Please ensure Javascript is enabled for purposes of website accessibility Skip to main content

National Healthcare Quality Week: We Are All Quality Improvement Leaders

National Healthcare Quality Week, celebrated from October 15th to 21st, is an opportunity to embrace the fact that every one of us has the potential to be a quality and process improvement champion. Process enhancement stands as a cornerstone in the realm of healthcare quality endeavors, and it’s a superpower we all share. Whether you’re someone who welcomes change or someone who prefers the tried-and-true, the ability to drive process improvement unites us all, weaving a common thread that binds our health care community and beyond.

Starting January 1, 2022, Colorado businesses were required to start charging consumers a 10-cent fee for each plastic and paper bag they carry out of the store. Almost two years have passed since this bill came into effect, and consumers have adapted and changed their processes to bring reusable bags into stores or suffered the cost of forgetting.

For consumers who had not previously brought personal bags into the grocery store the new law encouraged a shift in behavior. Instead of shoppers solely focusing on their grocery list with a head full of vegetables and dairy to pick up, they needed to also remember to bring reusable bags. Over time, through trial and error, individuals came up with various techniques to improve their process of remembering to bring bags into the store. Most people gradually adapted their habits by implementing changes in their routines that increased the likelihood of remembering bags for the store perhaps by using a reminder on their smartphone, by designating a bag spot near the car keys or by pairing the new habit of remembering bags with an old habit of creating a grocery list.

This process is a way of continuously assessing the possibility and potential impact of scenarios (forgetting bags and having to pay), strategizing improvement opportunities (setting a reminder on your phone) and examining outcomes (reflecting on how trials of remembering bags worked). In process improvement, this cognitive framework is formally called a Plan-Do-Study-Act (PSDA) analysis, which is a model for continuous process improvement that you probably do regularly without even realizing it.

To provide context, here is a PDSA analysis applied to the habit development of consistently bringing reusable bags into the grocery store.


The planning phase started with the introduction of the new law in Colorado which required businesses to charge a fee for a plastic bag.

Consumers needed to adapt their behavior by bringing reusable bags to avoid paying for disposable bags and hence create a plan on how to do this.


In this phase, people started to execute the reminder techniques used to remember to bring bags into the car and into the store.

Some individuals initially paid the fee while others were “early adapters.”


The study phase involved observing the outcomes of the new reminder techniques and behaviors and analyzing the results.

Patterns of adaptation emerged as people tested different strategies to remember their bags.


Based on the outcome of new behaviors further and feedback, individuals took actions to refine their approach (increase behaviors that are found to have worked).


This widespread adaptation reflects process improvement as individuals responded to changes in bag fees, learned from their experiences, and adjusted their behavior and practices over time to achieve their desired goals. Similarly, within health care, we are constantly striving to improve the way we work and deliver care to individuals through process improvements like avoiding cost and increasing efficiency.

As we celebrate National Healthcare Quality Week, we take the opportunity to recognize and appreciate the relentless efforts made in the pursuit of better health care and improved patient outcomes. We pay tribute to the unwavering dedication of health care professionals who persistently work towards enhancing the health of patients, their colleagues, and themselves. This week also offers us the chance to acknowledge and celebrate the inherent potential for process improvement that resides in each of us.