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Corner Stone: The Improvement Model

Corner Stone: The Improvement Model. Debbie Barnard, MSc, CPHQ January 30, 2013. Acknowledgement My thanks to the IHI and API as without them and the materials they share at IHI.org the pages of this presentation would be blank. What is this session all about?. Know the theory

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Corner Stone: The Improvement Model

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  1. Corner Stone: The Improvement Model Debbie Barnard, MSc, CPHQ January 30, 2013

  2. AcknowledgementMy thanks to the IHI and API as without them and the materials they share at IHI.org the pages of this presentation would be blank

  3. What is this session all about? • Know the theory • State the three fundamental questions that are the basis of the Model for Improvement: • Identify the processes that make up the Plan-Do-Study-Act (PDSA) cycle; • Understand how to apply the theory and • Describe how an improvement team can use the model to make changes in a real-world setting • Being able to share that knowledge in a way that empowers the learner to make the knowledge their own

  4. Foundation forBreakthrough Improvement • Will to do what it takes to change to a new system • “own the problem” and leadership support to improvement. • Ideason which to base the design of the new system • don’t recreate the wheel, rather learn from the success of others • Executionof the ideas • use proven quality methods to test and measure. Source: IHI.org

  5. The Model for Improvement: Your Engine for Change IHI.org

  6. Aim Measures Changes Execution Source: The Improvement Guide, API

  7. What are you trying to accomplish? • Do you know exactly what you are trying to do • Do you have clearly defined aims/objectives? • How good do you want to be by when? Source: NHS Scotland – Science of Improvement Learning Sessions (The Improvement Guide by API)

  8. Our Teaching SampleUnderstanding the System for Weight Loss with Measures AIM: How much by when? Source: Richard Scoville, Ph.D.

  9. How will you know that change results in improvement ? • Do you have a balanced set of measures (process outcome and balancing measures) in place that will enable you track progress towards your goal? Source: NHS Scotland – Science of Improvement Learning Sessions (The Improvement Guide by API)

  10. Our Teaching SampleUnderstanding the System for Weight Loss with Measures Measures: What does success look like? Source: Richard Scoville, Ph.D.

  11. What Changes Can We Make That Will Result in Improvement? • What have others done? • What hunches do we have? • What can we learn as we go along? • Principles: • Everything goes • Think outside the box • Borrow from other disciplines or organizations • Use established change packages Source: NHS Scotland – Science of Improvement Learning Sessions (The Improvement Guide by API)

  12. Our Teaching SampleUnderstanding the System for Weight Loss with Measures Action Plan Clearly Defined Source: Richard Scoville, Ph.D.

  13. The PDSA Cycle for Learning and Improvement Act Plan What changes are to be made? Next cycle? Objective, questions and predictions (why) Plan to carry out the cycle (who, what, where, when) Study Do • Complete the • analysis of the data • Compare data to • predictions • Summarize what • was learned Carry out the plan Document problems and unexpected observations Begin analysis of the data Source: NHS Scotland – Science of Improvement Learning Sessions (The Improvement Guide by API)

  14. Repeated use of the PDSA cycle Implementing new procedures & systems - sustaining change PLAN PLAN PLAN PLAN PLAN PLAN ACT ACT ACT ACT ACT ACT STUDY STUDY STUDY STUDY STUDY STUDY DO DO DO DO DO DO Testing and refining ideas Accumulating information and knowledge Bright idea! How is the methodology applied? Source: NHS Scotland – Science of Improvement Learning Sessions (The Improvement Guide by API)

  15. Source: IHI.org

  16. P P P P A A A A D D D D S S S S S S S S D D D D A A A A P P P P A A A A P P P P Testing and adaptation S S S S D D D D P P P P A A A A D D D D S S S S 1. Triage 2. Diagnostic Testing 3. Fast Track Patients 4. Capacity / Demand Change Ideas Methodology applied to the Frontline e.g. Improving ED Services Source: NHS Scotland – Science of Improvement Learning Sessions (The Improvement Guide by API)

  17. What do you say when, you are asked – testing why???? • To learn whether the change will result in an improvement • To predict the amount of improvement possible • To learn how to adapt the change to different environments • To understand the costs and impact of change • To reduce resistance

  18. Practice:“Make the Invisible, Visible”

  19. Simulation/Other Resources • Teaching the Model for Improvement: (Airplane Game) Training Guide available at http://www.nahq.org/uploads/apps/files/PDSA%20Simulation%20Training%20Guide.pdf • Langley GL, Nolan KM, Nolan TW, Norman CL, Provost LP. The Improvement Guide: A Practical Approach to Enhancing Organizational Performance (2nd edition). San Francisco: Jossey-Bass Publishers; 2009. • The Breakthrough Series: IHI’s Collaborative Model for Achieving Breakthrough Improvement. IHI Innovation Series white paper. Boston: Institute for Healthcare Improvement; 2003. (Available on www.IHI.org) • www.IHI.org

  20. Thank YouQuestions/Discussion

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