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General Approach On How To Use The Basic Tools Of Quality Improvement Issue To Consider Flow Chart Existing Process Brainstorm & Consolidate Data Cause.

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Presentation on theme: "General Approach On How To Use The Basic Tools Of Quality Improvement Issue To Consider Flow Chart Existing Process Brainstorm & Consolidate Data Cause."— Presentation transcript:

1 General Approach On How To Use The Basic Tools Of Quality Improvement Issue To Consider Flow Chart Existing Process Brainstorm & Consolidate Data Cause & Effect Diagram – Greatest Concern Use 5 Whys To Drill Down To Root Causes Gather Data On Pain Points Translate Data Into Information Pie Charts Pareto Charts Histograms Scatter Plots, etc. Flow Chart New Process Monitor New Process & Hold The Gains Run Charts Control Charts Data Management Strategy – Ch. 14 As Is State to Should Be State As Is State Brainstorming Force and Effect Analyze Information and Develop Solutions Solution and Effect Diagram Source: The Public Health Quality Improvement Handbook, R. Bialek, G. Duffy, J. Moran, Editors, Quality Press, © 2009, p.160 AIM

2 Plan 1.Identify and Prioritize Opportunities 2. Develop AIM Statement 3. Describe the Current Process 4. Collect Data on Current Process 5. Identify All Possible Causes 6. Identify Potential Improvements 7. Develop Improvement Theory 8. Develop Action Plan 1.Implement the Improvement Do 2. Collect and Document The data 3. Document Problems, Observations, and Lessons Learned Check/ Study 1. Reflect on the Analysis Act 2. Document Problems, Observation, and Lessons learned Adopt Adapt Abandon Standardize Do Plan The ABCs of PDCA, G. Gorenflo and J. Moran

3 Some Tools To Help Create AIM Statements 1.Current and Future State Model 2.AIM Work Sheet 3.Force Field Diagram 4.Force and Effect Diagram

4 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? 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? Pathway Consequences Driving Forces: Benefits

5 AIM or Opportunity Statement An opportunity exists to improve the ________________________________________________________________________ (name process, or area to work on) beginning with ___________________________________________________________ (beginning boundary, starting point) and ending with __________________________________________________________. (ending boundary, finish point) This effort should improve _______________________________________________________________________ _____ __________________________________________________________________ (key characteristics of area the team is working on) for the _________________________________________________________________ ______________ _________________________________________________________. (customers, staff or those affected by the process under improvement) This process is important to work on now because _______________________________________________________________________ ____ ___________________________________________________________________ (what will it improve and for whom?)

6 Positive ForcesNegative Forces Current State Force Field Diagram - Basic Desired State

7

8 Process/Activities: Begins With: Ends With: Inputs: Suppliers: Outputs: Customers: Constraints: High Level S I P O C+CM Collection Form Measures

9 SIPOC+CM

10 Flow Chart Symbols Activity: Operation/Inspection Decision Start/End Bookends Document Wait/Delay Storage Data Base Transport Input Output Flow Lines A Connector Forms Comment Collector Input/ Output Data Manual Operation Preparation Manual Input Display Unfamiliar/ Research

11 Flow Chart Summary Matrix PHF E-News, March 2, 2010, Flow Chart Step Number Type of Step Type of Step: P – process, D – decision, T – transport, W – wait, S – storage Delta = Proposed – Actual – the more negative the subtraction the better – more savings 1.Touch Point () 2.Cost 3.FTEs/Person Hrs. 4.Supplies Required 5.Equipment Required 6.Space Required 7.Time 8.Cost of Quality 8.Partnerships Needed 9.Etc. 10.Value added Actual Delta +/- Proposed P D P T W P D S

12 LSS 5S is a visual method of setting the workplace in order. It is a system for workplace organization and standardization. The five steps that go into this technique: Seiri – sort – essential items Seiton – set in order – promote work flow Seison – shine – clean workplace Seiketsu – standardize - consistency shitsuke)- sustain – hold the gains

13 Definition of 8 Types of Waste: WasteDescriptionPublic Health Example OverproductionItems being produced in excess quantity and products being made before the customer needs them Insurance filing or immunization record opened before all required information is received WaitingPeriods of inactivity in a downstream process that occurs because an upstream activity does not produce or deliver on time. Paperwork waiting for management signature or review Unnecessary Motion Extra steps taken by employees and equipment to accommodate inefficient process layouts. Immunology testing equipment stored in cabinets far from specialist work area. Transportation Handling Unnecessary movement of materials or double handling Department vehicles stored in central facility, requiring constant movement of vehicles to and from other high traffic locations Over-processingSpending more time than necessary to produce the product or service Combining client survey instruments into one form rather than develop specific instruments for each program Unnecessary Inventory Any excess inventory that is not directly required for the current clients order Over estimating vaccination support materials requiring additional locked storage cages, inventory counting and reconciliation DefectsErrors produced during a service transaction or while developing a product. Ineffective scripts for initial intake applications. Unclear directions for filling out required forms DuplicationHaving to re-enter data or repeat details on forms. Poorly designed client intake computer screens or services checklists

14 Cause and Effect Diagrams - Construction Generate ideas as to what are the main causes of the effect Label these as the main branch headers Organizes group knowledge about causes of a problem and display the information graphically Effect Header

15 Root Cause Analysis Rating Form Potential Root Cause Improved Quality Reduced Costs Improved Customer Satisfaction OthersTotal Score Ranking Impact Scoring Scale: Low = 1, Medium = 3, High = 5 Impact on the Problem

16 Cause and Effect Diagram

17 Solution and Effect Diagrams - Construction Generate ideas as to what are the main Solutions of the effect Label these as the main branch headers Effect Solution

18 Root Cause Analysis Solution Impact Analysis Potential Solutions Corrective Action Type Verification Method Cost To Fix Benefit Of Fix Cost Benefit Ratio Selected? Y/N Corrective Action Type: Immediate but Interim – II, Short-term Temporary - ST, Permanent – Short Term – PST, and Permanent – Long Term - PLT

19 Solution and Effect Diagram

20 Intervention Number Date What Was The Change? How Did It Impact The AIM? How Did Your Thinking Change? How Did It Impact Your Procedures? How Did It Impact Your Customer? How Do You Know? Measures Intervention and Impact Form AIM Statement Description:

21 The following columns can be added to the Intervention and Impact Form when needed to track the impact of unintended consequences Unintended Consequence Letter Unintended Consequence Description Date It Happened Impact To Aim Statement Need a Sub AIM Statement? Impact to Customer Modifications Made Intervention and Impact Form when needed to track the impact of unintended consequences.


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