© 2013 American College of Cardiology Quality Improvement in Action: Using the FOCUS-PDSA Method to Conduct a QI Project November 22, 2003 © 2013 American College of Cardiology

© 2013 American College of Cardiology Learning Objectives After viewing this presentation, you will be able to: State each step of the FOCUS-PDSA method Draft a QI project plan Build a QI project team Conduct a QI project step-by-step © 2013 American College of Cardiology

Getting started can feel like… Who’s in charge? Are we there yet? Haven’t we done this before? By going step-by-step, you can make sense of your QI project © 2013 American College of Cardiology

© 2013 American College of Cardiology FOCUS-PDSA Method Find a problem Organize a team Clarify the problem Understand the problem Select an intervention © 2013 American College of Cardiology

Commonly Used QI Tools* Stakeholder analysis Brainstorming Dot voting Prioritization matrix Flow chart Root cause analysis * Refer to the “QI Tool Box” for details © 2013 American College of Cardiology

Step 1. Find a Process to Improve Assemble QI project team Identify potential problems Identify primary stakeholders Select specific problems to improve Draft a problem statement Develop a project charter © 2013 American College of Cardiology

© 2013 American College of Cardiology Step 2. Organize a Team Form project team Select a team leader and facilitator Conduct kick-off meeting Helpful hint: Make sure your team includes a representative of everyone affected by your QI problem © 2013 American College of Cardiology

Step 3. Clarify Current Knowledge of the Process Develop understanding of situation Establish measurement process Collect data Helpful hint: Use a flow chart to document what is actually going on © 2013 American College of Cardiology

Step 4. Understand Process Variation Graphically present data Identify patterns of variation Identify sources of variation Helpful hint: Use a fishbone diagram or another root cause analysis tool to figure out the cause(s) of the problem © 2013 American College of Cardiology

Step 5. Select the Intervention Identify potential interventions Prioritize potential interventions Helpful hint: Your team should brainstorm all the possible solutions to your QI problem and vote to pick one © 2013 American College of Cardiology

FOCUS-PDSA Method Plan Act Study Do Implement the intervention and determine its success © 2013 American College of Cardiology 11

Step 6. Plan How to Implement Develop clear objectives Develop implementation plan Make a prediction about the impact Determine data and assess impact Plan the test cycle Seek buy-in from key stakeholders © 2013 American College of Cardiology

Step 7. Do – Implement the Plan Test your intervention Document what happens Begin analysis of test data Helpful hint: Test your intervention on a small scale with a few providers or patients...make it simple! © 2013 American College of Cardiology

© 2013 American College of Cardiology Step 8. Study the Results Analyze data Compare the results to your predictions Reflect on what happened Determine if modifications are needed Helpful hint: Look for the unintended consequences to your intervention © 2013 American College of Cardiology

Step 9. Act – Continue or Change Apply the lessons learned Change the project or implement again as-is Prepare a plan for the next test Helpful hint: A lesson learned may be that you need to change your implementation plan or just start over © 2013 American College of Cardiology