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 Prioritisation 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. Prioritisation Impact/difficulty matrix Pareto chart

5. Prioritisation Impact/difficulty matrix Pareto chart

6. Matrix: impact vs difficulty Impact High Low EasyHard Difficulty

7. 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  Driver 2  Driver Change ideas

8. New, healthier me! Impact High Low EasyHard Difficulty Cook from scratch

9. New, healthier me! Impact High Low EasyHard Difficulty Cook from scratch Reduce portion size

10. New, healthier me! Impact High Low EasyHard Difficulty Cook from scratch Reduce portion size Keep to shopping list

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

12. 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. 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. 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. 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. Matrix: impact vs difficulty Impact High Low EasyHard Difficulty

17. Prioritisation Impact/difficulty matrix Pareto chart

18. What is a Pareto chart? 80:20

19. 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. Access to primary care

21. Primary care practice X: reasons given by patients for not attending

22. 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. Primary care practice X: reasons given by patients for not attending

25. Central Hospital Ward F: Percentage of meals returned, by meal type (2013)

26. Ward X: Adverse drug events - causes

27. Hospital X: SAB cases by ward (SAB = Staphylococcus aureus bacteraemia)

28. 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

29. 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. 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. 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