Quality Improvement Proposal: Integrated Practice Units (IPUs)

Quality Improvement Proposal: Integrated Practice Units (IPUs)

Problem Overview and Setting

            Despite the hard-working, well-motived, and professionally trained clinicians, the healthcare system is still struggling with the rising cost of care and uneven quality of services. Health policymakers and leaders have attempted several times to reduce errors and enforce healthcare practice guidelines by digitalizing healthcare systems, but the impact is yet to yield a patient-centered system inclined towards patients’ needs. Achieving the best health outcomes at the lowest costs requires the healthcare systems to shift from supply-driven health systems to patient-centered systems of care. Supply-driven health systems are focused on the activities of physicians, while patient-centered systems are value-driven and focus on the needs of patients (Porter & Lee, 2015). Increasing value in the modern healthcare system requires the utilization of integrated systems to establish a patient-driven ending for healthcare clients.

This quality improvement proposal advocates for the introduction and utilization of an integrated practice unit (IPU). An IPU is a patient-centered approach to care that brings together all players (providers) whose services or activities impact a patient. The integrated system organizes itself around a patient and offers a full package of care for a particular medical condition. This includes services such as patient education, rehabilitative care, patient follow-ups, and supportive services. An IPU system in the healthcare setting involves working together in a coordinated style for the purpose of sharing relevant medical information and common goals for bettering patient interventions and outcomes (Colldén & Hellström, 2018). The greatest improvement in healthcare outcomes is said to emanate from a properly defined compendium of medical practices and services. Embracing this strategy for value transformation in a healthcare organization is a road towards ensuring quality improvement and patient-centered outcomes and experiences.

Significance of Quality Improvement Practice and Expected Outcome

            An integrated practice unit has the potential to transform clinician ways of delivering care to patients. This is because the model is organized around clients (patients) and their needs. The process is organized around a patient’s medical condition rather than the traditional organization of healthcare systems in terms of specialty and departments. The IPU structure comprises of a dedicated team of clinical and non-clinical personnel to offer a complete cycle of patients’ treatment and recovery options. IPUs not only treat a specific disease that a patient is suffering from but also a related medical condition or complications that relate to symptoms of their condition (Colldén & Hellström, 2018). The quality improvement method (IPU) in this proposal is important because besides offering medical treatment, it also takes responsibility by engaging patients and their families. This includes guidance and counseling, education, fostering to treatment, and prevention of disease protocols, among other roles.

The IPU team works together to achieve a common agenda, thereby maximizing the overall patient outcome with the highest possible efficiency. The team often comprises of experts that work together with experience, trust, and coordination, which helps to reduce time and resource wasting. The coordinated personnel also help to reduce medical errors by increasing the accuracy and safety of medical procedures. Every team member knows exactly the condition of their clients and interventions that the patients are subjected to for recovery (Porter & Lee, 2015).  The IPU teamwork eliminates the chances of misdiagnosis and wrong medical prescriptions because of the accuracy and information sharing amongst the experts. Correction in case of mistakes can occur easily because an expert in a team can detect and correct a medical error. As such, an integrated health system ensures quality and safety for clients through the coordination of health experts in a healthy environment.

Demonstration of Support from previous research

Previous researchers have already proven the effectiveness of integrated practice units in a healthcare organization. The Harvard Business School affirms that the greatest improvement in healthcare outcome and efficiency is a result of a team-based relationship within sustainably integrated practices and services (Shaw, Rosen & Rumbold, 2016). Michael Porter introduced the concept of value-based agenda in the healthcare setting and defined IPU as a system that combines a full package of providers and staff to address a specific clinical problem or disease (Porter & Lee, 2015). He affirmed the effectiveness of the process of driving improvement across the board for patients and the general healthcare organization. An IPU system has been proven to be effective in healthcare delivery after other approaches to healthcare improvement, such as digital health and medical billing, have failed to attain the highest and expected health outcomes.

Steps Necessary to Implement the Quality Improvement Initiative

            Implementing an IPU quality improvement initiative begins by communicating the need for a value-based, patient-centered approach in the organization. This stage of implementing quality in a healthcare organization is conducted by the healthcare administrator within the organization. The need for change from traditional approaches to care systems to modern value bases systems such as IPUs should be communicated exclusively to create need and acceptance for the change. The second step of introducing the quality improvement initiative is to bring together a multidisciplinary team of healthcare and non-clinical professionals (Porter & Lee, 2015). The team shall be made aware of the need for change and the importance of bringing together their expertise. The multidisciplinary team shall comprise of representatives and individual personnel from every medical professional and process to collaborate in the treatment of patients and addressing other conditions related to the health of patients.

The team created shall elect a physician team captain who shall be leading in care practices and a manager to lead through each practice and process for patient treatment. The team shall be integrated through its leadership, and treatment processes shall be fostered by communication. After coming up with an effective, disciplined, and dedicated team, the next factor is establishing a common platform for relaying information (Shaw, Rosen & Rumbold, 2016). An information system that shall integrate every activity of each team member to the patient shall be created. This will ensure that each team member tracks processes and patient information from whatever location. This will help each team member to be fully aware of the activities of their peers towards ensuring and enhancing patient outcomes.

Evaluation of Quality Improvement

            The effectiveness of the IPU system in improving the quality of healthcare shall be determined by measuring the health outcome and experience of patients after going through treatment processes. A positive outcome from an integrated system shall be realized from the type of results obtained by a team of professionals. Similar and consistent results are an indication of improvement in terms of health diagnosis and treatment. Faster treatment and lower costs shall also serve as an indication of an improved healthcare system. The cost and outcome for every patient ought to reflect value rather than quantity. Evaluating an integrated process in healthcare shall also be achieved by considering patient feedback after treatment. Positive patient feedback is an indication of a properly working system, while negative feedback may suggest that patient experience and outcome did not meet their needs and expectation. Since an integrated system comprises of various experts, patients’ needs, and expectations not met at one point can be fulfilled in the next phase by another expert.

Identification of Variables, statistical tests, and statistical test

            Measuring outcome is important to improve the needs of patients and helps in lowering the costs of care for patients. A study in 2011 in Germany revealed that follow up costs after a hip replacement for patients amounted to 16% in hospitals with above-average outcomes compared to hospitals with outcomes below average. In low volume hospitals where providers possess relatively low experience, the cost is 25% lower. When the measure for an outcome does not consistently measure in health treatments, there is a tendency to lose the most powerful lever to reduce costs (Porter & Lee, 2015). Providers are supposed to know the expected level of outcome through their interventions by measuring the processes and variables incurred in patients’ treatment.


            Quality improvement in healthcare is a fundamental practice that every healthcare organization should engage in regularly to assure patients of value for their money and recovery from their illnesses. Implementing value in healthcare organizations is a teamwork process that aims at ensuring that healthcare organizations are achieving their goals in the most appropriate manner. Healthcare administrators must have the capacity to transform the available health systems to more efficient organizational systems that ensure experience and patient outcomes are attained. This health improvement proposal is going to lay a way forward in determining the best approaches and practices for enhancing safety and quality in a healthcare environment.