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Kp5 Nota 5d Deb 4332 Industrial Management
Kp5 Nota 5d Deb 4332 Industrial Management
Kp5 Nota 5d Deb 4332 Industrial Management
ion to Qua
Improvem lity
ent
T h an in
ad
Ahm
Objectives
0 To gain an understanding of what quality
improvement is
0 To present the Model for Improvement and PDSA
cycle
0 To introduce measurement in quality improvement
0 To introduce flowcharts
What is Quality
Improvement?
Proactive Reactive
Avoids blame Often Punitive
Fosters System change Tries to find who was at fault
STUDY DO
PDSA Cycle
0 Enables rapid testing and learning
0 Allows for incremental testing
0 Instead of spending weeks or months planning out a
comprehensive change, then putting it into practice
only to find that it is fundamentally flawed
PDSA Cycle
0 Can aid you in:
0 Developing a change
0 Testing a change
0 Implementing a change
What are we trying to accomplish?
ACT PLAN
STUDY DO
doa
n e xam
Improvement
’s
Let
The Problem
0 Patient’s at XY - Hospital emergency department
are often in pain
0 So…how do we do that?
Executing the Model for
Improvement
0 Form a team
0 Three Questions: The Aim,
The Aim
The Measures, The changes
0 Test changes - PDSA Cycle The Measure
0 Implement changes that
The Change
work
0 Spread the changes to other
ACT PLAN
areas
STUDY DO
You need a team
0 Why? 0 To come up with the
0 Need different right team you have to
perspectives have an idea of what
0 It’s a lot of work your aim is…
0 Increased buy-in by staff
0 Different levels of support
(e.g. management)
The Aim
What are we trying to accomplish?
The Aim
0 A strong, measurable
aim with a clear time The Aim
frame will help keep
your project on course The Measure
The Change
0 It has to be important to
those involved ACT PLAN
STUDY DO
The Aim
0 A good aim:
0 Is Specific
0 Is Measurable
0 Determines a time frame
0 Addresses who the change is for, and what has to be
achieved
0 Is Sustainable
The Aim
measurement for
research ACT PLAN
STUDY DO
Measurement
Measurement for Measurement for
Research Improvement
Purpose To discover new knowledge To bring new knowledge into
daily practice
Tests One large blind test Many sequential, observable
tests
Biases Control for as many biases Stabilize the biases from test to
as possible test
Data Gather as much data as Gather just enough data to learn
possible, just in case and complete another cycle
Duration Can take a long time Short duration
Measurement
0 3 types of measures for quality improvement
0 Outcome measures
0 Process measures
0 Balancing measures
0 (+/- Structure Measures)
Outcome Measure
0 = Where are we ultimately trying to go
0 Are your changes actually leading to improvement
Process Measures
0 = Are we doing the right things to get there?
0 To affect an outcome you have to improve your
processes
0 Are the parts/steps in the system performing as
planned
Balancing Measures
0 Tells you if changes designed to improve one part of
the system are causing new problems in other parts of
the system
The Measure
The Change
ACT PLAN
STUDY DO
Basic Techniques
0 Critical Thinking
0 Flow Chart/Diagram
0 Benchmarking
0 Compare to best practice
0 Using Technology
0 Barcodes for medications
0 Creative Thinking
0 Become a patient for a day
0 Using Change Concepts
Critical Thinking
0 Use a Flow Chart/Diagram
0 Manage Time
All improvem
ent will requ
change wil ire change,
l result in i but not all
mproveme
n t.
Testing Changes
0 Why test changes (even if they are already proven
elsewhere)?
0 To learn how to adapt the change to the particular
conditions in your setting
0 To evaluate the costs and side effects
0 To minimize resistance when implementing the change
in the organization
0 Increase your belief that the change will result in
improvement
STUDY DO
PDSA Cycle
0 Do The Aim
0 Carry out the plan
The Measure
0 Document problems and
unexpected results The Change
0 Begin Analysis
ACT PLAN
STUDY DO
PDSA Cycle
0 Study
0 Complete analysis of the The Aim
data
The Measure
0 Compare data to prediction
0 Summarize what was The Change
learned
ACT PLAN
STUDY DO
PDSA Cycle
0 Act
0 What changes are to be The Aim
made
The Measure
0 Next cycle?
The Change
ACT PLAN
STUDY DO
Testing Changes
0 Much can be learnt
from a failed test
ACT PLAN
STUDY DO
ACT PLAN PDSA
PDSA
STUDY DO
STUDY DO PDSA
PDSA
What happens when you
identify what works?
0 Are you done?
ACT PLAN
STUDY DO
Implementation
Implementation
0 Usually comes after a series of successful tests
Remember
The implementation phase is the most common
area where process improvements fails.
Hardwire Change
0 Those who don’t really care, and will follow when others
do
Summary
0 In this modules we have presented an introduction to:
0 Quality Improvement
0 The Model of Improvement
0 3 questions (What is your aim, measures, change) and PDSA
cycle
0 Types of Measures
0 Change and Implementation
Thank You