1. Quality Education for a Healthier Scotland Scottish Improvement Skills Prioritisation

2. System of Profound Knowledge Deming 2000

3. Quality Education for a Healthier Scotland Developing change ideas using process mapping By the end of this session you will be able to: use a 2 x 2 matrix (eg Difficulty vs Impact) to prioritise change ideas or drivers Identify opportunities to use Pareto charts, and analyse Pareto charts to generate and prioritise change ideas.

4. Quality Education for a Healthier Scotland Prioritisation Impact/difficulty matrix Pareto chart

5. Quality Education for a Healthier Scotland Prioritisation Impact/difficulty matrix Pareto chart

6. Quality Education for a Healthier Scotland Matrix: impact vs difficulty Impact High Low EasyHard Difficulty

7. Quality Education for a Healthier Scotland Driver diagram Aim A new healthier me! Lose 7 pounds by end July 2015 Calories in Calories out Leisure activity Calories in meals Calories in drinks Calories in alcohol Work activity Calories in snacks No alcohol Monday to Thursday Max 1 x juice or soft drink per day Reduce portion size Cook evening meals from scratch Replace biscuits/cakes with fruit Keep to shopping list Get up from desk to talk, instead of phone or email Use stairs not lift Walk to a daily step target Swim at least twice a week 1  Driver2  Driver Change ideas

8. Quality Education for a Healthier Scotland New, healthier me! Impact High Low EasyHard Difficulty Cook from scratch

9. Quality Education for a Healthier Scotland New, healthier me! Impact High Low EasyHard Difficulty Cook from scratch Reduce portion size

10. Quality Education for a Healthier Scotland New, healthier me! Impact High Low EasyHard Difficulty Cook from scratch Reduce portion size Keep to shopping list

11. Quality Education for a Healthier Scotland New, healthier me! Impact High Low EasyHard Difficulty Cook from scratch Reduce portion size Keep to shopping list Replace biscuits with fruit

12. Quality Education for a Healthier Scotland New, healthier me! Impact High Low EasyHard Difficulty Cook from scratch Reduce portion size Keep to shopping list Replace biscuits with fruit 1 soft drink / day No alcohol Mon – Thurs

13. Quality Education for a Healthier Scotland New, healthier me! Impact High Low EasyHard Difficulty Cook from scratch Reduce portion size Keep to shopping list Replace biscuits with fruit 1 soft drink / day No alcohol Mon – Thurs Swim twice / week

14. Quality Education for a Healthier Scotland New, healthier me! Impact High Low EasyHard Difficulty Cook from scratch Reduce portion size Keep to shopping list Replace biscuits with fruit 1 soft drink / day No alcohol Mon – Thurs Swim twice / week Increase steps

15. Quality Education for a Healthier Scotland New, healthier me! Impact High Low EasyHard Difficulty Cook from scratch Reduce portion size Keep to shopping list Replace biscuits with fruit 1 soft drink / day No alcohol Mon – Thurs Swim twice / week Increase steps Use stairs at work

16. Quality Education for a Healthier Scotland Matrix: impact vs difficulty Impact High Low EasyHard Difficulty

17. Quality Education for a Healthier Scotland Prioritisation Impact/difficulty matrix Pareto chart

18. Quality Education for a Healthier Scotland What is a Pareto chart? 80:20

19. Quality Education for a Healthier Scotland When to use a Pareto chart When you can categorise items that have the potential to contribute to the improvement you are considering When you want to analyse data about the frequency of problems

20. Quality Education for a Healthier Scotland Access to primary care

21. Quality Education for a Healthier Scotland Primary care practice X: reasons given by patients for not attending

22. Quality Education for a Healthier Scotland Primary care practice X: reasons given by patients for not attending ReasonsNumber% cumulative % Unable to contact to cancel3524% Forgot2618%43% Unaware of appointment2316%59% Confusion about appointment time1913%72% Inconvenient day128%80% Other96%87% Unwell64%91% Inconvenient time43%94% No value in appointment43%97% Working32%99% No transport11%99% Unable to afford time off work11%100% Total143100%

23. Quality Education for a Healthier Scotland Primary care practice X: reasons given by patients for not attending

24. Quality Education for a Healthier Scotland Primary care practice X: reasons given by patients for not attending

25. Quality Education for a Healthier Scotland Central Hospital Ward F: Percentage of meals returned, by meal type (2013)

26. Quality Education for a Healthier Scotland Ward X: Adverse drug events - causes

27. Quality Education for a Healthier Scotland Hospital X: SAB cases by ward (SAB = Staphylococcus aureus bacteraemia)

28. Quality Education for a Healthier Scotland When to use a Pareto chart When you can categorise items that have the potential to contribute to the improvement you are considering When you want to analyse data about the frequency of problems When you have at least 30 observations across the categories (vertical axis) Consider: measure, period, existing data Ari

29. Quality Education for a Healthier Scotland Pareto chart examples 1.For this project, what data could a Pareto chart be used with? 2.Which driver(s) or change idea(s) is this Pareto chart related to? 3.Which categories would you focus your improvement efforts on? 4.What action would you take based on this chart?

30. Quality Education for a Healthier Scotland Project work: prioritise Would a Pareto chart be useful for your project? If so, what data would you need, and how could you get it? Use the Impact vs Difficulty matrix to identify your top priority for change.

31. Quality Education for a Healthier Scotland Prioritisation: summary Impact/difficulty matrix Pareto chart

32. Quality Education for a Healthier Scotland References and further resources Pareto chart http://www.ihi.org/resources/Pages/Tools/ ParetoDiagram.aspx