How to maintain momentum in a healthcare QI project

To maintain momentum in a QI project, give the team a manageable next test, protected time to do it and a regular review that turns evidence into decisions. Make responsibilities visible, resolve blockers early and recognise useful learning as well as improved results.

Momentum means continuing to learn and act towards the aim. A busy meeting schedule or a long list of completed tasks does not necessarily show that the service is improving. This guide is part of our series on running a successful QI project.

Why do QI projects lose momentum?

Common warning signs include repeatedly postponed tests, out-of-date measures, actions with no owner and meetings that revisit the same unresolved issue. Before asking people to be more motivated, find out what is making progress difficult.

The cause may be an unclear aim, an oversized test, missing data, competing priorities or a decision the team cannot make itself. A project that relies on spare time and one enthusiastic individual is especially vulnerable when workload changes.

1. Reconnect the work to a clear, useful aim

Start the review by stating the problem, who experiences it and the result the team is trying to achieve. Ask whether the aim still matters and whether the current test offers a plausible route towards it.

Invite staff and patient partners to explain what they are seeing. If priorities or conditions have changed, discuss the implications with the sponsor. Document any revision to the aim statement, scope or timescale rather than quietly moving the goalposts.

2. Keep the next step small enough to complete

“Improve clinic preparation” is too broad to assign as an action. “Test the revised room-readiness checklist with one colleague at next Tuesday’s clinic” gives the team a concrete next step.

Use the learning from the previous PDSA cycle to choose the next question. Limit work in progress to what the team can realistically complete and review. Starting several new ideas while earlier tests remain unstudied creates activity without a clear learning trail.

Keep an overall timetable with decision points, but allow the detail of future tests to evolve. The IHI’s QI Project Management tool includes strategies for keeping a project’s pace and focusing on learning.

3. Protect time and clarify responsibility

Agree with operational managers when collection, testing and review will happen. Be specific about the work involved; a general promise of support may not translate into time on the rota.

Every action needs one accountable owner, an agreed due date and a clear description of completion. Others can help, but avoid assigning an action to “the team”. Identify cover for essential tasks and keep the project record accessible when people are away.

If the available capacity cannot support the plan, reduce the scope or escalate the resource decision. Repeatedly carrying overdue actions forward does not solve a capacity problem.

4. Run short reviews that end in decisions

Choose a review frequency that fits the pace of your tests and the availability of useful data. A short weekly review may suit a weekly clinic; other projects need a different rhythm.

A practical 20-minute agenda could be:

1. Purpose and context - 2 minutes: confirm the aim and any changes affecting the work.
2. Evidence and learning - 6 minutes: review measures, test observations and patient or staff feedback.
3. Actions and blockers - 5 minutes: identify what is complete, what is stuck and what decision is needed.
4. Next test - 5 minutes: agree the question, owner, timing and observations.
5. Recap - 2 minutes: confirm decisions, escalation and the next review.

This is a suggested agenda, not a required formula. Send the chart and short update beforehand where practical. Keep a decision log so absent colleagues can see what changed and why.

5. Escalate blockers with a specific request

Distinguish something the team can resolve from something requiring sponsor or operational authority. A useful escalation names the problem, its effect on the project, the options and the decision needed by a date.

For example: “The next test needs access to the preparation room before the clinic opens. Without it, we cannot test the revised sequence. Please confirm an access arrangement or agree a different test setting before Monday.”

Use sponsor reviews to obtain help, not simply report a traffic-light status. The IHI’s guidance on executive project reviews focuses on diagnosing problems and helping projects succeed.

Healthcare example: restarting a stalled outpatient project

This is a hypothetical scenario, not a report of achieved results. An outpatient team has postponed its preparation-checklist test twice. Its meetings keep ending with “try again next week”, while the data lead is struggling to obtain the latest waiting-time extract.

At a reset review, the team separates the two problems. The checklist is too long to use during the available preparation time, and the extract depends on a colleague who is away.

The team agrees to test only the essential readiness items in one room. The clinic manager arranges time for one colleague to take part, while the data lead and backup agree a repeatable extraction process with the data owner. The next review is booked after the clinic.

The project update records the revised test, the unresolved data limitation and the owners of both actions. The team can now assess whether the reset helps; it does not label the project successful merely because a new plan exists.

6. Communicate what each audience needs

Keep one current project record and tailor the update:

• Core team: next test, observations, actions and decisions.
• Wider staff: what is changing, when, how it affects their work and how to give feedback.
• Patient partners: what has been learned, how their input influenced the work and what needs their view next.
• Sponsor: progress towards the aim, risks and the specific support needed.

Use a channel people already check. More messages will not help if the important decision is buried among repeated status reports.

7. Recognise learning without overstating results

Thank people for identifying a problem, making collection easier or explaining why a test did not work. Be specific about the contribution and include staff whose work is less visible.

Distinguish a milestone from an outcome: completing a first test is worth acknowledging, but it does not demonstrate sustained improvement. Share promising results with their timeframe and limitations, alongside what remains to be learned.

When should a QI project pause or change direction?

Consider a deliberate pause or reset when essential capacity is unavailable, the aim is no longer relevant, data cannot answer the question or tests reveal that the proposed approach is unsuitable. Agree the decision with the sponsor and those responsible for the service.

Record the reason, the owner of any remaining work and the conditions for restarting. If the project will not resume, use a clear close-out process so the learning and outstanding responsibilities are preserved.

Project review and action-log template

Use a short review record with the date, aim, latest evidence, learning, decisions, blockers, next test and next review. For each action, record its owner, due date, status and evidence of completion.

Download the QI project review pack for an editable review agenda, action log and blocker tracker with a completed healthcare example.

Frequently asked questions

How often should a QI team meet?

Often enough to review useful observations and make the next decision. Match the rhythm to the tests and the service. If meetings repeatedly have no new evidence or decision, review the collection and testing plan.

What if only one person is doing the work?

Revisit the team’s roles and responsibilities, agree realistic contributions and raise capacity gaps with the sponsor. Reduce the scope if the current plan depends on effort the team cannot sustain.

How do we know when to move from testing to implementation?

Review whether the change is useful and workable under relevant conditions, whether unintended effects are acceptable and whether there is an owner and a plan for routine use. See how to implement and sustain QI changes.

Make the next decision visible

Use Simana’s project management tools to organise improvement work, and collaboration tools to keep discussion connected to the project. Start by agreeing the next test and the review that will follow it.