Table 1

Stages and tools in the A-TEAM model

StageMeaning—the team uses QI tools to:Tools
Agree on care or service to improve, the objective/s of the QI project and stakeholders to involveAgree by consensus as a team the subject, objective/s and stakeholders for a QI projectStructured brainstorming
Consensus-building tools including nominal group process, Delphi process and multivoting
Affinity diagram
Test the team’s and stakeholders’ commitment to the QI projectIdentify the benefits and barriers the team may experience in carrying out the QI project, and ensure they—and key stakeholders—are committed to itStakeholder analysis
Force-field analysis
Establish a baseline by describing or measuring the way things work now and the effects of current practiceLearn exactly how patient care is delivered now and quantitatively or qualitatively measure the effects of current practice on patients, staff or othersClinical audits of current practice, using evidence-based practice (timing and nature of staff interventions with patients)
Run charts of incidents and complaints
Surveys of staff and carers
Process maps of current practice
Analysis of data on length of stay and number of sedatives administered by Team B
Analyse how things can be improved and act to change practiceIdentify the problems impeding quality care and their root causes, and implement changes to address the problems and achieve desired improvementsRoot cause analysis of problems identified by baseline measurement, including fishbone diagram and asking why five times
Tree or driver diagram
Setting priorities for change interventions
Project planning and management
Measure again to compare the way things work after change and demonstrate benefits to patients or othersRepeat measurement of the way things work and compare the findings with baseline measurement to see if intended improvements have been achievedRepeat clinical audits and surveys
Continuous run charts of incidents and complaints
Continuous capture of data on length of stay and sedatives administered for Team B
  • QI, quality improvement.