Chartering a project for improvement

What change can we make that will result in improvement? What are we trying to accomplish? How will we know that a change is an improvement? What change can we make that will result in improvement? Model for Improvement Act Plan Study Do Langley, et al.

Background information This section represents a place to provide some essential information to the audience which sets the stage for improvement. It should be limited to 7 or less bullets It should cover issues like geography, history, context, environment, political sensitivities, etc.

Define the need for improvement This slide should succinctly make the case for improvement In just a couple of bullets lay out, what the problem is, which requires the application of QI methods to create better quality

What are we trying to accomplish? This is place to define the Aim of your improvement project Some teams like to answer the above question “what are we trying to accomplish” using these two questions “by how much do you want to change” and “by when do you want to change” Implicit is answering those questions is an understanding of current performance, this too should be reflected in the aim (i.e. mortality is currently at X% and we aim to reduce this to Y% is Z amount time)

How will we know that a change is an improvement? On this slide you should list the measures you suspect will help you to know if and how much progress you are making during the course of the next 6-12 months Include an outcome measure, process measures and any balancing measures you think are relevant Remember measures are defined through a statistic you will be reporting on lets brainstorm 3 possible measures All measures should be reported with the statistic you will be collecting each week, or month

O1 P1 O2 P2 B S3 S2 S1 System of Feedback Measure Types O = Outcome Measure P = Process Measure B = Balance Measure S = Process Step Measure PDSA = Learning Cycle Measure O2 P2 B S3 S2 S1 System of Feedback PDSA1 PDSA2 PDSA3 PDSA4

What changes can we make which will result in an improvement? This slide represents a good place to display a driver diagram which you have created to supplement your charter It is a place to display concepts you think articulate why things are the way they are and as a result where the leverage points exist for change which will result in improvement If you have a change package or preliminary change ideas for testing, these can be presented here as well

Conceptual Driver Diagram Outcome 1⁰ driver 2⁰ driver Change Concepts Specific Change Ideas 2⁰ driver 1 Ideas: 1 2 3 4 5 6 7 8 9 . N Concept 1 1⁰ driver 1 Concept 2 2⁰ driver 2 Concept 3 Aim or Outcome 2⁰ driver 3 Concept 4 2⁰ driver 4 1⁰ driver 2 Concept 5 2⁰ driver 5 Concept 6

Who will lead and participate in improvement? Critical to any improvement process is the participation of people whom the improvement work with effect On this slide it will be good to: Lay out who will be leading the change effort Who will support the change effort as part of a QI team? – position and name if possible Who is sponsoring the change effort (to whom does the change effort matter, which senior leader)? Who is accountable for the improvement initiative?

Break out Spend some time formulating a real project, whether you are ready to move on it now or not, this will be a useful exercise Start with Background info Define the need What are you trying to accomplish How will you know a change is an improvement (measures) What changes can you make (theory for change) Who will be involved in the effort