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John Leon, RN, MPH Nursing Homes Projects Specialist, OFMQ Building Success with Small Improvements
Transcript of John Leon, RN, MPH Nursing Homes Projects Specialist, OFMQ › sites › default › files ›...
John Leon, RN, MPH
Nursing Homes Projects Specialist, OFMQ
Building Success with Small Improvements
QAPI Process • QAPI team sets priorities for improvement efforts • Utilize interdisciplinary team to develop the
improvement process • Set a SMART goal to drive efforts
(Specific Measurable Attainable Relevant and Time bound)
“Could your home reduce number of residents that self-report moderate to severe pain from 21.3 to 16.4% in 6 months?”
• Create interventions to achieve your goal (PDSA)
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MDS Facility Level Report
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Determine Your Improvement
Calculate New Goal
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New Goal Statement
Tracking QMs
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Tracking Results
Tracking Pain Management
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Tracking Pain Management
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Tracking UTIs
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Tracking Falls with Injury
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MDS Resident Level Report
The PDSA Cycle for Learning and Improvement
Act Plan
Study Do
Presenter
Presentation Notes
contrast with P-P-P-Panic Plan: Each PDSA has an objective and a measure. Learn from predictions. Study: test hypothesis. Power of learning is things we didn't expect. P-D-S is scientific method. Act: what are we going to do next? Plan-Do is a common problem. If don't study, never know if it works. Some teams Do-Do-Do-Do: good news, get a lot done. Bad news: sometimes find yourself in do-do These things are not PDSA cycles: (unless test different ways) meetings specific tasks: revise a form improving a global measure a plan to accomplish each goal
PLAN
State the objectives/purpose
Make predictions
Develop a plan to test the change
DO
Carry out the test
Document problems and observations
Begin to study the data
STUDY
Complete the study of the data
Compare the data to predictions
Summarize and reflect
ACT
Adopt-Adapt-Abandon
Determine what modifications need to
be made.
Prepare a plan for the next test.
Small-scale, Rapid PDSA Cycle- Plan
Purpose: Decrease resident pain by
use of whirlpool bath Plan: • Make sure whirlpool is
working • Schedule time for
resident in whirlpool • Have staff available and
able to assist resident
Do: • Resident uses the
whirlpool • Record effects of
whirlpool Study: • What were the effects of
the whirlpool Act: • Adopt-Adapt-Abandon
Presenter
Presentation Notes
Scale down plan – just add powder to brownies on Tuesday. See what happens Don’t confuse the DO cycle with the “to do” list
Repeated Use of the Cycle
Hunches Theories
Ideas
Changes That Result in
Improvement
A P S D
A P S D
Presenter
Presentation Notes
I have an idea, I'd like to make it work. Start with a small test (example: goal setting Do a follow-up test.(new script) Do a wider-scale test, tougher more patients, more risk (different culture, different provider) implement at the top. Not one test, many tests Like learning an instrument.
TIPS FOR TESTING CHANGE
Always stay one cycle ahead Small scale does not equal small
change Choose changes that do not require
long process of approval Don’t reinvent the wheel
Tracking to Show Success!
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