Original ArticlesImplementing a 4C Approach to Quality ImprovementMcGonigal, Michelle DNP, RNAuthor Information Allegheny General Hospital, Allegheny Health Network, Pittsburgh, Pennsylvania. Correspondence: Michelle McGonigal, DNP, RN, Allegheny General Hospital, Allegheny Health Network, 320 East North Ave, 12th floor South Tower, Pittsburgh PA, 15212 ([email protected]). The author has disclosed that she has no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Critical Care Nursing Quarterly: January/March 2017 - Volume 40 - Issue 1 - p 3-7 doi: 10.1097/CNQ.0000000000000134 Buy Metrics Abstract Designing a quality improvement activity can be labor intensive and intimidating to facilitators who have not been specially trained in process improvement methodologies. To simplify the process, a team was formed with the specific task of developing a basic model that addresses key concepts in change theory. The 2010 Institute of Medicine report stresses the importance of health care professionals working together, collaboratively, to use data to improve patient outcomes and improve care nationally. In addition, as noted in Quality and Safety Education for Nurses (2013), competencies have been developed to promote frontline problem solving including using data for quality improvement, providing safe care, functioning in collaborative teams, respecting and addressing patient and family concerns, applying evidence-based practice, and using informatics to make decisions. The team completed a search of the literature on change theory to identify the factors that are imperative to address when initiating a process improvement cycle. Kotter's Model of Change provided direction and guidance on the creation of the 4C model, which involves centering on issue, collaborating with team members, using the change process, and celebrating successes. This model has been implemented in a multihospital system as a framework for process improvement with such initiatives as preventing hospital-acquired infections, implementing patient safety initiatives, and addressing human resource concerns such as turnover and patient satisfaction. © 2017 Wolters Kluwer Health, Inc. All rights reserved.