Strategic Continuous Improvement

8/12/2019 Strategic Continuous Improvement

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The Aged CareStandards and Accreditation Agency

Ltd

QAITQuality AssessorEducation andSeminar objectives

The seminar aims to:

Reiterate the information provided in thecontinuous improvement seminar series

Review the importance of continuousimprovement in the assessment of homes


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QAITQuality AssessorEducation andParticipant outcomes

On completion of this seminar, participants should be

able to:

Understand the relationship between continuous

improvement and strategic planning

Identify the elements of an effective continuous

improvement program that provides measurablebenefit for residents


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QAITQuality AssessorEducation and

Where does

Accreditation fit?

The Accreditation Standards provide a template fora well functioning aged care home the what

These standards provide a solid foundation forhomes continuous improvement program anexternal review of the organisation

The continuous improvement program determinesthe level of care and services the organisationstrives to provide the how and how well


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What constitutes high

quality aged care?

A number of areas of care must be addressed to be

comprehensive:

Health care physical and psychological health andcare

Personal issues belonging, wellbeing, autonomy,dignity and respect

Interactions inside and outside the organisationfamily role, staff and social communication

Services meals, recreational activities Environment safe, homelike, personal space


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Why have a continuous

improvement program?

A strategic continuous improvement program is the way in

which these quality of care and quality of life issues areaddressed:

By setting clear goals and priorities for these areas that

need to be monitored and improved areas of importanceto residents, carers and staff across the domains of quality

By systematically planning and implementing howmonitoring and improvement will occur through relevant

and effective improvement activities

By measuring progress towards achieving the goals, andbeing able to demonstrate exactly what level of care is

being provided


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What can a continuous

improvement programachieve - overview

Evaluate effectiveness

Manage and respond to risks

Monitor the processes

Implement the processes

Establish the people and

processes required to achieve it

Define the level of quality

Goals versus outcomes

Risk management

Monitoring and evaluation

Staff involvement and the righttools

Governance, planning, standards,

priorities

Organisational vision and goals

What it does How it is done


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A planned approach to a

successful continuousimprovement program

The continuous improvement program plan will demonstrate input fromall levels of the organisation and should include both what will be done

to improve care and services, and how that will happen, including:

1. Goals and priorities for providing a high quality of life and care prioritised and linked to the strategic goals

2. A governance structure that supports the achievement of the goals

3. A description of how the continuous improvement program works -how improvement activities are generated, implemented and

assessed

4. Sound data collection, analysis and reporting - to supportimprovement and achievement of the goals

5. A system to evaluate the overall continuous improvement program


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Goals and priorities are

clearly defined

Sources of information to help organisations to identify goalsand priorities for improvement include:

The organisations strategic goals

Information about things that impact on quality of careand quality of life of residents, and appropriate levels ofcare (from the Accreditation Standards, the aged careliterature, other organisations and internal discussions)

Areas in which routine data collections identify that

things could be better Issues of importance to residents and staff planned,

and as issues occur, across the domains of quality


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QAITQuality AssessorEducation andDefining goals and priorities

Priority improvement activities will include those that

contribute to achieving the strategic goals and goodgovernance of the organisation

Governing bodies have the same governance responsibilityfor the quality of care and services provided in their homeas they do for the homes business performance

Data needs to continue to be collected as part of thecontinuous improvement program to support the governingbodys accountabilities


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QAITQuality Assessor

Education and

Another way of identifying priorities is to look at areas of

risk to residents and staff. Key issues to be monitored in

the health of aged care residents include:

medications falls

infections

pressure ulcers

depression

nutrition and hydration

pain

Defining goals and prioritiesDefining health care risks in aged care


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Education and

Key issues of importance to be monitored in the

quality of life of aged care residents:

Health care physical and psychological health and care

Personal issues choice, belonging, wellbeing,autonomy, dignity and respect

Interactions inside and outside the organisationfamily role, staff interactions and social communication

Services meals, recreational activities

Environment safe, homelike, personal space

Defining goals and prioritiesQuality of life issues


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Education and

As well as planned continuous improvement activities, thecontinuous improvement plan should make provision forone-off improvement activities to address issues as theyarise you cant plan for everything

The continuous improvement plan should describe theprocess for managers and staff to respond to unexpectedproblems that arise how to link them to the continuousimprovement goals, how to plan and report on them

The continuous improvement program will include planned(proactive), one-off (responsive) and monitoring (high riskand quality assurance) activities to achieve the goals

Defining goals and prioritiesBuilding in one-off activities


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Education and

Allocating clear continuous improvement responsibilitiesto staff promotes a strategic and accountability basedapproach to organisational continuous improvement

To build a culture of improvement that achieves theimprovement goals, staff responsibilities for residentquality of care and quality of life need to be clear andsupported through line management

GovernanceDefining staff responsibilities


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Education and

Examples of organisational

improvement roles

Improvement basics:spotting, reporting,

suggesting, discussing,data collection

Ensuring safety:proactive monitoring,

minimisingand managing risk

Continuous

improvement: doingthings better for

improved outcomes

Leadership in safety

and quality:local and organisational

Innovation: doingdifferent things for

improved outcomes Improving quality of careand quality of life


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Education and

Good governance should also help build a culture of

improvement, that includes:

a just culture a culture where unsafe situations for residents and staff

are not tolerated and action is taken a culture that focuses on improving systems to prevent

problems and promote good practice, rather than relyingon people to be perfect all the time

a culture of seeking customer feedback a culture wherein improvement is seen as something

important to be involved in every day as it makes a realdifference to the organisation

Governance

A continuous improvement culture


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Education and

How the continuous

improvement process works

The improvement plan will include information to enable staff

to easily participate:

Where to get assistance in the organisation

Individual roles and responsibilities for improvement The continuous improvement cycle, including:

How to decide what improvement issue to tackle

Who to involve in an improvement activity

How to choose the appropriate method/tools

How to report and evaluate the results.


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Education and

How the continuous


This information should guide staff in developing

effective improvement activities that contribute toachievement of the improvement goals, and include:

A clear aim that is understood by all those involved and

contributes to care and service improvement A good reason for doing it clearly communicated A clear plan and process for achieving it that all

interested stakeholders have worked on

Those involved are enabled to participate throughsupport and skills

And senior level support for all these things.


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Education and

How the continuous


1. An area for improvement isidentified from routine data collection, a

problem, anecdotal reporting or a desire toimprove something.

2. Analyse the problem/issue.

3. Develop ideas for solving theproblem/improving the area.

4. Put ideas into action and evaluate themusing the quality cycle

Plan

Do

Study

Act

The improvement cycle


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Education and

The continuous improvement

process

Each improvement activity should be planned to ensure

long term change and sustainability:

All improvement requires change but not all change is animprovement. To sustain and embed change, homes should:

capture both hearts and minds of staff show clear benefits of the change

change the system to embed the change work out long term monitoring keep an eye on how the

change is going

Without sustainability, an improvement is just a project, not a

solution.


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Education and

Data analysis

and reporting

Key to effective continuous improvement is the appropriate

use of data:

Some data will relate to continuous monitoring of risks Some will be generated by improvement activities

Data on individual activities needs to be presented andreported in such a way that it prompts action this shouldbe part of the planning phase of any continuousimprovement activity

Staff responsible for data analysis and reporting shouldreceive relevant skills development in improvement tools including data collection, analysis and presentation


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Education and

Continuous improvement is not research

Cant measure everything - depends on the purpose of theactivity

Need just enough data to see a trend and tell a story aboutthe effect of the changes

Needs to be accurate to carry any weight or to make acase for change

Both quantitative and qualitative data are useful

Routine and one-off data needs to be reported to staffinvolved, and to a relevant committee and senior managersto ensure action can be initiated, and that an overview ofcare and services is maintained

Data analysis

and reporting


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Education and

To be confidently acted on, data should be:

Valid

Validity means that the data are measuring what theyare designed to measure

Reliable Reliability means that the way in which the data are

collected will give you the same result, no matter whocollects the data

Sufficient

Consider if you have enough or adequate data tosupport your finding

Data analysis

and reporting


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Education and

EvaluationClosing the loop

Evaluation should be built into the overall continuous

improvement plan as well as into individual improvement

activities. What is evaluation?

Whereare wenow?

Where did

we start?

Where dowe want

to be?


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Education andEvaluation

There will be two types of evaluation in a continuous

improvement program:

Evaluation should be built into each continuous

improvement activity. Did the activity achieve theimprovement outcomes/objectives that were planned?

Evaluation of the overall improvement program. Is itachieving the planned goals for the residents, staff andorganisation?


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Education and

When reviewing the outcome of an individual

improvement activity, organisations should be able to

demonstrate four steps:

1. Restate the aim - what were they trying to achieve?

2. To what extent did they achieve the goal? How far did

they get in the time period and how do they know What does the data say?

Evaluation


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Education and

3. Has the change/action improved the standard of care orsituation or fixed the problem that is has the aim beenachieved?

4. If the home piloted the solution in one part of theorganisation, are they ready now to spread and embedthe change across the rest of the organisation (if

necessary)?

Evaluation


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Education and

Evaluation of the overall continuous improvement

program

Periodically, at least annually, the overall continuousimprovement program should be evaluated. This should

constitute a mix of process and outcome questions:

Is the home doing the right things? Is the home getting the results wanted?

Evaluation


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Education and

Examples of questions that can be asked to ascertain progress with

processes:

Does the home use the correct and evidence based standards forresident care and services, staff safety and equipment, and are theymeeting state and national requirements in these areas?

What are the homes key sources of information to help them monitor

and improve?

Where has the home reviewed and re-designed its systems toembed improved practice?

Is the home including consumers constructively in its improvementefforts?

What has the home learned through benchmarking with otherorganisations?

Evaluation


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Education and

Examples of questions that can be asked to ascertain progress with

outcomesinclude:

To what extent has the home achieved its continuous improvementgoals? Is the home delivering the planned levels of care and service inits priority areas across the domains of quality in aged care?

What are the homes high risk, high volume, high cost, high problem,high complaint areas? How is the home addressing them?

Does the organisation exhibit a culture of continuous improvement?

Are the homes staff competent and credentialed to do what they do topromote a high standard of care and service?

Are staff effectively participating in the program through the support

and skills being offered to them?

Evaluation


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Education and

And four questions that should be asked quarterly to ensure

things are on track, by individual departments and by seniormanagement:

How safe are the people in the homes care?

How is the residents quality of life?

How are the residents and staff better off because of thehomes continuous improvement program?

Is the continuous improvement program supporting theorganisation to be the type of home the home wants it tobe?

Evaluation


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Education and

Summary of the critical elements of a continuous

improvement program:

The what:

A planned approach with high level support Clear goals the why do it? factor

A few key priorities at a time, over time, across the

domains of quality Evidence of achievement or not

Seminar review


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Education and

The how:

Staff buy-in via clear goals and roles, training and support

Consumer input

Clear processes for achieving the goals action steps,improvement tools, data, learning from others

Regular review to ensure that both individual activities, andthe overall continuous improvement program, is working

towards the goals

Seminar review


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Education and

The continuous improvement program doesnt have

to be large and complicated, but to be useful, it does

have to be:

relevant to the key areas of care provided and residents

experience

planned, focused and systematic

evaluated for its effectiveness in improving the health andquality of life of residents

Seminar review


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Education and

Thank you

Strategic Continuous Improvement

Documents

Transcript of Strategic Continuous Improvement