Uncertainty is no stranger to higher education and healthcare. Whether sparked by a global pandemic, economic pressure, staffing shortages, or shifting policy landscapes, these moments of instability test the limits of even the most well-functioning systems. They stretch resources thin, fray communication lines, and expose inequities that have long existed below the surface.
Faced with such conditions, many organizations understandably shift into survival mode—cutting costs, pausing long-term projects, and narrowing their focus to what feels essential. But amid that urgency, one foundational effort should never be pushed aside: quality improvement.
In fact, during times of disruption, quality improvement is more vital than ever. It provides a structured way to adapt, to learn in real time, and to ensure that patient care doesn’t just continue—it improves. When everything else feels unpredictable, the principles of quality improvement offer a rare kind of stability: a commitment to reflection, measurement, and continuous learning. And perhaps most importantly, they offer a way to move forward thoughtfully instead of reactively.
The vital role of Quality Improvement during times of disruption
Bob Lloyd, a senior fellow in improvement science at IHI, recalled in a recent LinkedIn post that during a period of austerity at his organization, leadership decided to reduce funding for education, library services, and the quality department areas considered “nonessential” in a crisis. It was a mistake. Within a few months, those services were reinstated, as it became clear that the organization couldn’t function effectively without them. His story is a cautionary tale: pulling back on quality may offer a quick fix, but it weakens the very systems that allow healthcare to respond and recover.
We’ve seen this play out in large and small ways. During the COVID-19 pandemic, health systems that already had strong quality improvement cultures in place were able to respond more quickly and effectively. They used real-time data to understand where gaps were emerging. They adjusted workflows on the fly. They empowered frontline staff to test and implement changes that worked in their local context. These were not acts of heroism alone. They were the result of disciplined quality processes applied under pressure.
One of the clearest voices on this topic, psychiatrist and quality leader Dr. Amar Shah, described in a 2021 article in BMJ how QI methods helped many UK healthcare organizations navigate the pandemic more adaptively than they might have otherwise. Even amid chaos, they were able to use tools like rapid-cycle testing and daily data tracking to improve PPE distribution, staff training, and virtual care delivery. Shah persuasively argues that QI isn’t just a method for steady times; it’s what allows healthcare to operate safely and equitably when conditions are anything but steady.
Quality improvement, a foundation for resilience
The benefits of quality improvement go beyond operational resilience. During crises, the focus can easily shift inward—toward logistics, supply chains, and workforce challenges. However, quality improvement keeps patients at the center. It asks: Are we still delivering care safely? Are our outcomes slipping? Are some communities being left behind in our response? These are the questions QI equips us to answer.
And there’s a cultural dimension too. Organizations that prioritize quality improvement build a shared language across disciplines—creating alignment, reducing blame, and empowering teams to solve problems together. That sense of collective purpose is essential when teams are under strain. It keeps people connected to the mission, even when the road is uncertain.
Of course, maintaining a focus on quality during hard times isn’t easy. It requires leadership that values learning, even when the temptation is to retreat. It means protecting quality teams from budget cuts, making space for reflection even in a sprint, and trusting that the slow work of improvement pays off—especially when the pressure is high.
If we’ve learned anything over the past few years, it’s that we can’t predict every challenge that’s coming. But we can build systems ready to respond—systems grounded in evidence, committed to equity, and designed to learn. Quality improvement is not just a tool for better outcomes. It’s a foundation for resilience.
In uncertain times, it’s not something to cut. It’s what we should lean on most.
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