1. Fundamentals of Improvement Experience from the Field. How participants put to use, what they learned. A Panel Discussion

2. Objective Review agenda of 2 day capacity building course, The Fundamentals of Improvement Briefly review key concepts Ask participants from the course to reflect on their experiences using course content Describe upcoming workshops Dec1-2 and Dec 3

3. Agenda Day 1 –Getting Started –Model for Improvement –Constructing Run Charts for Data Analysis –Profound Knowledge –Analyzing Run Charts –Team Work: Some Basics –Running an Effective Meeting –Team Hygiene Documenting Improvement Managing the Effort

4. Quality Improvement Fundamentals 2 Day Action Learning Project Oriented Aim: cover basics in quality improvement, the science of improvement applied to a specific participant project And, to build self-reliance among participants to facilitate and engage in improvement.

5. Method for Change What are we trying to accomplish? How will we know that a change is an improvement? What change can we make that will result in improvement? ActPlan StudyDo Model for Improvement API’s Deming’s PDSA cycle

6. What are we trying to accomplish? Aim statement: –What? –For whom? –By when? –How much?

7. 7 Purpose of Setting Aims Having an exciting destination is like setting a needle in your compass. From then on, the compass knows only one point-its ideal. And it will faithfully guide you there through the darkest nights and fiercest storms." Daniel Boone

8. Your project Outcome Process Balancing - if helpful

9. Small Test of Change PDSA Cycle A structured trial for a change. Source: W. Edwards Deming

10. Appropriate Scope for PDSA Cycle Current Situation ResistantIndifferentReady Low Confidence that current change idea will lead to Improvement Cost of failure large Very Small Scale Test Cost of failure small Very Small Scale Test Small Scale Test High Confidence that current change idea will lead to Improvement Cost of failure large Very Small Scale Test Small Scale Test Large Scale Test Cost of failure small Small Scale Test Large Scale Test Implement Staff Readiness to Make Change Lloyd Provost, Associates in Process Improvement

11. Cycle Time for Practices 1, 2 and 3 Practice 1 Practice 2 Practice 3 Source: Institute for Healthcare Improvement

12. Developed by Associates in Process Improvement

13. Team Roles Member Leader Timekeeper Recorder Facilitator Sponsor

14. Forming: orientation Storming: conflict Norming: cohesion Performing: task performance Adjourning: transform dissolve Teamness

15. Tools & The Model for Improvement Improving Non-urgent Patient Wait Times in the ED 1.Aim statement & Block Diagram of Process 2.Flowchart of how process currently works 3.Cause and Effect Diagram of reasons for wait times 4.Data collection plan 5.Data run chart and analysis 6.Brainstorm, M.V. and R. O. improvement ideas 7.Create test plan for selected improvement idea

16. Team Hygiene Bad Team Hygiene Good

17. What’s next? December 1, 2 –Fundamentals of QI with focus on Ambulatory Care Settings December 1 pm Special session for leaders responsible for QI December 3 - Advanced Session Returning participants engage in deeper project based learning.