Table 1.

Stages and tools in the A-TEAM model

Stage	Meaning—the team uses QI tools to:	Tools
Agree on care or service to improve, the objective/s of the QI project and stakeholders to involve	Agree by consensus as a team the subject, objective/s and stakeholders for a QI project	Structured brainstorming Consensus-building tools including nominal group process, Delphi process and multivoting Affinity diagram
Test the team’s and stakeholders’ commitment to the QI project	Identify the benefits and barriers the team may experience in carrying out the QI project, and ensure they—and key stakeholders—are committed to it	Stakeholder analysis Force-field analysis
Establish a baseline by describing or measuring the way things work now and the effects of current practice	Learn exactly how patient care is delivered now and quantitatively or qualitatively measure the effects of current practice on patients, staff or others	Clinical 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 practice	Identify the problems impeding quality care and their root causes, and implement changes to address the problems and achieve desired improvements	Root 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 others	Repeat measurement of the way things work and compare the findings with baseline measurement to see if intended improvements have been achieved	Repeat 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.