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Holding the gains: Tips for Sustaining Improvements Over Time

Learn how to maintain and build on your initial improvement efforts, create a plan for sustained gains, and understand factors that can hinder or support long-term success. Discover core principles for sustainability, system and process solutions, and the importance of a culture of improvement.

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Holding the gains: Tips for Sustaining Improvements Over Time

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  1. Holding the gains: Tips for Sustaining Improvements Over Time Susanne Salem-Schatz, Sc. D. sss@hcqi.com June 17, 2014

  2. Objectives • Understand ways to hold the gains from your initial improvement work • Make a plan to help guide holding the gains made by your team(s)

  3. UTI in the Elderly Collaborative MEASURE / MONITOR TEST / IMPLEMENT / SUSTAIN

  4. Continuum of Improvement Improvement Hold Gains / Sustain TestImplement After implementation During testing During implementation

  5. Testing vs. Implementing • Testing – Trying and adapting existing knowledge on small scale. Learning what works in your system • Implementation – Making this change a part of the day-to-day operation of the system

  6. A P Implementation of change S D D S P Wide-scale tests of change A A P S D Follow-up tests A P S D Very small scale test Testing your way to implementation Changes That Result in Improvement Learning from Data Hunches Theories Ideas

  7. What inhibits holding gains? • Turnover- new employees aren’t educated in new processes • Competing priorities - putting out fires kept us from paying attention • One and done – we met our goals and started to work on something else • Understaffed – too busy to pay attention

  8. What inhibits holding gains? • Turnover • Competing priorities • One and done • Understaffed

  9. What facilitates holding gains? • Success of collaborative team • Intentionto hold gains • Organizational priority • Clear leadership support • What gets measured gets done.

  10. Core principles for sustainability • Hardwire changes – create systems • Implement policies • Ongoing leadership • Maintain staff engagement • Create an oral history • Maintain visibility

  11. Systems and process solutions • Policies • Documentation • Hiring procedures • Job descriptions • Staff education / training • Information flow • Equipment purchases

  12. Culture of improvement • It’s not just a project • It’s a way of thinking about the work • Resident centered care • Engaged and empowered front line staff • Make the connections between various quality initiatives

  13. Planning to hold your gains • Goals • Activities • Who needs to be included; who else? • Resources needed • What else is needed • Make a one-page summary in plain English

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