Process Improvement Overview

Key Questions for making improvements What are we trying to accomplish? How will we know a change is an improvement? What changes can we make that will result in an improvement? Thomas W. Nolan, IHI The Key Questions to start with when making improvements are>>>>>>>>>>.

1. What are we trying to accomplish?? (what is our aim??) Must state a clear purpose or direction for improvement Define when we have reached Success

P-(Plan) Select Process and identify the opportunity Understand Current Process Identify all possible causes of problem and which would have the greatest impact Develop improvement action plan Now that we understand the 3 questions that we need to be answering with our improvements, How do we “do it?’ PDSA

Making Improvements IHI-4 Phases of improvement: Plan, Do, Study, Act Combine PDSA Cycle of change with 3 questions Turns the ideas into actions Framework for connecting actions to learning and thus the Model for Improvement Rapid Cycle/PDSA/100 Day Improvement Projects are buzz words we all may have heard around HE. But what do they mean??? For the most part they are all interchangeable terms with some underlying themes. They combine 4 phases: the planning of the improvement( often done by leadership), Testing or “doing” the improvement and collecting the data( typically done by the project team), studying the results (leadership and project team involvement), and acting on the learnings and implementing on a larger scale. (Will involve both leadership (support) and the project team)

2. How will we know a change is an improvement. (What are our measures Is the change driven from the aim? Is the pt population defined? Does trending reflect progress? Are data available and can it be measured frequently?

3. What changes can we make that will result in improvement 3. What changes can we make that will result in improvement? (What are our “actions”?) Implement simultaneous small tests of change Faster improvements Ability to troubleshoot problems earlier Enc staff involvement Lowers resistance to change Utilizes resources wisely Helps to make choices for successful process changes Ultimately allows you to achieve and sustain aims Here are some reasons why trying small tests of change will help quality improvement projects achieve their aims quicker and sustain them. READ through bullets

D-(Do) Implement process changes on a small scale Carryout action plans Monitor and report progress Collect and report data: Create charts and diagrams Communicate project progress

S-(Study) Review and evaluate the result of the change Revise process as needed; recommend changes Document project progress

A-(Act) Reflect and act on what has been learned from the pilot Communicate to stakeholders Revise policies and procedures as needed Train, expand, document, and celebrate milestones along the way.

100 Day Project Plan Commissions leadership involvement and support throughout the project Helps define goals, roles, and success Helps hold the team accountable for accomplishing it’s goals in a timely manner. HealthEast is using what is being called the 100 project approach. There are several different named tools out there, but the approach is very similar to that of other improvement methodologies. The reason behind the project planning worksheet is to give time and meaning to a project. Many times it is easy to get caught up in our everyday work and as many of us know, projects lag and get put aside to put out other burning issues (which we seem to have a lot of around here). Anyway, if you take a look at it, it gives definition to the timeframe as well as accountability to those involved from Senior leadership to the front line staff and implementation team.

100 Day Project Plan Cont. Works on initiating the “spread” of the project work to other sites Helps plan out the monitoring and maintenance of improvements