Care of the patient having a radical prostatectomy

Koch, M., Smith, J .,Hodge, E.,Brandell, R.

Care of the patient having a radical prostatectomy

Koch, M., Smith, J .,Hodge, E.,Brandell, R.

What are we trying to accomplish?AIM

What are we trying to accomplish?AIM

How will we know that a change is an improvement?Data

(Tools: Surveys, Run Charts)

How will we know that a change is an improvement?Data

(Tools: Surveys, Run Charts)

What changes can we make that will result in an improvement?Process Analysis

(Tools: Flowchart, Cause & Effect Diagram, Pareto Chart, etc.)Decide on changes

What changes can we make that will result in an improvement?Process Analysis

(Tools: Flowchart, Cause & Effect Diagram, Pareto Chart, etc.)Decide on changes

IMPROVEMENT MODEL

Planthe

Improvement

Studythe

Results

Dothe

Improvement

ActAct to keep changeor Abandon and try

another change

PDSA Cycle—Small rapid cycles of changeLangley, Nolan, et al. 1996

P

A D

SWeb Link for Resources: www.ihi.org/ihi/sitemap.aspx

What are we trying to accomplish?

Aim: To develop of a cost-efficient program for radical

prostatectomy

What are we trying to accomplish?

Aim: To develop of a cost-efficient program for radical

prostatectomy

How will we know that a change is an improvement?

Length of hospital stayReduction in OR time

Material and utilizationCharges

Affect on quality of care

How will we know that a change is an improvement?

Length of hospital stayReduction in OR time

Material and utilizationCharges

Affect on quality of care

What changes can we make that will result in an improvement?

Changes Identified

What changes can we make that will result in an improvement?

Changes Identified

PDSA CYCLEPDSA CYCLE

Planthe

Improvement

Studythe

Results

Dothe

Improvement

ActAct to keep changeor Abandon and try

another change

PDSA Cycle—Small rapid cycles of changeLangley, Nolan, et al. 1996

P

A D

S

Improvement Plan• A multidisciplinary team was

formed to improve care• Each step of the care process

was reviewed for cost, appropriateness, etc

• Changes were proposed, unnecessary variation was reduced

From M.O. Koch and J.A. Smith Jr. Br J. of Urology 1995

From M.O. Koch and J.A. Smith Jr. Br J. of Urology 1995

From M.O. Koch and J.A. Smith Jr. Br J. of Urology 1995

From M.O. Koch and J.A Smith Jr.Br J of Urol, 1995 showing a44% decrease in cost per case. (study done at VUMC)