@SAFE_QI Chapter 1 Introducing Quality Improvement

@SAFE_QI Chapter 1: Introducing Quality Improvement S.A.F.E uses quality improvement (QI) as a core methodology. This chapter will focus on understand QI methods.

@SAFE_QI Resources Plan Do Study Act Checklist and Log Driver Diagram Measurement Plan Stakeholder Map

@SAFE_QI Domains of Quality CROSSING THE QUALITY CHASM: A New Health System for the 21st Century INSTITUTE OF MEDICINE NATIONAL ACADEMY PRESS Person centred What matters to me Safe Do we harm patients? Effective Do we give the right treatment every time all the time? Equitable Are the services and outcomes equal for all Timely Is there good access? Efficient Do we get value?

@SAFE_QI What is Quality Improvement? Quality Improvement can be defined 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” Batalden and Davidoff

@SAFE_QI Deming System where you work Variation in the system Psychology - the people Theory of knowledge Deming’s Profound Knowledge

@SAFE_QI Staff PatientsPerformance Leadership Strong LeadershipGreat Organizational SupportFocus on Staff (Professionals)Education and Training of StaffInterdependence of Care Team Performance Result FocusedProcess Improvement FocusedPatient-Centered (Patient Focus) Community and Market FocusInformation & Information Technology Orientation Reference Nelson et al 2008 Reference Dartmouth Microsystems

@SAFE_QI Theory Method SystemsVariation Psychology Theory of knowledge Measure Theory to method to measurement

@SAFE_QI The Model for Improvement What are we trying to accomplish? How will we know if the change is improvement? What changes can we make that will result in improvement? PlanDo StudyAct

@SAFE_QI The individual Clinical skills Self management Personal development Clinical Micro system Individual team and patient Where improvement takes place Meso system Supports micro system Macro organisation Connects meso systems and micro systems Network district regional Whole patient journey Across organisations Change in the Microsystem

@SAFE_QI Purpose - Our aim and mission.Patients - Our reason for doing our work. People - Our staff who take care of patients. Processes - Our interrelated process that make up the micro system. Patterns – The way we work and measure what we do (Measurements, Data, Run Charts) Reference Dartmouth 5 Ps to Assess Improvement in a Microsystem

@SAFE_QI Model for Improvement The PDSA Cycle What change can we make that will result in an improvement ? Langley Nolan et al. The Improvement Guide: A Practical Approach to Enhancing Organizational Performance, 2nd Edition April 2009, Jossey-Bass P 89

@SAFE_QI Where to start? Define area for change Set aims Establish measures Test changes Implement changes

@SAFE_QI S.A.F.E Driver Diagram

@SAFE_QI PDSA Paper Aeroplane Activity Quality Improvement in Action Aim: Design a paper plan that will fly the furthest distance Think of the areas you need to consider: Design Construction Measurement Run your tests a few times: What are you learning? How will you factor your learning into the next test? Did your change result in improvement ?

@SAFE_QI Spreading Change through Collaboration The success of S.A.F.E has been in establishing, encouraging, and supporting networks to share learning, experiences, and ultimately, change. What networks can you engage with to help spread your improvements?