Quality Improvement
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Transcript of Quality Improvement
Quality Improvement Processes
Joint Advisory Inc.
Quality Improvement Processes come in many shapes and sizes go by many different names are marketed by many different sources
With a common goal…
To improve and assure the safety, quality, and cost efficiency of health care
Basic Concept
Our goal today is to lay the groundwork for future training sessions regarding quality improvement
We will get a taste of numerous methodologies and approached to quality improvement
One size does not fit all Quality improvement is a journey taken in baby steps –
not giant leaps
Today’s Goal
Model for Improvement Rapid Cycle Quality Improvement
PDSA
Human Factors Lean Methodology
5S Failure Modes and Effects Analysis Root Cause Analysis
Common Quality Improvement Processes
Let’s make the perfect peanut butter and jelly sandwich!
Exercise
Do we all define the process in the same way? Did we assume steps without spelling them out? Did we all address the problem in the same way, or were there
variations in our processes?
Learning
A process improvement approach to evaluate change This model allows for integration of new and existing
systems. This model promotes small scale rapid cycle change
over short periods of time.
Rapid Cycle Process Improvement
A process improvement approach to evaluate change This model allows for integration of new and existing systems. This model promotes small scale rapid cycle change over short
periods of time.
WHAT is the PDSA Cycle?
The PDSA Cycle for Learning and Improvement
PlanAct
DoStudy
- Objective- Questions and predictions (Why?)- Plan to carry out the cycle(who, what, where, when)
- Carry out the plan- Document problems and unexpected observations- Begin analysis of the data
- Complete the analysis of the data - Compare data to predictions - Summarize what was learned
- What changes are to be made?
- Next cycle?
Let’s PLANPLAN The Perfect Peanut Butter and Jelly Sandwich!!!! What do we want to improve? What change should we test? What is our anticipated outcome? Theorize
What Do We Mean by Rapid Cycle Improvement?
Let’s DODO The Perfect PB & J Sandwich!!! Put the theory into practice Map the new plan Carry out the change on a small scale or pilot basis Evaluate change with qualitative and quantitative data
What Do We Mean by Rapid Cycle Improvement?
Let’s STUDYSTUDY The Perfect PB & J Sandwich!!! Evaluate and determine the degree of success. Determine what, if any, modifications are required.
What Do We Mean by Rapid Cycle Improvement?
Let’s ACT ONACT ON The Perfect PB & J Sandwich!!!Adopt
by testing on a larger scale in a new cycle
Adapt based on lessons learned from the test
Abandon By trying something different
What Do We Mean by Rapid Cycle Improvement?
The PDSA Cycle for Learning and Improvement
PlanAct
DoStudy
- Objective- Questions and predictions (Why?)- Plan to carry out the cycle(who, what, where, when)
- Carry out the plan- Document problems and unexpected observations- Begin analysis of the data
- Complete the analysis of the data - Compare data to predictions - Summarize what was learned
- What changes are to be made?
- Next cycle?
Repeated Use of the Cycle
Hunches Theories Ideas
Changes That Result in Improvement
A P
S D
APS
D
A P
S DD S
P ADATA
Allows you to test your theory on a few patients It may take several PDSA cycles and several months to get
your process manageable. That’s OK!
PDSA
1. Testing or adapting a change
2. Implementing an improvement
3. Spreading the improvements to the rest of your organization
Use the PDSA Cycle for:
Active Quickly plan and make process changes
Iterative Cycle after cycle
Learning Take time to study effects of your actions
PDSA Cycles Must Be:
Human Factors is about how features of our tools, tasks, and work environments continually influence what we do and how we do it.
Human Factors
Human Factors is about how the design of things impacts how well we do any task. Design of our workplace Design of the tools we use Design of processes (how we do things
around here)
In Other Words…
No! Human Factors is complementary to what
you are already doing to improve health care Human Factors will make your improvement
efforts more efficient and effective There is a Human Factors concept behind
every successful improvement effort
Is This the Same Old Thing?
Each line represents the RN’s movement from one location to another. For example, RN moves between patients 14A and 14B twice.
Talk About Human Factors!!!
Human Factors and the Model for Improvement
Plan
Study Do
Act
What are we trying to accomplish?
How do we know that a change is an improvement?
What changes can we make that result in an improvement?
Human factors can help answer this question!
It’s all about: Waste and Value Always challenging processes to
Produce better outcomes for customers Create more value with less wasted time, effort, and resources Speed delivery while reducing cost Lay less burden on the people doing the work.
Lean Methodology
5S is a philosophy and a way of organizing and managing the workspace.
The key impacts of 5S is upon workplace morale and efficiency. By ensuring everything has a place and everything is in
its place then time is not wasted looking for things and it can be made immediately obvious when something is missing.
The real power of this methodology is in deciding what should be kept and where and how it should be stored
5S
5S
Seiri Seiton Seiso Seiketsu Shitsuke
Sort Set In Order Shine Standards Sustain
Based on Japanese words that begin with ‘S’, the 5S Philosophy focuses on effective work place organization and standardized work procedures.
5S simplifies your work environment, reduces waste and non-value activity while improving quality efficiencyand safety.
Failure Modes and Effects Analysis (FMEA) is a systematic, proactive method for evaluating a process to identify where and how it might fail, and to assess the relative impact of different failures in order to identify the parts of the process that are most in need of change.
Failure Mode Analysis
FMEA includes review of the following:
Steps in the process Failure modes (What could go wrong?) Failure causes (Why would the failure happen?) Failure effects (What would be the consequences of
each failure?)
Failure Mode Analysis Continued
A way of looking at unexpected events and outcomes to determine all of the underlying causes of the event and recommend changes that are likely to improve them.
Root Cause Analysis
The 5 Whys? Appreciation Drill Downs Cause and Effect Diagrams (Fishbone Diagrams)
RCA Tools
“There are no secrets to success. It is the result of preparation, hard work, and learning from failure.”
General Colin L. Powell
Success
Quality Improvement Quality Improvement is a is a Process, Process, not an not an EventEvent