CQI activities

💡 Use this page to turn your gout mahi into a quality improvement (CQI) project that counts. Pick a ready-made activity, measure a few things that matter, and use the results to improve care, especially for whānau Māori and Pacific peoples. Everything here can count towards your CPD and practice accreditation.

Why run a gout CQI project?

Gout is common, serious and very treatable, yet too many whānau Māori and Pacific peoples are not on regular prevention medicine. A small, focused improvement project is one of the most practical ways to close that gap, and the work you are already doing through this Guide can count towards:

Your CPD (for GPs, the RNZCGP Te Whanake programme): both audit of practice and peer review activities.
Cornerstone practice accreditation: the continuous quality improvement module.
Foundation Standard criteria.

Start here: pick a ready-made activity

You don't have to design a project from scratch. Choose one of these and you're underway.

▶ 1. Run the BPAC gout audit (easiest start)

▶ 2. Set a baseline with the EPiC gout dashboard

▶ 3. Hold a peer group discussion on gout

▶ 4. Run a PDSA cycle on proactive recall

What to measure (with an equity lens)

Choose two or three measures and always break them down by ethnicity, so you can see whether the gap is closing. Most can be drawn from your PMS, PHO reports or the EPiC dashboard.

Measure	What good looks like
Māori and Pacific patients with gout dispensed regular urate-lowering therapy in the last 6 months	Increasing
Patients with gout at target serum urate (< 0.36 mmol/L, or < 0.30 mmol/L with tophi)	Increasing
Patients started on flare prophylaxis when beginning urate-lowering therapy	Increasing
Patients with a serum urate test in the last 12 months	Increasing
The gap between Māori and Pacific patients and others on the measures above	Narrowing

Use a simple improvement method

Most gout CQI work uses the Model for Improvement (Institute for Healthcare Improvement), which asks three questions:

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What are we trying to accomplish?
How will we know a change is an improvement?
What change can we make that will lead to improvement? </aside>

Then test changes in small Plan, Do, Study, Act (PDSA) cycles. Start small, learn fast, and build what works into everyday practice.

Address the drivers of gout inequity

PHARMAC describes five drivers of inequitable medicine access. Use them as a checklist for your project, and ask: what can our team do about each one?

Driver	What it means	What your team can do
Availability	Is the medicine funded and in stock?	Keep allopurinol scripts current; partner with community pharmacy (CPGMS) for supply and titration
Accessibility	Can people reach care and testing?	Point-of-care urate testing, extended hours, virtual and home visits, proactive contact
Affordability	Can people afford visits and scripts?	Free or subsidised visits, Community Services Card pricing, funded blister packs
Acceptability	Is care culturally safe and trusted?	Whānau-centred care; kaiāwhina and health coaches; counter blame and stigma using the key messages
Appropriateness	Is the right treatment given well?	Treat to target, titrate the dose, prescribe flare prophylaxis when starting, follow up

Source: Achieving medicine access equity in Aotearoa New Zealand: towards a theory of change. PHARMAC, 2019.

Tools and templates

He Ako Hiringa CQI Toolkit – an Activity Guide, Data Collection Form and Information Sheet. It uses antimicrobial stewardship as the worked example, but the templates adapt easily to a gout project.
EPiC gout dashboard – baseline and re-measure (see above).
BPAC gout audit and peer group discussion (see above).
Your PHO – ask your PHO or Health NZ contact for help with query builds, data and project support.

Make it stick, and celebrate

Build the change into business as usual: recall systems, standing processes, shared care with pharmacy.
Share your results with the team and your community, and celebrate the wins. Reflect on why an approach worked (the "5 whys" is a simple tool).
Re-measure to confirm the improvement has held.

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About the Gout Guide

A practical guide for primary care teams in Aotearoa New Zealand, focused on equitable gout care for whānau Māori and Pacific peoples. For sources and the team behind it, see the References and About & Contact pages.

Spotted something out of date, or have feedback? We'd love to hear it, email [email protected]. We review content regularly and welcome corrections.

Brought to you by Health Literacy NZ and **Health Navigator Charitable Trust which provides the Healthify He Puna Waiora website.** This Gout Guide website builds on the ProCare Gout Collaborative and Whanganui GOUT STOP programme.

Healthify He Puna Waiora is a charitable trust. Support our mahi to keep trusted health information free.

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Last reviewed: 12 June 2026 · Next review due: June 2028 · Reviewer: Dr Janine Bycroft, GP and Clinical Director, Healthify He Puna Waiora