Quality Improvement Methodology Beth Hickerson Quality Improvement - PowerPoint PPT Presentation

Quality Improvement Methodology Beth Hickerson Quality Improvement Advisor September 18, 2017

WHAT IS QUALITY IMPROVEMENT?

What is Quality Improvement? Quality Improvement is systematic and continuous action that lead to measurable improvement in: Outcomes Cost Efficiency Experience Value Driven.Health Care. Solutions. 3

What Quality Improvement is NOT Quality Improvement is NOT Quality Control Quality Improvement Quality Control Better Perfect “What could we do?” “What should we do?” Real, messy world Controlled environment Value Driven.Health Care. Solutions. 4

How does it relate to GLPTN? Milestone 19 PCP/ 14 SPEC of the PAT “Practice uses an organized approach (e.g. use of PDSAs, Model for Improvement, LEAN, Six Sigma) to identify and act on improvement opportunities.” Phase 2 – The practice is beginning to incorporate regular improvement methodology to execute change ideas but the methodology has not been implemented in all areas. Phase 4 – The practice fully incorporates regular improvement methodology to execute change ideas. Value Driven.Health Care. Solutions. 5

How does it relate to GLPTN? Milestone 20 PCP/ 15 SPEC of the PAT “Practice builds QI capability in the practice and empowers staff to innovate and improve.” Phase 2 – Practice is actively building QI capability within the practice through approaches such as including QI skills in orientation for all new staff and ensures that all staff participate in QI training. Phase 3 – Practice has developed QI capability within the practice and empowers staff/providers to participate by allocating time for QI activities, including QI within defined job duties, recognizing and rewarding innovation and improvement. Value Driven.Health Care. Solutions. 6

WHY IS QUALITY IMPROVEMENT METHODOLOGY IMPORTANT?

Quality Improvement gone wrong Value Driven.Health Care. Solutions. 8

QUALITY IMPROVEMENT PRINCIPLES

The Building Blocks Value Driven.Health Care. Solutions. 10

“Where there’s a WILL there’s a way.” No will = the hard way Value Driven.Health Care. Solutions. 11

Resistance to Change is Human The greatest reason for resisting change is the human need for certainty. Change brings uncertainty, which leads to anxiety. Anxiety suggests that my existing paradigm is in danger. Our paradigms create our reality and we feel safe there. Source: www.derekhendrikz.com Value Driven.Health Care. Solutions. 12

Building (Good) Will Start with leadership (aka YOU!) Explain what – problem and vision Explain why – make the status quo uncomfortable and the possible attractive Identify and acknowledge objections Share WIIFM Clarify expectations Avoid punishment Acknowledge effort Reward innovation Share achievements Value Driven.Health Care. Solutions. 13

The QI Secret Value Driven.Health Care. Solutions. 14

“IDEAS come from curiosity.” – Walt Disney Ideas Thoughtful conversation = Most powerful tool in QI Value Driven.Health Care. Solutions. 15

Why you need a QI Team Create good will and ownership with team members Team members become “buy - in” ambassadors “No decisions about me without me.” (not just for patients!) Many minds are better than one “Out of the box” ideas usually come from outsiders Good leaders know when to delegate Engage your “changers” Minimize discomfort on your “maintainers” Minimize and spread the work of execution Value Driven.Health Care. Solutions. 16

“EXECUTION is everything.” – Jeff Bridges Value Driven.Health Care. Solutions. 17

Step I – What needs improvement? Value Driven.Health Care. Solutions. 18

Step II – How can we improve it? Value Driven.Health Care. Solutions. 19

Small Tests of Change Framework Value Driven.Health Care. Solutions. 20

Adopt, Adapt or Abandon Value Driven.Health Care. Solutions. 21

Repeat as Needed Value Driven.Health Care. Solutions. 22

Smaller is Better Small test change cycles are short: • A single patient encounter • An hour • A day • A week Small tests of change increase the speed and impact of improvement work • People are less resistant to “testing” than “changing” • Fewer logistics and people to manage • Problems can be corrected earlier and easier Value Driven.Health Care. Solutions. 23

Record your Progress Value Driven.Health Care. Solutions. 24

SUMMARY – IMPROVE THE WAY YOU IMPROVE

Change is hard…when it’s done wrong OLD WAY NEW WAY Rush to solve Question the problem Leadership decides on solution Team discusses issue Run with first logical solution Gather ideas and analyze options Throw $ at the problem Invest time in a solution Spend as little $ as possible Research pros and cons Rollout full (theoretical) solution Run small tests of change Course-correct immediately Pause and learn from failure Throw baby out with bathwater Run, pause, learn, repeat Revert to original state Implement new solution Value Driven.Health Care. Solutions. 26

Final Thoughts Improvement can be a game rather than a burden • Promotes communication, collaboration, problem-solving Blame processes, not people • Every system is perfectly designed to achieve the results it achieves Always better, never perfect • “Perfection is the enemy of progress” – Winston Commit to the process, not the outcome • Avoid the tyranny of the urgent Improvement is a journey, not a destination • You can rest, but you can’t stop Value Driven.Health Care. Solutions. 27

QUESTIONS? COMMENTS?

Contacts Beth Hickerson, Quality Improvement Advisor • bhickerson@medadvgrp.com Value Driven.Health Care. Solutions. 29

NEXT MONTH Creating Joy in the Workplace October 17, 2017 at 11:30 a.m. at Soin Hospital, Kumar Conference Center