Quality Improvement Series Session 7- System Redesign Windy Stevenson [email protected]
Quality Improvement Series Session 4- shaping the AIM Windy Stevenson [email protected]
18
description
Quality Improvement Series Session 4- shaping the AIM Windy Stevenson [email protected]. Today’s Agenda. Where are we, and how did we get here? What are the pros and cons of our project? Where do we want to be, and what does that mean? . Take Home Points (review). - PowerPoint PPT Presentation
Transcript of Quality Improvement Series Session 4- shaping the AIM Windy Stevenson [email protected]
2
Today’s Agenda
1. Where are we, and how did we get here?2. What are the pros and cons of our project?3. Where do we want to be, and what does that
mean?
3
Take Home Points (review)
Real (sustainable) change comes from changing systems, not changing within systems
• education alone doesn’t work• don’t push the current system to work harder
It’s your job to spot the system that isn’t working
Be specific about what you want to accomplish, and why; be intentional
Focus on patients
Start before you think you are ready; don’t get paralyzed
Don’t be the donkey
4
Don’t be the donkey!
5
Problem statement
Advantages WE picked it, and therefore it has meaning to us We know there is plenty of opportunity for
improvement Capacity to improve both patient safety and
provider satisfaction Important to OHSU
The DCH ambulatory clinic problem lists are incomplete and inaccurate
6
Systems…
A system is a set of interdependent parts sharing a common purpose.
Every system is perfectly designed to achieve the results it achieves.
• The parts• The interaction of the parts• The people
7
The Problem List “System”
What results is our current system designed to produce?
WHY?
What is the definition of CHAOS?
8
Challenges (ie barriers)
Time Culture
– Ownership Definition of accuracy Lack of natural error identification Lack of natural rewards Need for manual audits
9
Where do you start?
Problem statement: The DCH ambulatory clinic problem lists are incomplete and inaccurate.
BUT WHAT DOES THAT MEAN???
10
Well child care
2yo WCC No documented medical or surgical conditions
11
Well child care
12
Well child care- complex kid
4 mo WCC- former premie
13
Acute care visit- healthy kid
5yo in clinic for cough No medical or surgical conditions Has had 3 acute visits and one ED visit but no WCC with us
14
Acute care visit- complex kid
3yo with complex hx in clinic for “dropped something on foot”
15
What about if they DON’T show?
5 yo with asthma; no show for scheduled clinic appt
16
Start SOMEWHERE!
Institutional or leadership priorities– Clinical– Fiscal
Safety risk Most annoying (therefore most motivation to fix?) Most easily solved Most easily measured Most meaningful to customers
17
How do you create a SMART aim?
Specific we are intentional and focused Measurable we can prove we’ve had an impact Actionable there are no known insurmountable barriers Realistic it’s within our scope Timely we’ll do it within a time frame
18
Where to go from here
What do we want to do first? – Success begets success
What can we ACTUALLY accomplish?– What patient population(s) or problem type(s)?– To impact what time point (before the visit?)
What is our AIM?
