HQO Quality Improvement Framework. Sandie Seaman & Lynn Dionne - PowerPoint PPT Presentation

HQO Quality Improvement Framework. Sandie Seaman & Lynn Dionne www.HQOntario.ca

www.HQOntario.ca

Objectives Participants will be able to: Apply HQO’s QI Framework in planning activities that will contribute to the achievement of Health Link year one goals and objectives Briefly describe 3 evidence informed improvement packages that can be used by Health Links. www.HQOntario.ca .

How to Participate Today • Open and close your Panel • View, Select, and Test your audio • Submit text questions • Raise your hand www.HQOntario.ca

How to use this time well www.HQOntario.ca

Presenter Disclosure Presenter(s) • Sandie Seaman • Lynn Dionne Relationships with commercial interests: • Grants/Research Support: Not Applicable • Speakers Bureau/Honoraria: Not Applicable • Consulting Fees: Not Applicable • Other: Not Applicable www.HQOntario.ca 5

Disclosure of Commercial Support • This program has received no commercial or financial support • This program has received no in-kind commercial or financial support • Potential for Conflict(s) of interest:  No speaker has received payment or funding from any for-profit organization  No organization has a product that will be discussed in the program www.HQOntario.ca 6

Who is joining the call today? www.HQOntario.ca

Health Links: Partnering Around Patients Ministry of Health and Long Term Care, June 25, 2013 www.HQOntario.ca

Health Links: A New Way of Working Together Ministry of Health and Long Term Care, June 25, 2013 www.HQOntario.ca

Healthcare: The Current State Ministry of Health and Long Term Care, June 25, 2013 www.HQOntario.ca

Health Links’ initial focus www.HQOntario.ca

Indicators of success Health Links: Work-planning & the Path Forward July 2013 Ministry of Health & Long-Term Care www.HQOntario.ca

bestPATH & Health Links bestPATH www.HQOntario.ca

bestPATH – A Support to Health Links • Build quality improvement capacity • Help to identify and address gaps in the quality of care & services • Facilitate discussions health link teams about implementing patient & family engagement strategies • Provide leadership and support in measurement and implementation of evidence supported change ideas www.HQOntario.ca

bestPATH – A Support to Health Links www.HQOntario.ca

Why HQO developed a framework Teams Sustainability Theory Phillips-Kirkpatrick Model 16

Sources Reviewed • The Improvement Guide: A Practical Approach to Enhancing Organizational Performance (Langley, et al.) • Leading Change: Why Transformation Efforts Fail (John P. Kotter) • NHS Sustainability Model • IHI Spread Model • Adult Learning Principles • Dr. W. Edwards Deming body of work • Lean literature • Kaoru Ishikawa 17

MODEL FOR IMPROVEMENT What are we trying to accomplish? How will we know that a change is an improvement? What change can we make that will result in an improvement? ACT PLAN STUDY DO www.HQOntario.ca

Overview DEFINING UNDERSTANDING DESIGNING AND IMPLEMENTING SPREADING GETTING THE YOUR SYSTEM TESTING AND SUSTAINING CHANGE STARTED PROBLEM SOLUTIONS CHANGES • Assemble Team • Identify • • Create PDSA • Formalize and • Implement Analyze Data Measures Plan Standardize Spread Plan • Create Project • Share Results Changes • Create and Test • Test Changes - • Communicate Charter • Future State • Collect Measurement PDSA broadly • Set Aims Map Plan Measures, Look • Collect • Collect • Capture Voice of • Update Charter for Slippage • Gather and Measures – is Measures, Look Customer • • Sustain Change Share Baseline Prioritize there for Slippage • Create and Data Opportunities improvement? • Implement • Sustain Change Validate Current • Create List of • • Share Results Brainstorm Sustainability State Map Improvement Change Ideas Broadly Plans Opportunities • • Engage Create Sub- • Define “ Spread ” team aims that Align Opportunity with High-level members or Problem Aims www.HQOntario.ca 19

Poll Using the HQO framework- where do you think your Health Link is in the QI journey? (use the #s below) DEFINING GETTING UNDERSTANDING DESIGNING AND IMPLEMENTING SPREADING THE YOUR SYSTEM TESTING AND SUSTAINING CHANGE STARTED PROBLEM SOLUTIONS CHANGES 2 1 3-4 5-6 OR- use zero, “0”, if your HL is not yet in the getting started phase. www.HQOntario.ca 20

Poll Results How can I apply the Quality Improvement Framework to Health Links? www.HQOntario.ca 21

Getting started DEFINING UNDERSTANDING DESIGNING AND IMPLEMENTING SPREADING GETTING THE YOUR SYSTEM TESTING AND SUSTAINING CHANGE STARTED PROBLEM SOLUTIONS CHANGES • Assemble Team • Create Project Charter • Set Aims • Capture Voice of Customer • Create and Validate Current State Map www.HQOntario.ca 22

GETTING STARTED www.HQOntario.ca

GETTING STARTED People with respiratory disease who are high risk for (re) admission to hospital. People with congestive heart failure who find it challenging to cope at home. www.HQOntario.ca 24

Set AIM Statement GETTING STARTED By September 1, 2014 we will reduce the number of people with COPD who require hospital admissions by 25%. www.HQOntario.ca 25

GETTING STARTED Map the value stream Understand the experience or voice of the customer www.HQOntario.ca

Poll 1. Have you included a Value Stream Mapping (VSM) exercise in the beginning stages of your Health Link planning? • Yes, No, Unsure www.HQOntario.ca

Poll 2. Have you included patients and their family members in the VSM exercise? • Yes, No, Unsure www.HQOntario.ca

Defining the problem DEFINING UNDERSTANDING DESIGNING AND IMPLEMENTING SPREADING GETTING THE YOUR SYSTEM TESTING AND SUSTAINING CHANGE STARTED PROBLEM SOLUTIONS CHANGES • Identify Measures • Create and Test Measurement Plan • Gather and Share Baseline Data • Create List of Improvement Opportunities • Define Opportunity or Problem www.HQOntario.ca 29

DEFINING THE PROBLEM www.HQOntario.ca

Understanding your system DEFINING UNDERSTANDING DESIGNING AND IMPLEMENTING SPREADING GETTING THE YOUR SYSTEM TESTING AND SUSTAINING CHANGE STARTED PROBLEM SOLUTIONS CHANGES • Analyze Data • Share Results • Future State Map • Update Charter • Prioritize Opportunities • Brainstorm Change Ideas • Create Sub- aims that Align with High-level Aims www.HQOntario.ca 31

UNDERSTANDING YOUR SYSTEM www.HQOntario.ca

UNDERSTANDING YOUR SYSTEM Future state map depicts a newly designed process that provides maximum value to the person who requires care, is effective and efficient www.HQOntario.ca

UNDERSTANDING Identify Change Ideas YOUR SYSTEM Change concepts and ideas can come from a variety of places, including: - Evidence based guidelines and improvement packages - Improvement Guide - Peers – what have others implemented? - Patients, clients, residents - Staff - Other stakeholders www.HQOntario.ca 34

DEFINING UNDERSTANDING DESIGNING AND IMPLEMENTING SPREADING GETTING THE YOUR SYSTEM TESTING AND SUSTAINING CHANGE STARTED PROBLEM SOLUTIONS CHANGES • Create PDSA Plan • Test Changes - PDSA • Collect Measures – is there improvement? • Share Results Broadly www.HQOntario.ca 35

DESIGNING AND TESTING SOLUTIONS www.HQOntario.ca

Sample Change Ideas DESIGNING AND TESTING SOLUTIONS At time of admission to hospital, phone primary care provider to discuss plan of care and notify of admission. Use teach back at every discharge – ensure the person knows how to recognize worsening respiratory symptoms and how to manage at home. Use teach back at every primary care visit – ensure the person knows how to recognize worsening respiratory symptoms and how to manage at home. Enable patients to email their primary care provider(s) with questions about their symptoms and /or treatment. www.HQOntario.ca

Is your PDSA working? DESIGNING AND TESTING SOLUTIONS www.HQOntario.ca 38

DEFINING UNDERSTANDING DESIGNING AND IMPLEMENTING SPREADING GETTING THE YOUR SYSTEM TESTING AND SUSTAINING CHANGE STARTED PROBLEM SOLUTIONS CHANGES • Formalize and Standardize Changes • Collect Measures, Look for Slippage • Sustain Change • Implement Sustainability Plans • Engage “ Spread ” team members www.HQOntario.ca 39

Hierarchy of Controls to Sustain IMPLEMENTING AND SUSTAINING Changes CHANGES Automation Fundamental Change of the Process Visual Control, Error Proofing, Standard Work Checklists, Audits, Signs, Memos www.HQOntario.ca 40

DEFINING UNDERSTANDING DESIGNING AND IMPLEMENTING SPREADING GETTING THE YOUR SYSTEM TESTING AND SUSTAINING CHANGE STARTED PROBLEM SOLUTIONS CHANGES • Implement Spread Plan • Communicate broadly • Collect Measures, Look for Slippage • Sustain Change www.HQOntario.ca 41

Where can you find more information about the QI Framework on our website? http://www.hqontario.ca/qua lity-improvement/quality- improvement-framework 42