1. Quality Improvement: Overview of Principles and Techniques
Phavinee Thongkhong-Park, PhD, RN
Adjunct Faculty, The University of Michigan School of Nursing
Project Director, Department of Standards, JCAHO

2. Quality Improvement Performance Improvement as a Management Philosophy
Data driven
Focuses on changing critical process steps
Bottom up decision making as well as top down
Teams as organizational unit

3. Quality Improvement Plan-do-check-act (PDCA) cycle
model is easy to use and understand
underlying philosophy is to continually raise the quality bar
Measurement continues until tools, techniques and behavior patterns part of daily practice

4. Quality Improvement It starts with values….. Vision Mission Goals
“What are we trying to accomplish and how does the action support that?”

5. Quality Improvement Identify important processes
relates to and support the mission and goals
attach indicators to each important process
outcome data
special indicators that measure the end of a process

6. Quality Improvement Process Indicator Selection
Locate the points of variability and measure them
Indicator Examples:
Left without being seen
Patient wait times
Medication errors

7. Quality Improvement Selection of Improvement Projects
Which indicator or outcome data tells you to act because it exceeds thresholds?
Do you have new processes to put in place?
Do you have imperatives preselected by management to improve?

8. Quality Improvement Improvement Project Characteristics
Clearly defined and measurable objectives
Utilizes a minimum of one indicator with a known baseline
Rearranges or restructures the basic process steps
Trials the process redesign before full implementation

9. Quality Improvement Teams as organizational unit Two types
Product or output teams (permanent teams)
Process Improvement Teams (project teams)

10. Quality Improvement Essential elements for team success
Training, training, training
Common vision
Data and measurable goals
Facilitation

11. Quality Improvement Formation of improvement teams
Team is assigned one project
Team is trained
Team establishes ground rules, objectives, and timetables
Team reports progress

12. Quality Improvement Team Roles
Facilitator does not make decisions or affect the output of the team
Leader is a team member who chairs meetings and coordinates activities

13. Quality Improvement Plan Assess the current indicator information
Analyze the process to be improved
Identify the steps in the process to be eliminated or changed

14. Quality Improvement Plan Look for variation
Flow chart important processes as a group
Generate multiple options for improvement
Select one
Select evaluation tool

15. Quality Improvement Do
Set up and initiate the pilot phase of the change
This is the experimental phase

16. Quality Improvement Check At the end of the pilot (or sooner)
Did this work the way we thought it would?
Evaluate the whole process to ensure that the change did not negatively impact another process

17. Quality Improvement Act Fully implement the selected change
Continue to monitor the process