Plan−Do−Study−Act! Using the PDSA Cycle to Improve Your Performance Improvement Projects

1. Plan−Do−Study−Act!Using the PDSA Cycle to Improve Your Performance Improvement Projects March 18, 2014 Presenter: Christi Melendez, RN, CPHQAssociate Director, Performance Improvement ProjectsHealth Services Advisory Group, Inc.

2. Performance Improvement Principle • Your current systems and improvement strategies have resulted in your current outcomes. • What you’re doing is getting you the results you have. • To GET different results, you have to DO something different.

3. Selecting Changes While all changes do not lead to improvement, all improvement requires change. What changes can you make that will result in improvement?

4. PDSA Cycle

5. Identifying Barriers • Conduct an initial barrier analysis to identify possible barriers. • Brainstorming and the “Five Whys” • Fishbone Diagram • Key Driver Diagram

6. Prioritizing Barriers • Request data related to identified barriers. • Evaluate whether data support barriers’ relevance. • Rank barriers—from highest to lowest priority.

7. Plan Interventions Development of Interventions Avoid “Passive” Interventions • Mailers • Reminder letters • Newsletter articles • Postcards, flyers, and brochures • Updating Web site/portals • Robot calls

8. Plan Interventions (cont.) Develop “Active” intervention(s) that directly address prioritized barriers and will impact indicator outcomes. • Face-to-face education efforts (enrollee and provider) • Outreach events—“boots on the ground” • Policy/process changes • Performance report cards • Incentive programs (enrollee and provider)

9. PDSA Cycle • Develop a strategy to implement the interventions. • Develop a plan to test the intervention (Who? What? When? Where? What data need to be collected?)

10. PDSA Cycle (cont.) • Try the intervention on a small scale. • Carry out the intervention as designed. It’s better to do a few interventions well!

11. PDSA Cycle (cont.) • Evaluate the effectiveness of the intervention. • Analyze your results. • What did you learn? • What were the results compared to your prediction?

12. PDSA Cycle (cont.) • Use what you learned from the evaluation/analysis. • Refine or revise. • Determine next steps. • If successful, how will the intervention be rolled out on a larger scale? • If unsuccessful, repeat the cycle.

13. What It Takes to Get Improvement Improvement will not happen without these components: • Will • Ideas • Execution

14. Setting Goals What are you trying to accomplish? The goal should be “S-M-A-R-T”. Specific Measurable Attainable Relevant Time-bound

15. Important Dates

16. Questions