Building Blocks to Improvement Lauren Smith

ECE Systems As we think about the work that we do, we must think about the systems we work within. The reality is that the work that we do every day does happen in isolation, rather it happens within systems. And systems can be complicated and stubborn by nature! I am sure many of you can relate to the experience of “knowing” that something could work better, but sifting through the layers of the causes of the “problem” can be quite a feat! This is where Quality Improvement can be a knight in shining armor. Quality Improvement is a method of looking at processes to make them more effective. It can empower staff, energize work as it reduces inefficiencies, improve processes and decrease frustrations. The first step is to identify a key “problem” or as I like to call it “opportunity for improvement” . One way of doing this, is to use a prioritizing tool such a systems inventory to help pinpoint areas of the system in which you are working.

Program System Inventory Let’s take out the Program Systems Inventory in the Pink tab section in your binders. This tool is designed to score or rank your programs current systems or processes around developmental surveillance screening. Please fill out the tool by scoring each of the items using a 0-11 scale. Note that the grey headers change from section to section. Remember that the goal is to capture how your systems are currently and so we would expect at this stage of the project that there will be some scores in the lower sections and that is OK! Based on your responses to these items, you have started to pin point potential areas for improvement based on the scores you have given the various items. This is not a test! This tool will assist your team and your QI coach to identify goals, and begin to make changes within your program. Your will be asked to fill out this form again at a later date to highlight changes that may occur as a result of participation in this study. We will be walking around to answer questions! We will reconvene in 10 minutes

Prioritizing Opportunity A list of problem areas A good starting point Designed to guide, not dictate QI target areas Allows an opportunity to think about the impact of change So now that you have described the “current state” of your ECE program as it relates to these areas; we are going to ask you to spend a few minute prioritizing the items on the system’s inventory. When you think about prioritizing, it is important to listen to multiple perspectives, to think about what areas are possible to change and what constraints or restrictions exist that could limit the feasibility of making changes to an area. For example, if space is tight, don’t select a change that requires a private meeting room to be used all day every day for screening.

Prioritizing change ideas activity Highlight responses that fall between 0-6/in the left columns Which items would have the biggest impact? Which are the most feasible? Now we are going to take a closer look at the ranked areas and go through a sorting exercise. First, we are going to focus on your responses that fell between 0-6, or in the left-most columns – indicating room for improvement in those areas. Go through and highlight those items. Looking at those highlighted items, which items do you think would have the most impact? Put a star next to those items. Of those starred items, which do you think are the most feasible? Put a circle around the star for those items. How many items do you have at this point? If you are left with more than 2 items, try to narrow them down once more to 2-3. (2 minutes) So now you have 2-3 specific areas which could be places your team chooses to focus on. This exercise does not limit you, and you may decide to focus on a different initial goal, or a variation of one of these areas. In your initial coaching sessions, we will review both the areas that you have identified today as well as an additional goal setting exercise to help determine a starting point. Report Out: It is always helpful to hear what others are working on as your get started on a change “journey” so I would like to ask a few programs to share how this process was for them to do, what areas you narrowed down to, etc. Please make sure your name is on them and hand your PSI to Becca or Lauren who will bring these back out at your next learning session.

Break Time! Grab a Snack!