AHS WHS Programs and Creating a “Culture of QI” · • Thus far, this work has culminated in a...
1
Project By: Dr. Aditi Amin, MD, MPH | PGY5 Occupational Medicine Resident Supervised By: Dr. Stephen Tsekrekos, MD, MSc, FRCPC | AHS WHS Medical Director AHS WHS Programs and Creating a “Culture of QI”: Applying AIW QI Principles to the Fit Test Designate Program Alberta Health Services (AHS) Workplace Health and Safety (WHS) and Quality Improvement (QI): • Within AHS’s overarching goals, AHS WHS Senior Leadership recognized the need for a stronger “QI Culture” within AHS WHS that includes: 1. A broader awareness of QI; 2. A better understanding of QI methodology and applications; 3. Integrating QI principles into the evolution and evaluation of existing Programs; and 4. Integrating QI principles into the development, implementation, and evaluation of new Programs. The Fit Test Designate (FTD) Program: • In discussion with AHS WHS Senior Leadership, the FTD Program was chosen in order to frame the application of the AHS Improvement Way (AIW) Yellowbelt QI methodology in addition to certain QI toos from the Evidence-based Practice for Improving Quality (EPIQ) methodology. • The FTD Program was thought to be a good choice as it was a well- established Program with areas requiring review and that may additionally benefit from QI. • 4 hours of instruction : PowerPoint presentation, written material, a practical component, and completion of a quiz. • Shadowing session : assist WHS with one scheduled fit testing drop-in session (completed within two months of receiving FTD training). N95 FTD Initial Training • “Obtain lists of staff to be fit tested.” •“Coordinate fit testing schedule of staff with manager(s).” •“Obtain the space for fit testing activities.” •“Clean and maintain the fit testing kit.” •“Order fit testing kit supplies as required.” • “Send all completed documentation from each fit testing session to WHS Advisor responsible for that site.” Role of the FTD • FTDs are required to complete an online “refresher…through MyLearningLink every two years.” • This training includes : “theory refresher, review of the fit testing kit contents and the proper fit testing protocol.” N95 FTD Refresher Training Applying the AIW Methodology and EPIQ Tools to the FTD Program: Problem Statement • There is currently no process, including no tools and timelines, in place for the assessment of FTD competence – specifically for the “during” and “immediately after” portions of a fit test session. • It is known that fit testers who incorrectly fit respirators and do not communicate effectively to those being fit tested can contribute to incorrect respirator assignment and use [1]. • This would put employees being fit tested at risk for airborne hazard exposure [2]. Goal Statement • Through a series of interventions, and corresponding QI cycles, spanning approximately 2 years; a sample of recently trained FTDs will have their competence assessed at 1 year post-initial training. • Those with competence scores of <85% at this first (annual) competence assessment will undergo both online and in-person “refresher” training such that all the FTDs in this sample will have competence scores of ≥85% at 2 years post-initial training compared to the scores of baseline sample of FTDs at 2 years post-initial training • Under the current standard practice, the baseline sample of FTDs would not have had a competence assessment at 1 year post-initial training and they would have only been required to complete an online “refresher” at 2 years post-initial training. As this is a hypothetical “worked example”, the above would be assuming that that during the collection of baseline data, as described anecdotally in the interviews conducted, only a (small) proportion of the FTDs in the baseline data sample would have had competence scores ≥85% at 2 years post-initial training. The FTDs in the baseline data sample would be operating under the current standard practice of no competence assessment at 1 year post-initial training and this sample would further only be required to complete an online “refresher” every 2 years after completing their initial training. Impact and Next Steps: • Thus far, this work has culminated in a presentation to AHS WHS Leadership and the production a report (including a discussion on ). • Increased awareness and receptiveness to integrating QI into Programs and practices. • Additional recommendations: identifying Programs that are interested, in or would benefit from, QI work; supporting a members of Program teams to pursue AIW certification etc. Applying the AIW Methodology and EPIQ Tools to the FTD Program ( Continued): S uppliers I nputs P rocess O utputs C ustomers • AHS WHS – FTD Program. • Manager identifies FTD candidate(s). • FTD initial training. • FTD completes shadowing. • FTD reviews contents of FTD script. • FTD completes sensitivity testing. • Etc… • Completion of respirator card. • Completion of paper documentation. • Etc… • Employees requiring fit testing. (6) Let us assume that our final data shows that a combination of the online “refresher” and in-person “refresher” demonstrates an improvement in maintaining competence assessment scores ≥85% compared to baseline. (This was assuming, as was anecdotally described, that the baseline data will show large proportion of FTDs will have scores <85% with no annual assessment and “refreshers”). Key sustainability factor Completed In progress Not started Responsibility Process owner identified AHS WHS FTD Program (Advisors and Managers) Impacted groups involved in change process AHS WHS FTD Program (Advisors and Managers) Etc. Stakeholder Relationship to project Position What we need from them Communication strategy Has decision authority Can influence outcome Will be affected Resistor Neutral Supporter Approval for implementation Resources (people, funding) Subject matter expertise Data Pilot support Meet with regularly Invite to team meetings Send copy of meeting minutes Speak with informally as needed AHS WHS FTD Program (Advisors and Managers) FTDs Etc. Timing Message Content Audience Method Responsibility Prior to QI cycle 1 (first use of competence assessment tool). • Reason for implementing intervention. • AHS WHS Senior Leadership. • Managers (Departments, Sites etc.) • FTDs. • Face to face. • Electronic memo. • AHS WHS FTD Program (Advisors and Managers). After last QI cycle. • Proposed changes to current standard practice. • AHS WHS Senior Leadership. • Managers (Departments, Sites etc.) • FTDs. • Face to face. • Electronic memo. • AHS WHS FTD Program (Advisors and Managers). Etc. Presentation PDF
Transcript of AHS WHS Programs and Creating a “Culture of QI” · • Thus far, this work has culminated in a...
Project By: Dr. Aditi Amin, MD, MPH | PGY5 Occupational Medicine ResidentSupervised By: Dr. Stephen Tsekrekos, MD, MSc, FRCPC | AHS WHS Medical Director
AHS WHS Programs and Creating a “Culture of QI”:Applying AIW QI Principles to the Fit Test Designate Program
Alberta Health Services (AHS) Workplace Health and Safety (WHS) and Quality Improvement (QI):• Within AHS’s overarching goals, AHS WHS Senior Leadership
recognized the need for a stronger “QI Culture” within AHS WHSthat includes:
1. A broader awareness of QI;2. A better understanding of QI methodology and
applications;3. Integrating QI principles into the evolution and
evaluation of existing Programs; and4. Integrating QI principles into the development,
implementation, and evaluation of new Programs.The Fit Test Designate (FTD) Program:• In discussion with AHS WHS Senior Leadership, the FTD Program
was chosen in order to frame the application of the AHSImprovement Way (AIW) Yellowbelt QI methodology in addition tocertain QI toos from the Evidence-based Practice for ImprovingQuality (EPIQ) methodology.
• The FTD Program was thought to be a good choice as it was a well-established Program with areas requiring review and that mayadditionally benefit from QI.
• 4 hours of instruction: PowerPointpresentation, written material, a practicalcomponent, and completion of a quiz.
• Shadowing session: assist WHS with onescheduled fit testing drop-in session(completed within two months of receivingFTD training).
N95 FTD Initial Training
• “Obtain lists of staff to be fit tested.”• “Coordinate fit testing schedule of staff
with manager(s).”• “Obtain the space for fit testing activities.”• “Clean and maintain the fit testing kit.”• “Order fit testing kit supplies as required.”• “Send all completed documentation from
each fit testing session to WHS Advisorresponsible for that site.”
Role of the FTD• FTDs are required to complete an online
“refresher…through MyLearningLink everytwo years.”
• This training includes: “theory refresher,review of the fit testing kit contents andthe proper fit testing protocol.”
N95 FTD Refresher Training
Applying the AIW Methodology and EPIQ Tools to the FTD Program:
Problem Statement
• There is currently no process, including no tools and timelines, in place for theassessment of FTD competence – specifically for the “during” and “immediately after”portions of a fit test session.
• It is known that fit testers who incorrectly fit respirators and do not communicateeffectively to those being fit tested can contribute to incorrect respirator assignment anduse [1].
• This would put employees being fit tested at risk for airborne hazard exposure [2].
Goal Statement• Through a series of interventions, and corresponding QI cycles, spanning approximately
2 years; a sample of recently trained FTDs will have their competence assessed at 1 yearpost-initial training.
• Those with competence scores of <85% at this first (annual) competence assessmentwill undergo both online and in-person “refresher” training such that all the FTDs in thissample will have competence scores of ≥85% at 2 years post-initial training compared tothe scores of baseline sample of FTDs at 2 years post-initial training
• Under the current standard practice, the baseline sample of FTDs would not havehad a competence assessment at 1 year post-initial training and they would haveonly been required to complete an online “refresher” at 2 years post-initial training.
As this is a hypothetical “worked example”, the above would be assuming that that during the collection of baseline data, as described anecdotally in the interviews conducted, only a (small) proportion of the FTDs in the baseline data sample would have had competence scores ≥85% at 2 years post-initial training.
The FTDs in the baseline data sample would be operating under the current standard practice of no competence assessment at 1 year post-initial training and this sample would further only be required to complete an online “refresher” every 2 years after completing their initial training.
Impact and Next Steps:• Thus far, this work has culminated in a presentation to AHS WHS
Leadership and the production a report (including a discussion on).
• Increased awareness and receptiveness to integrating QI intoPrograms and practices.
• Additional recommendations: identifying Programs that areinterested, in or would benefit from, QI work; supporting amembers of Program teams to pursue AIW certification etc.
Applying the AIW Methodology and EPIQ Tools to the FTD Program (Continued):
Suppliers Inputs Process Outputs Customers• AHS WHS – FTD
Program.
• Manageridentifies FTDcandidate(s).
• FTD initial training.
• FTD completesshadowing.
• FTD reviews contents of FTDscript.
• FTD completes sensitivitytesting.
• Etc…
• Completion ofrespirator card.
• Completion of paperdocumentation.
• Etc…
• Employeesrequiring fittesting.
(6) Let us assume that our final data shows that a combination of the online “refresher” and in-person “refresher” demonstratesan improvement in maintaining competence assessment scores ≥85% compared to baseline.
(This was assuming, as was anecdotally described, that the baseline data will show large proportion of FTDs will have scores<85% with no annual assessment and “refreshers”).
Key sustainability factor
Completed In progress Not started Responsibility
Process owner identified
AHS WHS FTD Program (Advisors and Managers)
Impacted groups involved in change process
AHS WHS FTD Program (Advisors and Managers)
Etc.
Stakeholder
Relationship to project
Position What we need from them Communication strategy
Has d
ecisi
on a
utho
rity
Can
influ
ence
out
com
e
Will
be
affe
cted
Resis
tor
Neu
tral
Supp
orte
r
Appr
oval
for
impl
emen
tatio
n
Reso
urce
s (pe
ople
, fun
ding
)
Subj
ect m
atte
r exp
ertis
e
Data
Pilo
t sup
port
Mee
t with
regu
larly
Invi
te to
team
mee
tings
Send
cop
y of
mee
ting
min
utes
Spea
k w
ith in
form
ally
as
need
ed
AHS WHS FTD Program (Advisors and Managers)
FTDs
Etc.
Timing Message Content Audience Method Responsibility
Prior to QI cycle 1 (first use of competence assessment tool).
• Reason forimplementingintervention.
• AHS WHS SeniorLeadership.
• Managers(Departments, Sites etc.)
• FTDs.
• Face to face.• Electronic memo.
• AHS WHS FTDProgram(Advisors andManagers).
After last QI cycle.
• Proposed changesto currentstandard practice.
• AHS WHS SeniorLeadership.
• Managers(Departments, Sites etc.)
• FTDs.
• Face to face.• Electronic memo.
• AHS WHS FTDProgram(Advisors andManagers).
Etc.
Presentation PDF
