3Overview Definitions Aims for improvement in health care Why is QI important for residents ?.Benefits of QI projects.How to start a QI project.Model for Improvement.PDSA cycle.Examples of success using QI.References.
4DefinitionsQuality: Meeting the needs and exceeding the expectations of those we serve. Delivery all and only the care that the patient and family needs.
5Definitions Improvement: It is not, Yelling at people to work harder, faster, or safer.Creating order sets or protocols and then failing to monitor their use or effect.Traditional QA.Research (but they can co-exist nicely)
6DefinitionsHealthcare Quality Improvement: is the body of knowledge, attitudes, and skills necessary to efficiently influence and continuously improve the multiple elements of care delivery within a medical practice.
7Six specific aims for improvement. Health care should be: Safe: Avoid injuries to patients from the care that is intended to help them.Effective: Avoid overuse of ineffective care and underuse of effective care.Patient-Centered: Providing respectful, responsive, individualized care.
8Six specific aims for improvement. Health care should be: Timely: Reducing waits and harmful delays in care.Efficient: Avoiding waste of equipment, supplies, ideas and energy.Equitable: Providing equal care regardless of personal characteristics, gender, ethnicity, geographic location, and socio-economic status.
9The Goal for Quality improvement in health care is TO PROVIDE THE RIGHT CARE FOR EVERY PATIENT, EVERY TIME!!
10Why is Quality Improvement important for YOU??? Why should you care? Why WE care?
11One of the Competencies: Practice Based Learning and Improvement Residents must be able to investigate and evaluate their patient care practices, appraise and assimilate scientific evidence, and improve their patient care practices.
12Benefits of resident involvement in Quality Improvement. Patient care outcomesResident learning and professional developmentResident engagement and satisfactionFaculty and other team member engagement and satisfaction.
15Model for Improvement The model has two parts: Three fundamental questions, which can be addressed in any order.The Plan-Do-Study-Act (PDSA) cycle to test and implement changes in real work settings.
17What are we trying to accomplish? Setting AimsThe aim should be time-specific and measurable; it should also define the specific population of patients that will be affected.
18How will we know that a change is an improvement? Establishing Measures Use quantitative measures to determine if a specific change actually leads to an improvement
19What changes can we make that will result in improvement? Selecting Changes All improvement requires making changes, but not all changes result in improvement. Therefore we must identify the changes that are most likely to result in improvement.
20The Model for Improvement Setting Aims Improvement requires setting aims. The aim should be time-specific and measurable; it should also define the specific population of patients that will be affected.Establishing Measures Teams use quantitative measures to determine if a specific change actually leads to an improvement.Selecting Changes All improvement requires making changes, but not all changes result in improvement. Organizations therefore must identify the changes that are most likely to result in improvement.Testing Changes The Plan-Do-Study-Act (PDSA) cycle is shorthand for testing a change in the real work setting — by planning it, trying it, observing the results, and acting on what is learned. This is the scientific method used for action-oriented learning.
21Testing changes:The Plan-Do-Study-Act (PDSA) cycle is shorthand for testing a change in the real work setting — by planning it, trying it, observing the results, and acting on what is learned. This is the scientific method used for action-oriented learning.
23Wheels in Motion: Continuous Quality improvement
24Implementing Changes After testing a change on a small scale, learning from each test, and refining the change through several PDSA cycles, the team can implement the change on a broader scale — for example, for an entire pilot population or on an entire unit.
25Spreading Changes After successful implementation of a change or package of changes for a pilot population or an entire unit, the team can spread the changes to other parts of the organization or in other organizations.
27How hospitals and clinics have shown success using QI. Mortality has declined.Rates of adverse events have decreased.The cost of care in ICU has seen a gradual decline.Critically ill patients have been recognized early by medical response teams.