Chartering a project for improvement

1. Chartering a project for improvement

2. Model for Improvement What are we trying to accomplish? What change can we make that will result in improvement? How will we know thata change is an improvement? Act Plan Study Do Langley, et al.

3. Background information • This section represents a place to provide some essential information to the audience which sets the stage for improvement. • It should be limited to 7 or less bullets • It should cover issues like geography, history, context, environment, political sensitivities, etc.

4. Define the need for improvement • This slide should succinctly make the case for improvement • In just a couple of bullets lay out, what the problem is, which requires the application of QI methods to create better quality

5. What are we trying to accomplish? • This is place to define the Aim of your improvement project • Some teams like to answer the above question “what are we trying to accomplish” using these two questions “by how much do you want to change” and “by when do you want to change” • Implicit is answering those questions is an understanding of current performance, this too should be reflected in the aim (i.e. mortality is currently at X% and we aim to reduce this to Y% is Z amount time)

6. How will we know that a change is an improvement? • On this slide you should list the measures you suspect will help you to know if and how much progress you are making during the course of the next 6-12 months • Include an outcome measure, process measures and any balancing measures you think are relevant • Remember measures are defined through a statistic you will be reporting on • lets brainstorm 3 possible measures • All measures should be reported with the statistic you will be collecting each week, or month

7. System of Feedback Measure Types O = Outcome Measure P = Process Measure B = Balance Measure S = Process Step Measure PDSA = Learning Cycle Measure O1 O2 B B P1 P2 P1 P2 S1 S2 S3 S1 S2 S3 PDSA4 PDSA4 PDSA3 PDSA3 PDSA2 PDSA2 PDSA1 PDSA1

8. What changes can we make which will result in an improvement? • This slide represents a good place to display a driver diagram which you have created to supplement your charter • It is a place to display concepts you think articulate why things are the way they are and as a result where the leverage points exist for change which will result in improvement • If you have a change package or preliminary change ideas for testing, these can be presented here as well

9. Conceptual Driver Diagram Outcome Change Concepts 1⁰ driver 2⁰ driver Specific Change Ideas 2⁰ driver 1 Ideas: 1 2 3 4 5 6 7 8 9 . . . . . . N Concept 1 1⁰ driver 1 Concept 2 2⁰ driver 2 Concept 3 Aim or Outcome 2⁰ driver 3 Concept 4 2⁰ driver 4 1⁰ driver 2 Concept 5 2⁰ driver 5 Concept 6

10. Who will lead and participate in improvement? • Critical to any improvement process is the participation of people whom the improvement work with effect • On this slide it will be good to: • Lay out who will be leading the change effort • Who will support the change effort as part of a QI team? – position and name if possible • Who is sponsoring the change effort (to whom does the change effort matter, which senior leader)? • Who is accountable for the improvement initiative?

11. Break out • Spend some time formulating a real project, whether you are ready to move on it now or not, this will be a useful exercise • Start with • Background info • Define the need • What are you trying to accomplish • How will you know a change is an improvement (measures) • What changes can you make (theory for change) • Who will be involved in the effort