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

2. 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

3. 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

4. 24-May-154 Interacting in WebEx 24-May-154 Be prepared to use: - Pointer Tool - Raise Hand - Chat “to all participants”

5. 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

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

7. 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

8. POTENTIAL MEASURES Marlies van Dijk

11. Extended length of anesthesia due to delays

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

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

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

16. 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?

17. Sample Measurement Sheet* *Adapted from Susan Macknak

18. http://www.uth.tmc.edu/schools/med/imed/ patient_safety/questionnaires/

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

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

22. 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)

23. 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

24. # 1 Goal for implementing the Checklist #2 Measures to support your goal # 3 Present to the OR teams and other stakeholders

25. 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

26. 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

27. Open Mike on Measurement

28. Poll Questions Relevance Check

29. Next Steps

30. 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

31. Advice to a “Newbie” Retrieved from: http://www.google.ca/imgres?imgurl=http://www.mlahanas.de/Physics/Bios/images /AlbertEinstein.jpg&imgrefurl=http://www.mlahanas.de/Physics/Bios/AlbertEinstein. 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!

32. Thank You You Guest speakers Faculty Facilitators Message from Chantal

33. 24-May-1533 Questions? Tanis Rollefstad, Safety & Improvement Advisor Phone:306.693.0780 Email:tanis.rollefstad@hqca.ca Leanne Couves, Improvement Associates Ltd. Phone:780.446.9940 cell Email:lcouves@telus.net

34. 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 #4901 Email: cbellerose@jgh.mcgill.ca

35. 24-May-1535 KEY THINGS TO CONSIDER WHEN IMPLEMENTING THE CHECKLIST: HIGHLIGHTS “See you” on June 23rd 0900-1030 PDT; 1000-1130 MDT; 1100-1230 CDT; 1200- 1330 EDT; 1300-1430 ADT; 1330-1500 NDT 24-May-1535