Grace Gorenflo Jack Moran. Goal: To provide a foundation for COP-PHI awardees’ quality improvement...
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Transcript of Grace Gorenflo Jack Moran. Goal: To provide a foundation for COP-PHI awardees’ quality improvement...
Goal: To provide a foundation for COP-PHI awardees’ quality improvement efforts
Learning Objectives:- Understand the distinction between
quality improvement and other, related activities
- Understand the phases of a Plan-Do-Check-Act cycle
“Quality improvement in public health is the use of a deliberate and defined improvement process, such as Plan-Do-Check-Act, which is focused on activities that are responsive to community needs and improving population health.
“It refers to a continuous and ongoing effort to achieve measurable improvements in the efficiency, effectiveness, performance, accountability, outcomes, and other indicators of quality in services or processes which achieve equity and improve the health of the community.”
This definition was developed by the Accreditation Coalition Workgroup (Les Beitsch, Ron Bialek, Abby Cofsky, Liza Corso, Jack Moran, William Riley,
and Pamela Russo) and approved by the Accreditation Coalition on June 2009.
Quality Assurance
Reactive Works on problems
after they occur Regulatory usually by
State or Federal Law Led by management Periodic look-back Responds to a
mandate or crisis or fixed schedule
Meets a standard (Pass/Fail)
Quality Improvement
Proactive Works on processes Seeks to improve
(culture shift) Led by staff Continuous Proactively selects a
process to improve Exceeds expectations
Evaluation
Assess a program at a moment in time
Static Does not include
identification of the source of a problem or potential solutions
Does not measure improvements
Program-focused A step in the QI
process
Quality Improvement
Understand the process that is in place
Ongoing Entails finding the root
cause of a problem and interventions targeted to address it
Focused on making measurable improvements
Customer-focused Includes evaluation
Identify and prioritize quality improvement opportunities
www.adesblog.com/category/getting-things-done/
Identify / Prioritize Opportunities Example:
Vital Statistics Customer average wait
time more than 28 minutes
Develop an AIM Statement
WHAT are we striving to accomplish? WHEN will this occur (what is the timeline)? HOW MUCH ? What is the specific, numeric
improvement we wish to achieve? FOR WHOM ? Who is the target population?
Describe the Current Process for Vital Statistics:
Limited number of cashiers
to process transactions
Identify Possible Causes:
No. of cashier windows open,
Printer/network issues,
Incomplete documentation etc.
Identify Potential Improvements:
Increase the number of cashier
windows open(especially at rush hour)
Develop Improvement Theory:
Create trigger system for supervisor to
improve customer flow.
Maintain wait time to 15mins.
Develop Action Plan: Pilot Program:
One additional cashier added from
Correspondence and additional cashier/s
when wait time exceeds 15 minutes
Implement the improvement
Collect and document the data
Document the problems, unexpected observations, lessons learned, and knowledge gained
Implement the Improvement:
Implementation of Pilot
Program for a week
Collect and Document the data:
Wait time reduced by 50%
Problems, Observations, Lessons LearnedPilot Program Implementation
Day 1: Ran a snag – 4 staff out
Day 2: Successfully implemented Pilot
Program (5 cashier windows open)
Analyze the results: was an improvement achieved?
Document lessons learned, knowledge gained, and any surprising results that emerged.
Reflect on the Analysis:
Data obtained for wait time - 1 Week pilot program.
Cashier Survey data
Document Problems: Unavailability of Staff and Communication issues.
Observation: Smooth running of pilotLessons learned: Customer Wait time directly
proportional to # of cashier window open
Take action: Adopt - standardize Adapt – change and repeat Abandon – start over
Once you’ve adopted – monitor and hold the gains!
Plan
1. Identify / Prioritize Opportunities:Customer average wait time
more than 28 minutes
2. AIM: Reduce customerwait time to 15 minutes
3. Current Process: Limited number of cashiers
to process transactions
4. Collect Data On: Number of cashiers and the wait time
per customer
5. Identify Possible Causes: No. of cashier windows open,
Printer/network issues, Incomplete documentation etc.
6. Identify Potential Improvements:Increase the number of cashier
windows open(especially at rush hour)
7. Develop Improvement Theory: Create trigger system for supervisor to
improve customer flow. Maintain wait time to 15mins.
8. Develop Action Plan: Pilot Program – One additional cashier added from
Correspondence and additional cashier/swhen wait time exceeds 15 minutes
1. Implement the Improvement:Implementation of Pilot
Program for a week
Do
2. Collect and Document the data:Wait time reduced by 50%
3. Problems, Observations, Lessons LearnedPilot Program ImplementationDay 1: Ran a snag – 4 staff out
Day 2: Successfully implemented Pilot Program (5 cashier windows open)
Day 2-5: Pilot Successfully implemented
Check/Study
1. Reflect on the Analysis:Data obtained for wait time - 1 Week
pilot program. Cashier Survey data
Act:
2. Document Problems: Unavailability of Staff and Communication issues.
Observation: Smooth running of pilotLessons learned: Customer Wait time
directly proportional to # of cashier window open
Adopt
Adapt
Abandon
Standardize
Do
Plan
Blue Team: Vital Stats
PLAN
DO
CHECK
ACT: Achieve Results
?
Decide to do QI
Standardize
No/Maybe - Adapt
Yes - Adopt
No - Abandon
Myth: QI is about weeding out the bad apples
Truth: QI is about processes - series of steps or actions performed to achieve a specific purpose
Myth: If I don’t achieve my goal, I’ve failed
Truth: When doing QI, there is no such thing as failure