Published: 5/2026
Quality improvement and patient safety (QIPS) work in medicine is a powerful process that brings meaningful change to patient care and outcomes. However, it is sometimes challenging to think of the right question to ask. The first step is to identify the problem. Next it is important to align that problem with any relevant institutional, local, or national QI goals. Then you can create your AIM statement, to guide your QIPS project and interventions.
Let’s start with identifying the problem. Problems in patient care can be highlighted in a number of ways including cases discussed at Morbidity and Mortality (M&M) conferences, safety event reports, Root Cause Analyses of adverse outcomes or near misses, Failure Modes and Effects Analyses of new or suboptimal processes, departmental meetings, or any process that frustrates you.
Example 1a: A group of residents is talking about an incident that happened last week when a patient who underwent a cesarean delivery was readmitted with a surgical site infection (SSI). Several of them have noticed an increase in these admissions in the past few months and the challenges they pose. They submit an event report to the hospital reporting system, and a Root Cause Analysis is planned. You acknowledge their frustration, celebrate appropriate reporting of the concern, and determine that this is a big enough patient safety risk to merit a project.
Once you have identified the problem, you should consider how this problem aligns with any institutional, local, or national QIPS goals. Many organizations, such as the Joint Commission, set national standards or quality goals that institutions are required to report for accreditation purposes. Institutions likely have their own quality goals that they are trying to achieve as well. Aligning your question with one of these goals will likely result in improved resources and visible leadership support for the project.
Example 1b: The hospital quality team announces that one of their core quality goals for the upcoming quarter is to reduce SSI. The residents connect with the team that is spearheading this effort. By aligning their project with institutional goals, they can utilize the quality team’s resources for data collection.
Last, you will create your AIM statement. This is a SMART goal that will inform your QIPS intervention. It should be specific, measurable, achievable, relevant, and time bound.
Example 1c: The Root Cause Analysis shows that perioperative antibiotics were delayed in 65% of the cases of SSI readmissions. Using this information, as well as national guidelines for SSI prevention, the residents create the following AIM statement: We aim to increase the number of patients receiving perioperative antibiotics within one hour of incision by 80% in the next 6 months. They then proceed to designing their intervention.
Asking the right question in QIPS work is a critical first step in designing a successful intervention. Remember to identify the problem, align it with local, regional, or national guidelines, and create your AIM statement as a SMART goal.
Additional resources:
- The Joint Commission Perinatal Care Measures. https://www.jointcommission.org/en-us/knowledge-library/support-center/measurement/perinatal-care
- Evidence-Based Principles and Practices for Reducing Surgical Site Infections. The Joint Commission International. 2018. https://digitalassets.jointcommission.org/api/public/content/assets/3/7/jci_ssi_toolkit.pdf