members. This willingness to engage can help staff feel valued and included while bringing innovative new ideas to the table.

Celebrate the wins

“Rarely do leaders take time to reflect on and celebrate success,” AHRQ notes. “It is easy to gloss over seemingly small health IT wins, such as a valid clinical quality measure (CQM) report.” Instead, practice leaders should focus on “developing a culture where wins are regularly celebrated and rewarded.”

Recognizing gains, both big and little, can help staff members motivate one another, break past performance plateaus, and remain eager to continue the long but rewarding journey toward the highest possible quality of patient care.


Jennifer Bresnick is a journalist and freelance content creator with a decade of experience in the health IT industry.  Her work has focused on leveraging innovative technology tools to create value, improve health equity, and achieve the promises of the learning health system.

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