Quality improvement (QI) is not a one-time fix but a sustained, dynamic effort where data-driven insights and multidisciplinary collaboration come together to solve everyday challenges in healthcare systems. One sometimes overlooked ingredient in this complex recipe is communication. Email stands out as it offers a documented, asynchronous, and quickly accessible channel that healthcare teams across departments and geographic locations can rely on to coordinate patient care.
A Journal of the American Medical Informatics Association study on how email is used to improve team communication, “interdisciplinary ICU staff perceived wireless e-mail to improve communication, team relationships, staff satisfaction, and patient care”. This was supported by 92% of staff who said wireless e-mail improved the speed and reliability of communication, 88% believed it improved coordination of ICU team members, and 75% felt it reduced staff frustration. In terms of patient care, 90% agreed it resulted in faster care and 75% believed it led to safer care.
As these workflows consistently handle protected health information (PHI), and unauthorized disclosures can lead to severe harm both to patients and to organizations in terms of legal penalties and trust erosion. This is why HIPAA-compliant email systems are non-negotiable in healthcare settings.
QI is a continuous, data-driven process that seeks immediate enhancements in healthcare delivery by identifying areas for improvement. According to a Johns Hopkins Nursing Inquiry on QI, “a continuous and ongoing effort to achieve measurable improvements in the efficiency, effectiveness, performance, accountability, outcomes, and other indicators of quality in services or processes which achieve equity and improve the health of the community.”
The requirements for QI to be effectively implemented include the establishment of clear objectives, engaging multidisciplinary teams, and applying iterative testing methodologies like the Plan Do Study Act (PDSA) cycle. Through a structured approach based on these components, healthcare organizations can test small-scale changes in real time and assess their impact before wider implementation.
The Institute of Medicine (IOM), now known as the National Academy of Medicine, has established six aims for QI in healthcare. These include safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity. The dimension of safety, defined as avoiding harm to patients from the care intended to help them, is supported by the use of email to reduce communication errors.
Miscommunication among healthcare providers has long been identified as a primary contributor to adverse events. Secure email exchanges allow clinicians to clarify medication orders, share test results swiftly, and confirm treatment plans, reducing the risk of errors caused by missing or delayed information.
These aims align closely with the broader definition of quality improvement discussed in a BMJ Quality & Safety editorial article as “the combined and unceasing efforts of everyone—healthcare professionals, patients and their families, researchers, payers, planners and educators—to make the changes that will lead to better patient outcomes (health), better system performance (care) and better professional development (learning).” Defined in this way, improvement requires that “everyone in healthcare really has two jobs when they come to work every day: to do their work and to improve it.”
Email supports safety through error reduction, effectiveness through consistent application of evidence, patient-centeredness through personalized engagement, timeliness through faster decision-making, efficiency via reduced waste, and equity by enabling broader care access.
When communication flows smoothly, it lifts every aspect of healthcare quality, from preventing harmful errors to speeding up decisions and even empowering patients as partners in their own health journey. Intentional, clear, and secure communication transforms complex healthcare environments into coordinated, responsive, and compassionate systems. Intentional, clear, and secure communication transforms complex healthcare environments into coordinated, responsive, and compassionate systems.
According to the study ‘Quality improvement initiative to improve communication domains of patient satisfaction in a regional community hospital with Six Sigma methodology’, “the combined and unceasing efforts of everyone—healthcare professionals, patients and their families, researchers, payers, planners and educators—to make the changes that will lead to better patient outcomes (health), better system performance (care) and better professional development (learning).” Improvement requires that “everyone in healthcare really has two jobs when they come to work every day: to do their work and to improve it.”
The best treatments and protocols mean little if they aren’t communicated effectively among doctors, nurses, specialists, and patients. It is the glue that holds multidisciplinary teams together, allowing clinicians to share updates. Breakdowns in communication are a leading cause of adverse events, making communication improvement a direct path to better patient safety.
The cycle consists of four sequential phases. Plan, where objectives are set, a change is proposed, and data collection methods are designed; Do, which involves implementing the change on a small scale and collecting relevant data; Study, where the collected data is analyzed and compared against predictions to evaluate the impact of the change; and Act, during which organizations decide whether to adopt, adapt, or abandon the change and plan the next cycle accordingly. The process encourages careful testing, reflection, and refinement before system-wide deployment.
Evidence from a BMJ Open Access study shows that “many of these studies reported application of the PDSA method that failed to accord with primary features of the method,” with “less than 20% (14/73) fully documenting the application of a sequence of iterative cycles” and only “15% (7/47) reporting the use of quantitative data at monthly or more frequent data intervals to inform progression of cycles.” It shows that successful improvement depends not just on using PDSA cycles in name, but on applying them rigorously and systematically.
In the Planning phase, email enables stakeholders to collaborate asynchronously, discuss objectives, share improvement ideas, and distribute protocols or data collection tools efficiently across multidisciplinary teams. This supports early alignment and involvement, helpful for setting clear goals and preparing resources. During the Do phase, HIPAA compliant email specifically serves as a secure channel for implementing planned interventions.
Using an application programming interface offers seamless integration with existing systems.
Email integration with existing healthcare systems typically involves connecting email services with EHR systems or practice management software through APIs or middleware solutions.