DEEP DIVE: Measurement for Learning June 15th, 2010 Checklist Planning Group & Guests 24-May-151

Checklist Action Series Hosts 24-May-152 Leanne Couves, Improvement Associates Ltd. & Quality Moderator for Checklist Action Series DEEP DIVE Chantal Bellerose, Quebec Node SIA Safer Healthcare Now! & French Liaison for Checklist Action Series Tanis Rollefstad, Western Node SIA Safer Healthcare Now! & Technical Host for Checklist Action Series Angela Thiessen, Western Node Administrative & Technical Support for Checklist Action Series Marlies van Dijk, Western Node Leader Safer Healthcare Now! and Moderator for Checklist Action Series DEEP DIVE

Objectives for Today’s Call Identify your purpose for doing the checklist Choose which measures to start Explore detailed definitions for key measures, including data collection plans Using data for learning

24-May-154 Interacting in WebEx 24-May-154 Be prepared to use: - Pointer Tool - Raise Hand - Chat “to all participants”

What ideas have you tried? Measuring compliance with Y/N? Measured more than compliance? Measuring OR culture? Started measuring other items? Haven’t started measuring. Use the pointer

More on What Can Be Measured 24-May-156 Marlies vanDijk Western Node Leader, SHN! Leanne Couves Improvement Associates

Examples of Purpose Statements Anticipate problems Prevent adverse events and/or outcomes Prevent harm to patients Improve culture, teamwork and communication Use Pointer to indicate which resonate with your organization

POTENTIAL MEASURES Marlies van Dijk

Extended length of anesthesia due to delays

Overall Outcome Measure Measures using Small Multiples: Overall System and 4 sites

Meaningful Measures followed by a Quebec Hospital Chantal Bellerose SIA Quebec Node

More on HOW to Measure Small Group Discussions Breakout Rooms Led by Facilitators

Breakout Exercise Talk Through Measurement Plan What is your purpose ? What’s your measure? How would you define the measure? How would you collect the data? What will you do with the data?

Sample Measurement Sheet* *Adapted from Susan Macknak

patient_safety/questionnaires/

BREAKOUT SESSION SUMMARY & DEBRIEF Use text tool on next slide to record one idea from breakouts

How Much Data is Enough? Marlies van Dijk Western Node Leader, SHN!

Data Collection Methods Observation (direct or indirect) Informal conversations Surveys and questionnaires (written, phone, one- on-one interviews) Focus groups / group interviews Direct experience “trading places” Quantitative measurements (manual or electronic)

Sampling Random (from random number generator) Systematic random e.g. every X (random number from generator) of Y Judgment (requires process knowledge) –By time of day –By location –By patient population e.g. first 5 cases of the day, Mondays and Thursday’s Based on “The Data Guide” by Sandra Murray and Lloyd Provost

# 1 Goal for implementing the Checklist #2 Measures to support your goal # 3 Present to the OR teams and other stakeholders

Checklist Sampling Ideas Adverse Events Prevented Review incidents in the Glitch book weekly and categorize them Communication Equipment Medications/Blood Wrong site Lab work/chart issues Staff Room Display Length of anesthesia reduced with Checklist Hips and Knee procedures only Assign observational data collection Every Thursday when Dr. X is doing Hips Circulating Nurse will notate no. of minutes delayed on white board as they arise Assign responsibility for someone to capture data after each case Review monthly

Checklist Sampling Ideas Team work and communication Ask 5 questions on team work and communication (5 min to fill out) Capture discipline (nursing, surgery, anesthesia) Capture them during breaks and lunch Aim to get 10 people per discipline 10 nurses, 10 surgeons and 10 anesthesiologist, 10 others (RT) Collate and feedback to staff Compliance with Checklist Choose method (observational or audit form) Audit: Yes/No tool to each of the 3 stages of the checklist Choose surgical procedure (s) where checklist is being used Sample 2 charts a day (random or specific procedures) Sample 5 first charts once a week before they go down to health records Collate and feedback to staff

Open Mike on Measurement

Poll Questions Relevance Check

Next Steps

ACTION Items Between now and June 23rd Apply what you’ve learned today – start your data collection plan Download session materials and see examples of data collection tools – Sign up on the SSSL Community of Practice

Advice to a “Newbie” Retrieved from: /AlbertEinstein.jpg&imgrefurl= html&h=625&w=640&sz=27&tbnid=e5bsDYQz3HTO3M:&tbnh=134&tbnw=137&prev =/images%3Fq%3DEinstein&usg=__8X0EQ9DZKTZqOWv1jOsfee4tKS8=&sa=X&ei=lRM QTNHOHIWANrOg7NsM&ved=0CC0Q9QEwBA It’s not as simple as it looks!

Thank You You Guest speakers Faculty Facilitators Message from Chantal

24-May-1533 Questions? Tanis Rollefstad, Safety & Improvement Advisor Phone: Leanne Couves, Improvement Associates Ltd. Phone: cell

24-May-1534 French Speaking Teams Chantal Bellerose Dt.P.,M.Sc (cand). Conseillère en matière de sécurité et d'amélioration | Safety and Improvement Advisor SHN Campagne québécoise: Ensemble, améliorons la prestation sécuritaire des soins de santé! | Phone: 514‐340‐8222 #6705 et #

24-May-1535 KEY THINGS TO CONSIDER WHEN IMPLEMENTING THE CHECKLIST: HIGHLIGHTS “See you” on June 23rd PDT; MDT; CDT; EDT; ADT; NDT 24-May-1535