Practice-Based Quality Improvement and Patient Safety
This domain tests whether you can improve care systematically and prevent harm, using measurement rather than anecdote.
Improvement method
Plan-Do-Study-Act cycles are small, rapid tests of change. Define a measurable aim, collect baseline data, test one change, and study the result before adopting it. Run charts reveal whether change is real or ordinary variation. A root cause analysis uses tools such as the five whys and cause-and-effect diagrams; its purpose is system redesign, not assigning blame.
Safety practices
- Report incidents and near misses through a non-punitive pathway so patterns become visible.
- Use two patient identifiers before procedures or records linkage.
- Store look-alike and sound-alike drops separately and check expiry dates.
- Maintain equipment calibration logs; an uncalibrated tonometer produces plausible but wrong numbers.
- Close the loop on referrals and abnormal results: confirm receipt, not just transmission.
Worked example
A clinic notices rising missed appointments. A weak response is to tell staff to try harder. A quality response measures baseline no-show rates, tests reminder calls for four weeks, plots the run chart, and checks a balancing measure such as appointment availability. Only after the data show improvement is the change adopted.
Traps that cost marks
Changing several variables at once so the effect cannot be attributed; blaming an individual for a system failure; launching a project without baseline data; assuming a sent referral was received.