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Implementing a Large-Scale Quality Improvement Project

Implementing a Large-Scale Quality Improvement Project. Doug Salvador MD MPH Patient Safety Officer Maine Medical Center. Game Plan. Where we were…. Quality Strategy and Planning Change Management Leadership - Engagement Collaboration Logistics – Project Management. Where we were….

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Implementing a Large-Scale Quality Improvement Project

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  1. Implementing a Large-Scale Quality Improvement Project Doug Salvador MD MPH Patient Safety Officer Maine Medical Center

  2. Game Plan • Where we were…. • Quality • Strategy and Planning • Change Management • Leadership - Engagement • Collaboration • Logistics – Project Management

  3. Where we were…

  4. Quality Design of reliable systems of care in advance for planned excellence in clinical outcomes

  5. Current reliability in health care • Less than 80% despite: • Solid evidence based guidelines • Good intentions • Talented people • By definition, unreliable processes: Chaos

  6. Reliability of health care processes • Next level of Reliability • Success rates of 80 - 90% • Represents 1 or 2 failures out of 10 opportunities • Key to this level is the understanding that no articulated process exists • If 5 frontline individuals are asked to describe the process, less than 5 will be able to do so

  7. Reliability of health care processes • Next level of Reliability • Success rates of 95% • Represents 5 or fewer failures out of 100 opportunities • Key to this level is the understanding a articulated process does exists • If 5 frontline individuals will commonly be able to describe the process at this level of reliability

  8. Comprehensive Quality Program • Leadership • Accountability • Transparency • Measurement • Toolkit • Systems design

  9. Strategy and Planning

  10. Strategy and Planning • Large-scale improvement projects must be in the strategic plan • How do I get something into the strategic plan? • What is your strategic planning process? • Who sits at the table?

  11. Cascading Measures Examples

  12. Glycemic Control Program Proposal • Aim Statement • Problem Statement • Description of Program • Data Collection and Reporting Plan • Project Timeline • Justification of alignment to strategic plan • Pro-Forma

  13. Change Management

  14. Pre-contemplation Contemplation Preparation Action Make current state less desirable Raise awareness of problem What’s in it for me? Reason to change Show people how to change What is needed for change? Small tests of change Just DO it Stages (Prochaska and DiClemente)

  15. Leadership

  16. Collaboration

  17. Engagement

  18. Project Management

  19. Structures • Steering Committee • Working group • Subgroups • Who’s going to do the work?

  20. Project Management Tools • Meeting management skills • Ground rules • Leader, facilitator, timekeeper • The work before the work • Action planning documents • Gantt Charts • Communicate, communicate, communicate

  21. How Organizations Succeed CUSTOMER REQUIREMENTS ORGANIZATIONAL PURPOSE Structures Systems Processes Information Resources Leadership Professionalism/Respect Communication Commitment Teamwork Customer-centered Care Organizational Design Organizational Behavior CULTURE The Interaction of Design And Behavior Produces Rich Fitzpatrick, Fitzpatrick Consulting Together They Produce RESULTS

  22. Examples

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