Quality Improvement. What Is it and How Can It Help Me?
Rapid Cycle Improvement 2009
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7. Not good enough! Patients are waiting and getting angry Need to cut the time in half! What changes can we make that will lead to improvement?
8. Debrief: What did we learn? Teamness Aim, Goals & Measures PDSA Cycles
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12. Cycles Have Been Going on for Years “ Negative results on the fish… Let’s try rubbing two sticks together.”
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14. Rapid Cycle Change Repeated Use of The Cycle Hunches Theories Ideas Changes which result in Improvement After cycles have demonstrated that the change CAN work, use more cycles to help you figure out how the change WILL work, every day Use of Multiple PDSA cycles Adapted from The Improvement Guide P A D S P A D S P A D S P A D S
15. Aim: Improve HCAHPS score “% of patients who reported their nurses always communicated well”. Use of scripting Improved Score A P S D A P S D A P S D D S P A DATA D S P A Cycle 1A:Develop a script and have one nurse test with one patient. Cycle 1B:Revise script and test with three more patients. Cycle 1C: Revise and have nurses on one shift test script with all patients for one week Cycle 1E: Implement and monitor the feedback
20. Change and Information change denial anger bargaining depression acceptance renewal FACTS SUPPORT ENCOURAGEMENT Source: E. Kubler Ross
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23. When do we implement? Staff/Physician Readiness to Make Change Copyright 2008 Institute for Healthcare Improvement and R.C. Lloyd & Associates Current Situation Resistant Indifferent Ready Low Confidence that current change idea will lead to Improvement Cost of failure large Very Small Scale Test Very Small Scale Test Very Small Scale Test Cost of failure small Very Small Scale Test Very Small Scale Test Small Scale Test High Confidence that current change idea will lead to Improvement Cost of failure large Very Small Scale Test Small Scale Test Large Scale Test Cost of failure small Small Scale Test Large Scale Test Implement
26. If you always do what you have always done; You always will get what you always got!!!
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Editor's Notes
Any one who has done this activity before must be a quality officer
Any one who has done this activity before must be a quality officer
17 Do trial run – enough orientation – you know we need to conserve cost – so we only hire smart people so if you didn’t get it you must not be smart and perhaps need to look somewhere else where pressure is less…
Remember what I said about just do it and not just doing it – forget that with
Lots of small changes, tests and experiments create improvement. Each cycle can be either the same experiment under different conditions, or different tests like ICU rounding, followed by a cycle of controlling linen distribution, followed by a cycle of substituting less costly drugs.
Analysis paralysis
Why improve… read .. Or perhaps its counterpart is more true
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