Plan−Do−Study−Act! Using the PDSA Cycle to Improve Your Performance Improvement Projects March 18, 2014 Presenter: Christi Melendez, RN, CPHQ Associate Director, Performance Improvement Projects Health Services Advisory Group, Inc.

Performance Improvement Principle Your current systems and improvement strategies have resulted in your current outcomes. What you’re doing is getting you the results you have. To GET different results, you have to DO something different.

What changes can you make that will Selecting Changes While all changes do not lead to improvement, all improvement requires change. What changes can you make that will result in improvement?

PDSA Cycle

Identifying Barriers Conduct an initial barrier analysis to identify possible barriers. Brainstorming and the “Five Whys” Fishbone Diagram Key Driver Diagram

Prioritizing Barriers Request data related to identified barriers. Evaluate whether data support barriers’ relevance. Rank barriers—from highest to lowest priority.

Development of Interventions Plan Interventions Development of Interventions Avoid “Passive” Interventions Mailers Reminder letters Newsletter articles Postcards, flyers, and brochures Updating Web site/portals Robot calls

Plan Interventions (cont.) Develop “Active” intervention(s) that directly address prioritized barriers and will impact indicator outcomes. Face-to-face education efforts (enrollee and provider) Outreach events—“boots on the ground” Policy/process changes Performance report cards Incentive programs (enrollee and provider)

PDSA Cycle Develop a strategy to implement the interventions. Develop a plan to test the intervention (Who? What? When? Where? What data need to be collected?)

It’s better to do a few interventions well! PDSA Cycle (cont.) Try the intervention on a small scale. Carry out the intervention as designed. It’s better to do a few interventions well!

PDSA Cycle (cont.) Evaluate the effectiveness of the intervention. Analyze your results. What did you learn? What were the results compared to your prediction?

PDSA Cycle (cont.) Use what you learned from the evaluation/analysis. Refine or revise. Determine next steps. If successful, how will the intervention be rolled out on a larger scale? If unsuccessful, repeat the cycle.

What It Takes to Get Improvement Improvement will not happen without these components: Will Ideas Execution

Setting Goals What are you trying to accomplish? The goal should be “S-M-A-R-T”. Specific Measurable Attainable Relevant Time-bound

Important Dates DATE TASK March 21, 2014 Non-clinical PIP topics due to the Agency for Health Care Administration (AHCA) contract managers May 20, 2014 Quarterly Meeting—Tallahassee May 21, 2014 On-site, one-on-one technical assistance, as requested August 1, 2014 PIPs due to AHCA with first six activities completed (Study Design)

Questions