DEEP DIVE: Measurement for Learning

1. DEEP DIVE: Measurement for Learning June 15th, 2010 Checklist Planning Group & Guests

2. Checklist Action Series Hosts Marlies van Dijk,Western Node Leader Safer Healthcare Now! and Moderator for Checklist Action Series DEEP DIVE Leanne Couves, Improvement Associates Ltd. & Quality Moderator for Checklist Action Series DEEP DIVE Chantal Bellerose, Quebec Node SIA Safer Healthcare Now! & French Liaison for Checklist Action Series Tanis Rollefstad, Western Node SIA Safer Healthcare Now! & Technical Host for Checklist Action Series Angela Thiessen, Western Node Administrative & Technical Support for Checklist Action Series

3. Objectives for Today’s Call • Identify your purpose for doing the checklist • Choose which measures to start • Explore detailed definitions for key measures, including data collection plans • Using data for learning

4. Interacting in WebEx Be prepared to use: - Pointer Tool - Raise Hand - Chat “to all participants” 30-Oct-14 4

5. What ideas have you tried? Use the pointer • Measuring compliance with Y/N? • Measured more than compliance? • Measuring OR culture? • Started measuring other items? • Haven’t started measuring.

6. More on What Can Be Measured Leanne Couves Improvement Associates Marlies vanDijk Western Node Leader, SHN!

7. Examples of Purpose Statements • Anticipate problems • Prevent adverse events and/or outcomes • Prevent harm to patients • Improve culture, teamwork and communication Use Pointer to indicate which resonate with your organization

8. Marlies van Dijk Potential Measures

11. Extended length of anesthesia due to delays

13. Measures using Small Multiples: Overall System and 4 sites Overall Outcome Measure

14. Meaningful Measures followed by a Quebec Hospital Chantal Bellerose SIA Quebec Node

15. More on HOW to MeasureSmall Group Discussions Breakout Rooms Led by Facilitators

16. Breakout Exercise Talk Through Measurement Plan

17. Sample Measurement Sheet*

18. http://www.uth.tmc.edu/schools/med/imed/patient_safety/questionnaires/http://www.uth.tmc.edu/schools/med/imed/patient_safety/questionnaires/

19. Use text tool on next slide to record one idea from breakouts Breakout Session Summary & Debrief

21. How Much Data is Enough? Marlies van Dijk Western Node Leader, SHN!

22. Data Collection Methods • Observation (direct or indirect) • Informal conversations • Surveys and questionnaires (written, phone, one-on-one interviews) • Focus groups / group interviews • Direct experience “trading places” • Quantitative measurements (manual or electronic)

23. Sampling • Random (from random number generator) • Systematic random e.g. every X (random number from generator) of Y • Judgment (requires process knowledge) • By time of day • By location • By patient population e.g. first 5 cases of the day, Mondays and Thursday’s Based on “The Data Guide” by Sandra Murray and Lloyd Provost

24. # 3 Present to the OR teams and other stakeholders # 1 Goal for implementing the Checklist #2 Measures to support your goal

25. Checklist Sampling Ideas Adverse Events Prevented Length of anesthesia reduced with Checklist Hips and Knee procedures only Assign observational data collection Every Thursday when Dr. X is doing Hips Circulating Nurse will notate no. of minutes delayed on white board as they arise Assign responsibility for someone to capture data after each case Review monthly • Review incidents in the Glitch book weekly and categorize them Communication Equipment Medications/Blood Wrong site Lab work/chart issues • Staff Room Display

26. Team work and communication Compliance with Checklist Checklist Sampling Ideas Ask 5 questions on team work and communication (5 min to fill out) Capture discipline (nursing, surgery, anesthesia) Capture them during breaks and lunch Aim to get 10 people per discipline 10 nurses, 10 surgeons and 10 anesthesiologist, 10 others (RT) Collate and feedback to staff • Choose method (observational or audit form) Audit: • Yes/No tool to each of the 3 stages of the checklist • Choose surgical procedure (s) where checklist is being used • Sample 2 charts a day (random or specific procedures) • Sample 5 first charts once a week before they go down to health records • Collate and feedback to staff

27. Open Mike on Measurement

28. Poll Questions Relevance Check

29. Next Steps

30. ACTION Items Between now and June 23rd • Apply what you’ve learned today – start your data collection plan • Download session materials and see examples of data collection tools – Sign up on the SSSL Community of Practice

31. Advice to a “Newbie” It’s not as simple as it looks! Retrieved from: http://www.google.ca/imgres?imgurl=http://www.mlahanas.de/Physics/Bios/images/AlbertEinstein.jpg&imgrefurl=http://www.mlahanas.de/Physics/Bios/AlbertEinstein.html&h=625&w=640&sz=27&tbnid=e5bsDYQz3HTO3M:&tbnh=134&tbnw=137&prev=/images%3Fq%3DEinstein&usg=__8X0EQ9DZKTZqOWv1jOsfee4tKS8=&sa=X&ei=lRMQTNHOHIWANrOg7NsM&ved=0CC0Q9QEwBA

32. Thank You • You • Guest speakers • Faculty • Facilitators • Message from Chantal

33. Questions? Tanis Rollefstad, Safety & Improvement Advisor Phone: 306.693.0780 Email: tanis.rollefstad@hqca.ca Leanne Couves, Improvement Associates Ltd. Phone: 780.446.9940 cell Email: lcouves@telus.net

34. French Speaking Teams Chantal Bellerose Dt.P.,M.Sc (cand). Conseillère en matière de sécurité et d'amélioration | Safety and Improvement Advisor SHN Campagne québécoise: Ensemble, améliorons la prestation sécuritaire des soins de santé! | Phone: 514‐340‐8222 #6705 et #4901 Email: cbellerose@jgh.mcgill.ca

35. “See you” on June 23rd 0900-1030 PDT; 1000-1130 MDT; 1100-1230 CDT;  1200-1330 EDT; 1300-1430 ADT;  1330-1500 NDT Key Things to Consider when Implementing the Checklist: Highlights 30-Oct-14 35