QI 100 Rules of Engagement

1. QI 100 for Health Care CliniciansUnit 5: Capstone and Credit Aligning Forces for Quality is supported by the Robert Wood Johnson Foundation, through a grant to the Wisconsin Collaborative for Healthcare Quality. In Wisconsin, Aligning Forces for Quality is a joint project by the Wisconsin Collaborative for Healthcare Quality, the Wisconsin Hospital Association, and other organizations.

2. QI 100 Rules of Engagement Please read carefully: • This powerpoint must be in “Slide Show” mode in order for all links to be active (see the Slide Show menu at the top of your screen). • You must complete this unit in one sitting. You will not be able to exit and re-enter from where you left off. • This unit combines the knowledge from Units 1-4 and has two exercises that will serve as an optional review. • CEU’s will be awarded after you have taken all five units and completed the Capstone Quiz – a link to this quiz is given in this unit - Unit 5. You will be asked to enter your name. • The content provided in this unit is for educational purposes only and is not to be interpreted as an endorsement by WHA or any of it’s member or partner organizations. • This learning series is supported by the Aligning Forces for Quality grant. Aligning Forces for Quality is supported by the Robert Wood Johnson Foundation, through a grant to the Wisconsin Collaborative for Healthcare Quality. In Wisconsin, Aligning Forces for Quality is a joint project by the Wisconsin Collaborative for Healthcare Quality, the Wisconsin Hospital Association, and other organizations. • If you have questions or problems please e-mail: ssobczak@wha.org

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4. Unit 5: Getting Credit for QI 100 • When you see a light bulb icon, you can access a brief exercise to reinforce the concept. Simply click on the light bulb. • When you see a screen icon, you should access a quiz to test your knowledge. Simply click on the screen icon. • When you are done with an exercise simply close the page by clicking the or at the top of the page. • In order to officially participate in this unit, and receive continuing education credit, you need to complete the Capstone Quiz and score 80% or better. X

5. Introduction to Unit 5 You are about to participate in the QI 100 Unit 5 • Understand the similarities between all improvement approaches • Review the role staff clinicians play in health care improvement • Review the rationale behind quality improvement in health care. • Take the Capstone Quiz and qualify for credit.

6. Connecting the dots of QI Despite the apparent differences in the various improvement models and systemic improvement approaches, there are many similarities. When faced with learning a new aspect of QI, it is important to look for these similarities and make a connection. Let’s consider what is similar…

7. Similarities To Look For Each health care organization may choose different approaches. Over the course of a career, you may be exposed to a variety of improvement approaches. Keep in mind that there are more similarities than differences: All Improvement methods • Staff involvement • Consistent approach to change • Documented improvement • Measurable Results • All System approaches • “Big Picture” emphasis • Everyone is involved, including staff • Focus on long term results The takeaway: It’s good idea to get used to learning new things on a regular basis.

8. Barriers to Participating in QI Efforts In a 2009 survey, staff nurses across Wisconsin were asked, “If you are not involved in your hospital’s QI efforts, why not?” This chart is a summary of the reasons given. Are any of these true for you?

9. Reframing the barriers to participation Exercise #1 Try this brief exercise about how might you re-frame some of the barriers to participation in QI that other clinical staff have listed Just click on the light bulb  This is a matching exercise. See if you can make the connection. X When you are done, simply close out by clicking the or at the top.

10. QI’s Impact on Facilities Hospitals and Clinics with a robust improvement culture tend to show similar characteristics: Great clinical outcomes Higher patient satisfaction Higher retention of staff Better staff satisfaction and engagement Positive local reputation

11. QI’s Impact Locally or Regionally Wisconsin has long been a leader in health care quality. Early adoption of improvement methods and models has contributed to the high level of quality care in Wisconsin. Even so, we can expect the demands of continuous improvement to become greater as the population needing care grows.

12. QI’s Impact Nationally In the United States health care costs have been rising for decades, and the trend continues. Some measures of U.S. population health have been declining. High health care costs impact the cost of goods, services, and the overall standard of living. Improvement focusing on getting the right care to the right people at the right time is essential to slow or reverse this trend.

13. Why QI in Health Care is so Vital In the near future, the importance of QI efforts will be magnified by several factors: • Increased scrutiny on medical errors. • New reimbursement models partially based on quality of care and good performance. • Increasing pressures to control costs. • Mandates to adopt information technology.

14. Staff Participation – a missing link We know recent surveys of QI Managers and other studies that staff participation in improvement is a difference maker. Even in our state, a quality leader, we have room for improvement:

15. How Does All of this Connect? You can always find a connection between you and the big picture

16. You Can Connect Anything in this Way: This is one example: Pick another clinical issue, an try it for yourself

17. Unit 5 – The Capstone Quiz Congratulations! You have completed Units 1 - 5 and can now proceed to the: Capstone Quiz To obtain full credit for your participation in QI 100, you must take the 30 question quiz. This quiz is worth 50 points. Simply click on the screen icon  **Please note: You must take the assessment to get full credit for the QI 100 Learning Series. X When you are done, simply close out by clicking the or at the top.

18. Unit Resources WHA Reports QI Managers Survey: http://www.whaqualitycenter.org/Files/SR_Quality082009%20-%20FINAL.pdf Staff Nurse Survey: http://www.whaqualitycenter.org/Files/Quality_Staff%20Nurse%20Survey.pdf A Survey of Hospital Quality Improvement Activities, Alan B. Cohen et al. Medical Care Research and Review 2008 (65) 571. Quality Improvement Implementation and Hospital Performance on Quality Indicators. Bryan J Weiner, et al. Health Services Research 2006 41:2, 307.