PDSA: Plan, Do, Act, Study Marsha Spence, PhD, MPH, RDN, LDN Department of Nutrition Public Health Nutrition Graduate Program

Overview Continuous Quality Improvement (CQI) Performance Management Plan, Do, Act, Study (PDSA) Health Happens! CQI Strategies Health Happens! Parent Recruitment PDSA Conclusion

Continuous Quality Improvement (CQI) Deliberate and defined process Continuous and ongoing effort Seeks to achieve measurable improvement Goal is to improve: efficiency, effectiveness, performance, accountability, outcomes

Performance Management Looks at data/processes for CQI Sets objectives Measures objectives Reports progress toward objectives, Engages in specific activities when objectives aren’t being met

Minnesota Department of Health Minnesota Department of Health. Quality Improvement and Performance Management. Available at: http://www.health.state.mn.us/divs/opi/qi/

PDSA: Plan, Do, Act, Study One of many CQI strategies Focuses on improvement in a specific area or process Deming Wheel/Deming Cycle

Sutton G. The Model for Improvement. Education Scotland. Analyze data Compare to predictions Summarize Sutton G. The Model for Improvement. Education Scotland. http://www.educationscotland.gov.uk/earlyyearsmatters/t/genericcontent_tcm4829102.asp

Health Happens! CQI Techniques Weekly meetings Round-robin sharing of what worked and what didn’t work Teacher In-Service Parent Meetings Child Nutrition/Physical Activity Education Brainstorming ideas for improvement (formal and informal sessions) Discussing alternatives Maintaining minutes on file

Health Happens! Parent Recruitment PDSA Cycles Plan Incentives: food, prizes and free childcare Do Directors were in charge of notifying parents about the meetings Study 6-7 parents/meeting at first childcare center 2-3 parents/meeting thereafter Act New Strategy: Basic flyers were given to directors to give to parents

Plan Do Study Act Incentives: food, prizes and free childcare Basic flyers were given to directors to give to parents Do Basic flyers were distributed Study No change in parent attendance Act New Strategy: Enhanced flyers will be given to directors to distribute to parents and hang on the door

Plan Do Study Act Incentives: food, prizes and free childcare Enhanced flyers were given to directors to give to parents and to post Do Enhanced flyers were distributed and posted Study No change in parent attendance Act New Strategy: Professionally developed flyers will be put in backpacks or “home” folders of children

Plan Incentives: food, prizes and free childcare Professionally developed flyers were placed in children’s backpacks or “home” folders Do Professionally developed flyers were distributed and posted Study No change in parent attendance Act New Strategy: Health Happens! staff will wear fruit and vegetable costumes and distribute professional flyers to parents during the afternoon pick-up the day before meeting

Plan Do Incentives: food, prizes and free childcare Health Happens! staff will wear fruit and vegetable costumes and distribute professional flyers to parents during the afternoon pick-up the day before meeting Do Staff distributed professional flyers to parents at afternoon pick-up Study No change in parent attendance Act New Strategy: Professional posters that advertise the meetings will be made and displayed at the childcare center, plus staff will distribute flyers at pick-up day before meeting

Plan Do Study Act Incentives: food, prizes and free childcare Health Happens! staff will distribute professional flyers to parents during pick-up day before meeting Posters will be displayed Do Staff distributed professional flyers to parents at afternoon pick-up and hung posters Study No change in parent attendance Act New Strategy: Professional posters that advertise the meetings will be made and displayed at the childcare center, plus staff (in costumes) will distribute flyers at pick-up the afternoon before and the morning of the meetings. These cycles continued with

Additional Cycles Fruit and vegetable characters distributed flyers 2-3 days before, the afternoon before, and the morning of the meetings Created sailor hats for the preschoolers with the flier attached as the feather Created social media campaign (Twitter and Facebook) Sent emails and texts to parents who provided permission to remind them about the meetings. Contacted churches within a 5-10 mile radius of the childcare center and informed them of the parent meeting. Meetings announced at church services and was in church bulletins. Partnered with schools and community centers to advertise and hold meetings Yard signs that advertised the meetings were placed in yards of childcare centers; Stickers that said “Health Happens Parent Meeting Tonight” were given to the preschoolers

Final Cycles At one center, held meeting in conjunction with “parent-child snack day”; parent attendance was high, but could not be duplicated. Due to inclement weather, created videos for each parent meeting lesson; provided flyer with link and QR code to the school. Requested that parents sign and return “attendance” slip to childcare teacher to indicate that they had watched the video. 12 parents watched the first video 17 watched the second video

Next Cycle to Begin August 2015 Plan Incentives: food, prizes and free childcare for first and last meeting; drawing for grand prize based on attendance (including virtual attendance) Health Happens! staff will distribute professional flyers with links and QR codes to directors to distribute to parents Posters and yard signs will be displayed to advertise onsite classes and online videos Videos will be professionally produced using “Captivate” Attendance will be recorded by “attendance slips” and online monitoring of video site. These cycles continued with

Conclusion Continuous Quality Improvement strategies should be planned into program implementation to strengthen program components PDSA cycles can be used to frame weekly meetings: Plan: What will happen if we try something new? Do: Do it! Study: Did it work? Act: What’s next?

Questions?

Funding for Health Happens Funding for Health Happens! provided by grants from Blue Cross Blue Shield of Tennessee and East Tennessee Children’s Hospital Foundation