1. INTERPROFESSIONAL QUALITY IMPROVEMENT PROJECTS
Boise VAMC Center of Excellence in Primary Care Education
Workshop 2 of 3 on Quality Improvement
Introduce ourselves and ground our work in our lived experience

2. RETURN OF THE ZOMBIE ATTACK:
Boise VAMC Center of Excellence in Primary Care Education
RETURN OF THE ZOMBIE ATTACK:
Improving Quality, Building Teams, Avoiding Having Your Brain Eaten
Remind the group why Zombie theme was selected.

3. Boise VAMC Center of Excellence in Primary Care Education
SCENARIO
Zombie Apocalypse has struck Boise, Idaho. You and your team of survivors have holed up in an abandoned conference room. With dwindling supplies of stale donuts and tepid coffee, you must decide a means to survive the zombie attack, and minimize the number of humans you lose to zombification…
Reminder of the scenario for the workshop

4. PDSA Plan Identify the problem Analyze the problem Do
Boise VAMC Center of Excellence in Primary Care Education
PDSA
Plan
Identify the problem
Analyze the problem Do
Develop solutions
Implement a solution
Study
Evaluate the results – goal achieved?
Act
Standardize the solution & make it work
Restart the cycle
The group discusses/brainstorms possible causes of the zombie apocalypse.

5. PDSA Plan Identify the problem Analyze the problem Do
Boise VAMC Center of Excellence in Primary Care Education
PDSA
Plan
Identify the problem
Analyze the problem Do
Develop solutions
Implement a solution
Study
Evaluate the results – goal achieved?
Act
Standardize the solution & make it work
Restart the cycle
Review of the PDSA cycle

6. POSSIBLE CAUSES OF THE ZOMBIE APOCALYPSE
Boise VAMC Center of Excellence in Primary Care Education
POSSIBLE CAUSES OF THE ZOMBIE APOCALYPSE
Evil geniuses
Government Labs (may or may not have evil geniuses)
Hospitals – mutated cancer = zombification
Voodoo curse
Solanum Virus
Experimental Chemicals/Medicines
The Democrats
Review of the PDSA cycle

7. GROUP ACTIVITY – PART A Gather some specific data
Boise VAMC Center of Excellence in Primary Care Education
GROUP ACTIVITY – PART A
Gather some specific data
Review cases/causes of Zombie conversions
Tally zombification's & report these out
What does this suggest about your approach to stopping the spread of zombification?
10 minutes…
Introduction of group activity A

8. TOOLS USED FOR CONTINUOUS IMPROVEMENT
Boise VAMC Center of Excellence in Primary Care Education
TOOLS USED FOR CONTINUOUS IMPROVEMENT
CHECK SHEET
Item A B C D E F G
Zombification Causes
Injection l
Ingestion ll
Sleep Deprivation
lll
Inhalation
lllll
Biting
lll lll lll
After the group has completed the activity discuss approaches to collecting data in QI. Review the use of a check sheet to collect information on the incidence of specific events.

9. Public Transportation
Boise VAMC Center of Excellence in Primary Care Education
TOOLS USED FOR CONTINUOUS IMPROVEMENT
168
151
134
118
101 84 67 50 34 17
0.0
100.0%
90.0%
80.0%
70.0%
60.0%
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
This is an example of a perato chart that shows the incident rate on the left axis and the percentage on the right. The Bar represents the number/percentage of time that a specific reason let to arriving late at an appointment. The Red line is the cumulative percentage added up from the most frequent to the least. This type of char allows for a QI group to determine areas for intervention that might have the highest yield. For example targeting childcare problems might have a bigger positive impact then targeting oversleeping.
Traffic
Child Care
Public Transportation
Weather
Overslept
Emergency

10. Goal Setting ► Aims Statement ► SMART Goals
Boise VAMC Center of Excellence in Primary Care Education
Goal Setting ► Aims Statement ► SMART Goals
SPECIFIC
Well defined so that anyone can understand the goal
MEASURABLE
Need to have parameters (quantity/quality/time) in order to know if the goal was met.
ATTAINABLE
You must be realistic-create a goal that challenges you, but is achievable.
RELEVANT
Make sure that your goal is consistent with your other goals and will aid you in achieving your long term goal.
TIME ORIENTED
Create a time frame for when you what to accomplish your goal.
Discussion of using SMART goals as a way to create a clear and specific Aims statement.

11. GROUP ACTIVITY – PART B: SAVE HUMANITY
Boise VAMC Center of Excellence in Primary Care Education
GROUP ACTIVITY – PART B: SAVE HUMANITY
Overall goal: Save humanity/prevent zombie apocalypse/improve the world*
Write a specific (SMART) aims statement to help focus efforts to improve that problem
Handout group activity part B

12. AY 16-17 iQIP GROUPS Secondary Prevention of Hip Fracture
Boise VAMC Center of Excellence in Primary Care Education
AY iQIP GROUPS
Secondary Prevention of Hip Fracture
Panel Management
To improve secondary prevention of hip fracture by developing a hip fracture admission order set with a goal of 50% of patients having current vitamin D and TSH levels, appropriate bone protection, and DEXA scan ordered prior to discharge.
To improve diabetes and opioid registry compliance among Silver Team trainees by 10% and ensure trainees access the registry at least twice throughout the intervention period.
We include Aims statements from project groups in the past to highlight how groups used the SMART goals approach to development their statements. Consider including past Aims statements into your presentation/workshop.

13. PDSA Plan Identify the problem Analyze the problem Do
Boise VAMC Center of Excellence in Primary Care Education
PDSA
Plan
Identify the problem
Analyze the problem Do
Develop solutions
Implement a solution
Study
Evaluate the results – goal achieved?
Act
Standardize the solution & make it work
Restart the cycle
Review of the PDSA cycle

14. RECAP & QUESTIONS PDSA approach Gathering data
Boise VAMC Center of Excellence in Primary Care Education
RECAP & QUESTIONS
PDSA approach
Gathering data
Potential interventions…
Change is made
Median Line
GOAL: 12%
35.00%
30.00%
25.00%
20.00%
15.00%
10.00%
5.00%
0.00%
Jan-93
Mar-93
May-93
Jul-93
Sep-93
Nov-93
Jan-94
Mar-94
May-94
Jul-94
Sep-94
Nov-94
Jan-95
Mar-95
May-95
Jul-95
Sep-95
Nov-95
Jan-96
Mar-96
May-96
Jul-96
Sep-96

15. iQIP WORKS IN PROGRESS #1
Boise VAMC Center of Excellence in Primary Care Education
iQIP WORKS IN PROGRESS #1
Who: Your iQIP Team
What: WiP #1
Background info, why you care
Aim statement
Baseline data
Bonus
Understanding the Context
Process Map
Fishbone Diagram
Possible interventions?
When: Wednesdays in December/January
Where: Wednesday Interprofessional Noon Conference Room