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Office of Mental Health


QI Team
Quality Improvement

The PSYCKES-CQI project leverages the Quality Improvement (QI) model of data-driven decision-making to promote the use of evidence-based practices, in which the best evidence from scientifically sound research guides health care decisions. QI is a series of activities designed to improve processes and systems in order to achieve better outcomes.  A key principle of QI is the use of data to assess the need for change and the effectiveness of interventions.  Continuous quality improvement (CQI) breaks the QI process into manageable pieces.  The Plan-Do-Check-Act (PDCA) cycle is the core process of CQI.  Each PDCA cycle identifies one or more barriers to the desired outcome, implements processes to address the barriers, and uses data to determine the effectiveness of the intervention. 

The FOCUS-Plan-Do-Check-Act (FOCUS-PDCA) model of QI begins with the FOCUS stage–Find an opportunity to improve; Organize a QI team; Clarify current knowledge and processes that influence opportunities to improve; and Understand variation that is contributing to the problem and Select/start PDCA cycles to improve outcomes.  The FOCUS stage gives QI teams a roadmap for organizing the project team and setting the stage for success in its PDCA cycles. 

The PDCA cycles are:

Plan: Plan the action, or a pilot test of the action. Include in the plan a measure of performance and means of data collection. This will enable the QI team to know if the intervention is working.

Do: Implement the intervention. Make sure necessary data are generated.

Check: Collect and analyze data to see whether the intervention works before making it part of ongoing daily operations.

Act: If the new process is effective, make it part of ongoing operations. If the change is an incremental step, continue on to the next step in the subsequent PDCA cycle. If the new process is not effective, use what was learned to design another intervention that will be tested in the next PDCA cycle. The “Act” of one cycle informs, or sometimes becomes, the “Plan” of the next cycle, creating a continuous process of improvement.

OMH has worked with participating clinics around the state to identify key processes that have contributed to positive outcomes, and consulted with QI experts to determine the alignment of these best practices with the FOCUS-PDCA model.  For more details about medication-focused quality improvement and the FOCUS-PDCA model, please review Implementing CQI Projects in the CQI Handbook.  This chapter provides an overview of the model, a step-by-step explanation of the best practices associated with the PDCA cycles, and examples of how a large agency and a small agency might implement the PSYCKES project using the PDCA model.

The CQI Handbook was developed for staff in freestanding mental health clinics participating in the PSYCKES-CQI Initiative.  However, much of the content is relevant across settings. 

Comments or questions about the information on this page can be directed to the PSYCKES Team.