Quality Improvement Breakout Neil Korsen, MD, MSc MaineHealth April 16-17, 2009.
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Transcript of Quality Improvement Breakout Neil Korsen, MD, MSc MaineHealth April 16-17, 2009.
Quality Improvement Breakout
Neil Korsen, MD, MScMaineHealth
April 16-17, 2009
Objectives
• Describe a basic structure for running an effective meeting
• List some of the reasons that small tests of change (PDSA cycles) are useful in quality improvement
• Design an appropriate small test of change as part of an improvement activity
Effective Meetings
• A simple approach to making the best use of the time we spend in meetings– Organizing the agenda– Meeting roles– Ground rules
Team Meeting Date: Tuesday March 27, 2009
Time: 11:00 – 12:00
Participants: Leader: Recorder: Time Keeper: Facilitator: Aim/ Purpose of this meeting: Time
I tem Aim/ Action Action
Steps 1 min
Assign roles
15 min
Topics
10
Updates
5 min Review Next Steps
What do we plan to accomplish by next week’s meeting?
2 min Evaluate Meeting
What went well? What can we do to improve for the next meeting?
Meeting Roles• Leader
– Prepares agenda, moves thru agenda, elicits participation
• Recorder– Minutes, list of action items at the end
• Timekeeper– Monitors time on each item and lets leader know if
over time• Facilitator
– Manages group process to balance participation and keep on task
Meeting Ground Rules
• Agreed to by the group
• Reviewed at the beginning or posted to remind all of what was agreed to.
Ground RulesClinical Integration Staff Meetings
– Begin and end the meeting on time– Speak only to the agenda item on the table– No interruptions– Be sure there is a parking lot for additional items– Work to includes others’ ideas– Commit to decisions– Come prepared– Have fun
– If you are opposed, try to propose
Rhythm of Improvement
• Daily huddles – Which patients coming in today are candidates for mental health assessment? (5-10 min)
• Weekly check-ins – What small tests of change are we working on and what are we learning? (15-30 min)
• Monthly partnership meetings – How are we doing in implementing integrated services? (60 min)
Model for Improvement
1. What are you trying to accomplish? (Aim Statement)
2. How do you know if a change has resulted in an improvement? (Measurement)
3. What changes can you make in a process to promote improvement? (PDSA cycles)
A PS D
PDSA Cycle
PlanIdentify: -the problem-the most likely causes-potential solutions
DoImplement solutions
and collect data
StudyAnalyze data
and develop
conclusions
ActRecommend
action/further study
PDSA Cycles
Hunches Theories
Ideas
Changes That Result in
Improvement
A PS D
APS
D
A PS D
D SP A
DATA
Why Test Changes?
• Increases belief that the change will result in improvements in your setting
• Learn how to adapt the change to conditions in your setting
• Evaluate the costs and “side-effects” of changes• Minimize resistance when spreading the change
throughout the organization
Designing PDSA’s
• Think small at first:– One clinician– A few patients– A day or two
• Think creatively – use your team• Learn from initial tests, then gradually
enlarge• Work on one thing at a time
Exercise
• Think about a PDSA that your team has developed.– How could you make that PDSA smaller and
more focused?• Talk to people around you