PA SPREAD Review of Aim Statements Connie Sixta, DSN, RN, MBA Robert A. Gabbay, MD, PhD

The Fundamental Questions for Improvement What are we trying to accomplish? How will we know that a change is an improvement? What changes can we make that will result in an improvement? Yesterday we talked about the three questions that any successful improvement effort must address. To review: 1. The first question is about setting an aim that is measurable, specific, and yet a stretch aim that requires taking the status quo off the table in order to achieve it. 2. The second question requires that the team decide on how it will measure its progress in reaching the aim. For example: you don’t know whether your golf game is improving unless you keep track of the number of strokes per round. 3. The Breakthrough Series (BTS) gives teams a place to start - with changes that have been shown to be effective. This question is based on the assumption that all improvement requires change, but not all changes lead to improvement. The following slides show the kind of results that improvement teams can achieve by using this model. 17

What are we trying to accomplish? Office Aim Statement Characteristics States that we are going to change (redesign) the practice. Describes the population for improvement in terms of site, provider, and disease. Describes the changes we are going to use to improve care for the population (Chronic Care Model, Patient Centered Medical Home). Describes the important outcomes we want to improve for the population that define success (compare DM guidelines with baseline data and target those with largest gap).

Aim defines population you working with Pilot Population (Diabetes) A P S D A P S D Small-scale tests of change The Total Population of DM Patients in the Practice (spread providers and sites) Your job is to work in the pilot site. Your senior leader will be addressing the total health care system. You will be providing valuable information the senior leader needs for spread.

What are we trying to accomplish? Office Aim Example Aim: The practice will be transformed (redesigned, changed) into a Patient-Centered Medical Home for all patients within the practice. The practice will provide chronic illness care, preventive care, and risk management using patient-centered approaches and continuous team-based healing relationships. Practice transformation will occur through implementation of the Chronic Care Model so that 70% of patients with diabetes will have an A1c <8.0% and 80% will have a BP < 140/90. In addition 75% of patients will have self-management goals.

Let’s review your aim statement…