Quality Education for a Healthier Scotland Scottish Improvement Skills Prioritisation

System of Profound Knowledge Deming 2000

Quality Education for a Healthier Scotland Prioritisation By the end of this session you will be able to: use a 2 x 2 matrix (eg Difficulty vs Impact) to prioritise change ideas or drivers Identify opportunities to use Pareto charts, and analyse Pareto charts to generate and prioritise change ideas.

Prioritisation Impact/difficulty matrix Pareto chart

Prioritisation Impact/difficulty matrix Pareto chart

Matrix: impact vs difficulty Impact High Low EasyHard Difficulty

Driver diagram Aim A new healthier me! Lose 7 pounds by end July 2015 Calories in Calories out Leisure activity Calories in meals Calories in drinks Calories in alcohol Work activity Calories in snacks No alcohol Monday to Thursday Max 1 x juice or soft drink per day Reduce portion size Cook evening meals from scratch Replace biscuits/cakes with fruit Keep to shopping list Get up from desk to talk, instead of phone or Use stairs not lift Walk to a daily step target Swim at least twice a week 1  Driver 2  Driver Change ideas

New, healthier me! Impact High Low EasyHard Difficulty Cook from scratch

New, healthier me! Impact High Low EasyHard Difficulty Cook from scratch Reduce portion size

New, healthier me! Impact High Low EasyHard Difficulty Cook from scratch Reduce portion size Keep to shopping list

New, healthier me! Impact High Low EasyHard Difficulty Cook from scratch Reduce portion size Keep to shopping list Replace biscuits with fruit

New, healthier me! Impact High Low EasyHard Difficulty Cook from scratch Reduce portion size Keep to shopping list Replace biscuits with fruit 1 soft drink / day No alcohol Mon – Thurs

New, healthier me! Impact High Low EasyHard Difficulty Cook from scratch Reduce portion size Keep to shopping list Replace biscuits with fruit 1 soft drink / day No alcohol Mon – Thurs Swim twice / week

New, healthier me! Impact High Low EasyHard Difficulty Cook from scratch Reduce portion size Keep to shopping list Replace biscuits with fruit 1 soft drink / day No alcohol Mon – Thurs Swim twice / week Increase steps

New, healthier me! Impact High Low EasyHard Difficulty Cook from scratch Reduce portion size Keep to shopping list Replace biscuits with fruit 1 soft drink / day No alcohol Mon – Thurs Swim twice / week Increase steps Use stairs at work

Matrix: impact vs difficulty Impact High Low EasyHard Difficulty

Prioritisation Impact/difficulty matrix Pareto chart

What is a Pareto chart? 80:20

When to use a Pareto chart When you can categorise items that have the potential to contribute to the improvement you are considering When you want to analyse data about the frequency of problems

Access to primary care

Primary care practice X: reasons given by patients for not attending

ReasonsNumber%cumulative % Unable to contact to cancel3524% Forgot2618%43% Unaware of appointment2316%59% Confusion about appointment time1913%72% Inconvenient day128%80% Other96%87% Unwell64%91% Inconvenient time43%94% No value in appointment43%97% Working32%99% No transport11%99% Unable to afford time off work11%100% Total143100%

Primary care practice X: reasons given by patients for not attending

Central Hospital Ward F: Percentage of meals returned, by meal type (2013)

Ward X: Adverse drug events - causes

Hospital X: SAB cases by ward (SAB = Staphylococcus aureus bacteraemia)

When to use a Pareto chart When you can categorise items that have the potential to contribute to the improvement you are considering When you want to analyse data about the frequency of problems When you have at least 30 observations across the categories (vertical axis) Consider: measure, period, existing data

Pareto chart examples 1.For this project, what data could a Pareto chart be used with? 2.Which driver(s) or change idea(s) is this Pareto chart related to? 3.Which categories would you focus your improvement efforts on? 4.What action would you take based on this chart?

Project work: prioritise Would a Pareto chart be useful for your project? If so, what data would you need, and how could you get it? Use the Impact vs Difficulty matrix to identify your top priority for change.

Prioritisation: summary Impact/difficulty matrix Pareto chart

Quality Education for a Healthier Scotland References and further resources Pareto chart ParetoDiagram.aspx