Refresher to the IHI Model for Improvement 1/31/2018

Objectives Review the main components of the IHI Model for Improvement Demonstrate how the IHI Model has broad utility for TCPI work Discuss any challenges or barriers to using this with your practices

Why use an “improvement methodology”? “While all changes do not lead to improvement, all improvement requires change.” – IHI A method like the IHI Model provides: A systematic way to approach and drive change A means to discern and discover those changes that lead to improvement A common language for the team to use http://www.ihi.org/resources/Pages/Changes/UsingChangeConceptsforImprovement.aspx

IHI Model for Improvement Three planning questions The P-D-S-A Cycle

IHI Model for Improvement Aims In your experience, what is the default for change in the practice or organizational setting? What gets left out? Measures Changes Testing + Implementing + Scaling Changes

How the IHI Model can Help Meet Milestones

Practice has no proactive strategies aimed at creating joy in work. Specialty Milestone 19 Practice has effective strategies in place to cultivate joy in work and can document results. Practice has no proactive strategies aimed at creating joy in work. Practice has developed strategies to improve the experience of staff and create joy in work but implementation of these initiatives is limited. Practice has strategies in place to promote joy in work (e.g. reward and recognition programs, staff development, social activities) but has no mechanism for determining whether the programs initiated are successful. Practice has implemented strategies to support joy in work and can demonstrate the results through metrics such as staff survey results, high retention rates, or low turnover rates.

Primary Care 11/Specialty 8 Practice links patients with appropriate community resources to facilitate referrals. Practice does not regularly refer patients to available community resources. Practice is compiling an inventory of resources and establishing communication with them to link patients with appropriate community resources. Practice is referring patients to appropriate community resources but does not have a consistent approach for following up on referrals made. Practice has completed its resources inventory and consistently links patients with appropriate community resources and follows up on referrals made.

Practice does not have a process in place to measure continuity. Primary Care 7 Practice has a process in place to measure and promote continuity so that patients and care teams recognize each other as partners in care. Practice does not have a process in place to measure continuity. Practice is starting to measure continuity but does not have systems in place to promote it. Practice has introduced processes and systems for promoting continuity (e.g. scheduler scripts, patient cards with team member names and photos) but patients sometimes see providers other than their panel provider. Practice has implemented processes to promote continuity and has the metrics to demonstrate that the processes are effective.

What is your experience with helping managers and physicians put this in practice? What is working well? What isn’t working well? What are some ways you can help them succeed at this?