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Summary of Action Period 3

Summary of Action Period 3. TN Patient Safety Collaborative: Reducing Physical Restraints Learning Session 4 April 6, 7, & 8, 2010 Beth Hercher, QI Specialist. Hardwiring Changes by Overcoming Barriers to Change. Setting goals Developing and testing changes

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Summary of Action Period 3

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  1. Summary of Action Period 3 TN Patient Safety Collaborative: Reducing Physical Restraints Learning Session 4 April 6, 7, & 8, 2010 Beth Hercher, QI Specialist

  2. Hardwiring Changes by Overcoming Barriers to Change • Setting goals • Developing and testing changes • Team composition and functioning • Organizational change issues

  3. Setting Goals • Solutions • Enlist senior leaders • Identify barriers, seek solutions • Outline approach and timeline • Repeat & review goals at team meeting • Barriers • Goal is not a stretch • Goal gets diluted over time • Initial goal statement is unclear

  4. Developing and Testing Changes • Barriers • Disagreement on change concepts • “We’ve tried this before” • Disagreement on what to change first • Fear that resources will not be available • Solutions • Establish process changes first. Include front line staff • Identify why previous efforts have failed • Testing ideas provides quick assessment of what will work • Share plans with leaders and get feedback; be specific about skills and resources needed

  5. Team Composition and Functioning • Barriers • Change may create additional work for front line staff • Team meetings unproductive • Team does not meet regularly • Team does not follow through • Solutions • Make changes part of day-to- day routine; include front-line staff in designing changes • Establish team rules • Investigate reasons, lack of focus • Clarify specific responsibilities and time frames for completing

  6. Organizational Change Issues • Barriers • Interdepartmental • Resistance to change • Physician resistance • Mergers, downsizing or reorganization • No visibility for the project • “That won’t work here” • Solutions • Bring them into the project • Work with early adopters • Identify one physician champion • Align project with organizational goals • Storyboard, facility newsletter/ poster • Recruit resisters

  7. Hardwiring Changes Summary • Establish and document clear goal-setting • Use concurrent monitoring/feedback • Align the project with organizational goals • Make reversal as difficult as possible • Establish and reward ownership • Leadership buy-in and support

  8. “Today’s problems will not be solved with the same thinking that created them.” — Albert Einstein This presentation and related materials were developed by QSource, the Medicare Quality Improvement Organization for Tennessee, under contract with the Centers for Medicare & Medicaid Services (CMS), a division of the Department of Health and Human Services. Contents do not necessarily reflect CMS policy. QSource-TN-PS-2010-05

  9. Thank You! TN Patient Safety Collaborative: Reducing Physical Restraints Learning Session 4 April 2010 Beth Hercher, QI Specialist bhercher@tnqio.sdps.org 901.273.2640

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