1 / 41

MLC-3 States Teleconference/Webinar November 7th, 2008

MLC-3 States Teleconference/Webinar November 7th, 2008. The Key Components of Quality Improvement Project: A Step by Step Process John W. Moran – Senior Quality Advisor Public Health Foundation Grace L. Duffy – Quality Consultant Public Health Foundation. … PHF Mission :

keefe
Download Presentation

MLC-3 States Teleconference/Webinar November 7th, 2008

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. MLC-3 States Teleconference/Webinar November 7th, 2008 The Key Components of Quality Improvement Project: A Step by Step Process John W. Moran – Senior Quality Advisor Public Health Foundation Grace L. Duffy – Quality Consultant Public Health Foundation

  2. …PHF Mission: Improving public health infrastructureand performance through innovative solutions and measurable results.  Innovative Solutions. Measurable Results.

  3. Objectives By the conclusion of this MLC-3 Call, participants will develop a better understanding of how to: Plan For A Quality Improvement Project Build AIM QI Project Statements Move from Priorities to Action Track the Quality Improvement Project

  4. Planning For A Quality Improvement Project Think about the end state before you start – Telling Those Not Involved: Why you picked the problem What you focused on How you analyzed it Difficulties or roadblocks How you improved it What the improvements will accomplish

  5. Planning For A Quality Improvement Project What are the key components of a quality improvement project? Technical Content and Team Dynamics Must Be In Sync

  6. Questions? Please change the “feedback” color to purple (top right side of your screen) if you have a question.

  7. Planning For A Quality Improvement Project Creating an AIM statement Developing a theory for improvement Testing the theory / intervention Analyzing results Standardizing improvements

  8. Progression to the AIM Statement Focusing Statement: Strategic data gathering level to describe current state of process(es) involved in the area of opportunity/discomfort. Issue Statement:Strategic statement of desired future state once the opportunity/discomfort is successfully addressed. Aim Statement: Operational definition of measureable outcomes that will move the current state situation to the future state desired by the project champions.

  9. Driving Forces • Future State: • Current State: Pathway • Consequences Benefits

  10. Issue and Focus Statements Developing the AIM of the QI Project: What is the Issue? What are the current state conditions? What is driving us to change? What are the consequences of not changing? What are the benefits of changing? What will the future look like?

  11. Developing Focusing, Issue, and AIM Statements When developing the Focusing and Issue Statements, stay at a strategic level in the explanation and try not to get too operational – let the participants move to the details. Also, try not to suggest or imply any solutions.

  12. Focusing Statement – Current State Describe some background around the issue/problem that has been selected for those who will be working on it. What is the current state? Why is this important? What is it costing us – time/dollars/staff/etc? What is the impact on our clients? What is the impact on our division/agency?

  13. Focusing Statement – Current State Example Too few state and local public health agencies are measuring their success based on improvements in community health outcomes. Through development of agency-wide performance management systems and the routine employment of quality improvement (QI) techniques, public health agencies can improve their performance, become more accountable to the public and policy makers, and achieve better community health outcomes. At the present time, performance management and QI are not well-integrated into most public health agencies

  14. Issue Statement – Moving To The Future State Want to give the participants working on the issue some of your thinking, in broad terms, on what the future state should look like. What needs to improve, change, or be created. Want to describe: What are the important aspects of the future state? What is driving us to this future state? What might be the consequences of not moving to the future state? What might change? What is the proposed timeline?

  15. Issue Statement – Moving To The Future State Example To improve the current public health situation and begin moving public health to the "cutting edge of quality and innovation," how will XYZ accomplish this within the next 3 years?

  16. Components of the Issue Statement Describe the components of the issue statement in discrete high level elements. In this section we want to answer the questions: Do we as a group have complete control over the element? Can we implement a solution to this element when we finally develop it? Do we have to involve and influence others to get the element resolved? Is this element outside our control and influence ability?

  17. Components of the Issue Statement Outside Our Control & Influence Involve & Influence Element Control Implement For each element check which column(s) apply From this, select the area(s) of focus, develop a ranking of the elements to focus on, and write the AIM statement for the Quality Improvement project to be started.

  18. AIM Statement At this level we begin to look more operationally rather than strategically. Example: How to focus our department’s resources on the shifting socio-economic clients now requiring services from us. How will we serve people now needing health services? How will we implement a property maintenance program to preserve our community’s character?

  19. Questions? Please change the “feedback” color to purple (top right side of your screen) if you have a question.

  20. Measurement How do we currently measure this area and what is the current baseline data telling us about the situation?

  21. Time Frame What are the key critical dates when things must be completed? Who is responsible? Use a Gantt Chart

  22. Driving Forces: • Economy • Practice Standard • Morally Right • Future State: • What are the important aspects of the future state • What is driving us to this future state? • What might be the consequences of not moving to the future state? • What might change? • What is the proposed timeline? • Current State: • What is the current state? • Why is this important? • What is it costing us – time/dollars/staff/etc? • What is the impact on our customer/clients? • What is the impact on our division/agency? Pathway • Consequences • Could become • irrelevant • Others drive the agenda • Those in need still struggle • Benefits • Understand true costs • Better able to respond • Qualify for grants • Increased budget • Those in need get services

  23. Planning For A Quality Improvement Project Developing a theory for improvement Testing the theory / intervention Analyzing results Standardizing improvements

  24. Plan–Do–Check–Act Plan Plan changes aimed at improvement, matched to root causes Do Carry out changes; try first on small scale Check See if you get the desired results Act Make changes based on what you learned; spread success Also called Plan-Do-Study-Act (PDSA), PDCA, PDCA Cycle, or Shewhart Cycle

  25. Plan–Do–Check–ActExpanded in 7 Steps Select the problem or improvement opportunity  Describe the current process  Describe all of the possible causes of the problem, and agree on the root cause(s) to address  Develop a workable solution and action plan, including targets or measures to know if the change is an improvement Plan

  26. Plan–Do–Check–ActPLAN: 3 questions to use in any order Model for Improvement* What are we trying to accomplish? What change can we make that will result in improvement? How will we know that a change is an improvement? What happens when we need to just sustain current practice? *Associates in Process Improvement. (Langley, Nolan, et al, 1996.)

  27. Plan–Do–Check–Act • Implement the solution or process change • Review and evaluate the result of the change • Reflect and act on learnings Do Check Act

  28. Measures of changes that lead to improvement in… CAPACITY • Health dept. workforce turnover • Completion of annual health profile by every LHD PROCESS • No-show WIC appointments • % women who receive adequate prenatal care OUTCOME • Influenza deaths • Multi-drug resistant tuberculosis cases

  29. Continuous Improvement The continuous improvement phase of a process is how you make a change in direction. The change usually is because the process output is deteriorating or customer needs have changed

  30. Maintenance and Standardization The Maintenance and Standardization phase of a process is how we hold the Gains. If our process is producing The desired results we standardize What we are doing.

  31. Integrated Cycle The SDCA and PDCA cycles are separate but integrated. Once we have made a successful change we standardize and hold the gain. When the process is not performing correctly we go from SDCA to PDCA and once we have the process performing correctly we standardize again. This switching back and forth between SDCA and PDCA provides the opportunity to keep our process customer focused.

  32. Successful improvement efforts “check in” along the way • Know if you are on track to reach your destination • Make mid-course adjustments • See how one thing affects another

  33. Questions? Please change the “feedback” color to purple (top right side of your screen) if you have a question.

  34. Integrating the Gantt Chart and the PDCA Cycle

  35. Integrating the Gantt Chart and the PDCA Cycle Select Target Areas – 1st Qtr 2008 Conduct RFP Process – 2nd Qtr 2008 Develop Semi-Annual Reports 2nd Qtr 2009 Hold 2-day Kickoff QI Training 3rd Qtr 2008 Develop Collaborative Work Plans 4th Qtr 2008 Hold Routine Technical Assistance Calls 4th Qtr 2008 Original Concept developed by Livingston County Department of Health , NY

  36. Helpful Resources MLC Webpage: www.nnphi.org/mlc NNPHI eCatalog: www.nnphi.org/eCatalog NPHPSP User Guide: Fall 2007: www.cdc.gov/od/ocphp/nphpsp/Documents/NPHPSPuserguide2004Apr.pdf Guide to Community Preventive Services: www.thecommunityguide.org/ Healthy People 2010 Information Access Project: phpartners.org/hp/ NACCHO Model Practices: www.naccho.org/topics/modelpractices/index.cfm NPHPSP Online Resource Center: www.phf.org/nphpsp/ Public Health Infrastructure Resource Center: www.phf.org/infrastructure/ Public Health Memory Jogger II: www.goalqpc.com/shop_products_detail.cfm?PID=754&PageNum_GetProducts=1&ProductShopBy=7

  37. Thank You For additional information: Jack Moran, Senior Quality Advisor, PHF: 202.218.4423; jmoran@phf.org Grace Duffy, PHF Consultant; 352.406.8262; grace683@embarqmail.com

  38. Questions? Please change the “feedback” color to purple (top right side of your screen) if you have a question.

  39. Announcements • Additional Opportunities for Sharing: Your input is requested • RWJF Call for Proposals • Update on Site Visits • MLC Wiki • Important Dates • Quarterly Report due 11/17 • Semi-annual financial report due 11/17 • December 12th at 12:00 ET: Planning Call for Open Forum • December 12th at 1:00 ET: Webinar by Spitfire Strategies • January 9th, 2009 at 1:00 ET: Teleconference (Accreditation focus)

More Related