Presentation on theme: "Designing and implementing a quality improvement plan"— Presentation transcript:
1 Designing and implementing a quality improvement plan Sonja Armbruster, Sedgwick CountyJoy Harris, Iowa Department of HealthJack Moran, Public Health Foundation
2 Designing and Implementing A QI Plan Sonja Armbruster, Sedgwick CountyJoy Harris, Iowa Department of Public HealthJack Moran, Public Health Foundation
3 Overview of the Session The Quality Plan is a basic guidance document about how a Public Health Department will manage, deploy, and review quality improvement throughout the organization.The Quality Plan describes the processes and activities that will be put into place to ensure that quality deliverables are produced consistently.Over time, the quality planning, business planning, and strategic planning will integrate themselves into one aligned document. Initially, however, the quality plan needs to be separate to give it the proper focus and attention throughout the organization.
4 Audience Questions:Why should a Public Health Department build a Quality Improvement Plan?What should it include?Who should be involved in developing the plan?How will this help us in our accreditation activities?
5 Why of a Quality Improvement Plan Serves as the foundation of the commitment of a public health agency to continuously improve the quality of the services it provides to its community.Every public health agency must satisfy customers, stakeholders, and employees to survive in the future.Day-to-day details often divert attention from what is good for the agency and the QI Plan helps keep the focus.Conflicts in priorities and competition for resources can be a huge barrier to organizational excellence and the QI Plan can help mediate it.
6 Quality Improvement Plan The initial plan is a basic document of what you are planning to accomplish and when:provides written credibility to the entire processis a visible sign of management support and commitmentUpdated regularly to indicate what you are doing, how you are doing, and plan to do in the future.It is not a one time event
7 Quality Improvement Plan Overtime the Quality Improvement Planning, business planning, and strategic planning will integrate themselves into one aligned document.Initially the Quality Improvement Plan needs to be separate to give it the proper focus and attention throughout the organization.
8 Quality Improvement Plan The Quality Improvement Plan is a basic guidance document about how a Public Health Department will manage, deploy, and review quality throughout the organization.The Quality Improvement Plan describes the processes and activities that will be put into place to ensure that quality deliverables are produced consistently
9 Elements of the Quality Improvement Plan Need to Describe the Following: The overall management approach to quality and what is to be accomplished (goals) over a defined time frame.Key terms so everyone has the same vocabulary when it comes to the terms we use when describing quality and quality improvement.The quality program will be managed and monitored by the organization.
10 Elements of the Quality Improvement Plan Need to Describe the Following: The process for selecting quality improvement projects and selecting team leaders.The types of training and support that will be available to the organization.The quality process (i.e.: PDCA) and quality tools and techniques to be utilized throughout the organization.The ongoing communication plan
11 Elements of the Quality Improvement Plan Need to Describe the Following: Any quality roles and responsibilities that will exist in the organization (i.e. Sponsor, team leader, team member, facilitator, etc.) during or after implementation.How measurement and analysis will be utilized in the organization and how it will help define future quality improvement activities.Any evaluation activities that will be utilized to determine the effectiveness of the Quality Improvement Plan’s implementation
12 Who Does What Matrix Role Plan Train Other Aware Culture Champion FacilitateSenior LeadershipDivision DirectorsSupervisorsFront Line StaffOthersRole
14 QI Plan – Next 18 months – The 666 Plan Next six months – specifics:How to build awareness - launchHow to communicate the QI PlanRecognize those already doing itHow to educate staffAwarenessIn-depthQuality ChampionsEtc.How to get projects approved and startedHow to track projectsHow to measure and assess the programDevil Is In The Details
15 QI Plan – Next 18 months – The 666 Plan Assess progressLessons LearnedNext round of trainingNext round of projectsAdjustments to QI Plan and StructureBuild QI Champion base12 – 18 Months:Institutionalize it
16 Summary of Quality Improvement Plan Development: It is a guidance document that informs everyone in the organization as to the direction, timeline, activities, and importance of quality and quality improvement in the organization.It is a living document and needs to be revised on a regular basis to reflect accomplishments, lessons learned, and changing organizational priorities.It is not a one time static document but one that should constantly be describing the current state and future state of quality in any Public Health Department.
17 Two Examples of QI Plans Iowa Department of Public HealthSedgwick County
18 Developing a Quality Improvement Implementation Plan The Iowa JourneyTitle of the PresentationSub Title of the PresentationIowa Department of Public Health
19 A Lesson in Timing In the beginning…. Transition…… Multi-State Learning CollaborativeIdentified championsBeginning to establish common terminologyShared vision for role of QI in the departmentTransition……New DirectorNew Deputy DirectorVision is similar….how to get there is different!Iowa Department of Public Health
20 Developing a Quality Improvement Implementation Plan For our first try ….Developed a traditional QI planConducted research on other QI plansReviewed plans – identified common areasSelected componentsIntroduction – purpose and scopeKey PrinciplesManagement and MonitoringSustainabilityDefinitionsWrote the planPresentation/Request for SupportUnsuccessful…Back to square oneIowa Department of Public Health
21 Developing a Quality Improvement Implementation Plan The second time we tried…..Developed a Quality Culture RoadmapUsed feedback to address concernsSelected components – focused on developing a quality cultureBackgroundFoundational ActivitiesDeveloping a Culture of QualityScopeImprovement EffortsSustainabilityDefinitionsPresentation/Request for SupportMore successful than our first attempt, but approval not given…We think its important, we will try again!Iowa Department of Public Health
22 Developing a Quality Improvement Implementation Plan The one!Performance and Quality Improvement Implementation PlanTable to illustrate components of a quality culture, corresponding activities, and timelinesEducationAssessmentQuality CommitteeQI ProjectsCommunicationQuality MeasuresActivities and TimelinesActivities for each component (six-month timeframes from initiation – Year 2)Annual activities for each component (Year 3 +)Iowa Department of Public Health
24 Developing a Quality Improvement Implementation Plan Result = We could officially begin!Next StepsOperationalize each of the componentsDevelop mechanisms to formally:Assess, address, and monitor quality cultureIdentify possible QI projectsTrack QI effortsCommunicate results – both successes and lessons learnedLessons LearnedKnow your audience.Be persistent and enthusiastic.Don’t be afraid to try new approaches to encourage innovation!!Iowa Department of Public Health
25 But wait! We lost our QI coordinator. Our plan was more fragile then we knew..OR.. our support was.LESSONS:Have depth.Have passion.Try again.Iowa Department of Public Health
26 Iowa Department of Public Health 515-281-3377 Joy.Harris@idph.iowa.gov Questions???Contact Information:Joy HarrisIowa Department of Public HealthThank you!!!Iowa Department of Public Health
27 Sedgwick County Health Department 2010 Sedgwick County population: 498,3652010 Wichita (largest city) population – 382,2682011 SCHD budget: $12.9 million2011 staff: 159 FTEAdministrativeServicesHR, Payroll, Finance, Central Supply, HIPAA$2.1 M18.5 FTEClinicalImmunizations, Health Screenings, Blood screen, Lab services$2.9 M35.5 FTEChildren andFamily HealthChildren’s dental, Healthy Start, WIC$5.5 M75.0 FTEHealth Protectionand PromotionEpidemiology, Health Assessment, TB Control, STD Intervention, PHEM, MMRS, CRI, Health Promotion$2.5 M30.5 FTE
29 Creating a Culture of QI Timeline Staff-time dedicated to accreditation preparation and QIDeveloped QI capacity building plan (training, Q-Team, etc.)Launched 2011QI plan; QI policy approvedTarget date to launch QI planBegansix-monthleadership trainingNov2008Mar2009Nov2009Mar2010Aug2010Jan2011Feb2011Oct2011May2012Completed PHAB Standards vetting sessionInaugural“Q-team” meetingAll-StaffMeeting w/ QI focusBegan evaluation of 2011 QI plan & development of 2012 QI plan
30 2011 SCHD QI PlanPurpose: To improve customer satisfaction and community health services.Vision: A culture of CQI at SCHD.Major goals: Staff training & QI projects.Guiding principles summarized roles of supervisors and staff.Created by SCHD Q-Team and department leadershipOther: Performance review, resources, project ID and protocol
31 Major Themes Strengths Plan for Project Management & Documentation Accountability – Personnel EvaluationsTraining—Meeting Changing NeedsOpportunities for GrowthProject Selection EvolutionCommunications Planning
32 Project Management & Documentation SharePoint SiteQ-TeamAgendas and MinutesQI ResourcesProjectsDatabase for Project TrackingAll Forms and Tools/Tip SheetsProject folders for team notes
33 Accountability Plan required all staff to Participate in trainingLead or participate in a QI ProjectAssured through formal personnel evaluation process
34 Non-Supervisor- Approach to Work (3) Performs at Level (2), plus: Commits time and effort needed to accomplish tasks; Anticipates problems, attempts to prevent them and generates solutions; Innovative; Flexible and adapts well to change; Accepts full responsibility for own behavior; Shows initiative with communicating ideas and desire to seek out new methods and procedures for quality/quantity improvement; …
35 Supervisor: #1 Job Responsibility Support the Mission of the Health DepartmentGoals/Expectations:1. Support and involvement in a minimum of one annual QI project per division program2. Participates in the ongoing process of departmental strategic planning3. Ensure attendance of staff at quarterly all staff meetings4. Ensure staff completion of required ICS trainings5. Participate in required QI trainings.6. Participate in required QI activities.7. Participate in County-sponsored professional development activities (ex.: Brown Bags, trainings, Mind leaders)8. Establish and meet professional development goals.9. Enable staff to meet their professional development goals.
36 TrainingPhase 1Two- day workshop for key staff leadersWebinars, conferences, readings, MLC participationPhase 2Hire consultant training for department leadersWorkshop initial QI projectsPhase 3Train all staff with external expertPractice with QI tools at QI Team meetingsQI Principles & Tools Training taught by LHD staffPhase 4Continue QI Principles & Tools TrainingIntegrate QI Basics into New Employee OrientationProvide Just-In-Time Training and Project Management SupportThe types of training and support that will be available to the organization.
37 Project Selection Evolution Great Debate – Ownership and Responsibility“Process improvement is led from the top but occurs from the bottom-up: engage those who do the work in QI projects.” (“Realizing Transformational Change Through Quality Improvement”)SelectionFromIdentifying problemsUsing QI Tools for problem solvingCompleting ProjectsToUse of performance measuresIdentifying opportunities for improvement
38 Communications From Sending Q-Tips Information about trainings To Presentations to leadership and staff meetingsConsistent Documentation
39 Communications Polling Question How do you share the QI work with others?all staff as projects are completedPresentations at all staff meetingsPresentations to the leadership group with expectation that the message gets shared (trickle down)Regular NewslettersAll of the aboveSome of the aboveOther
40 Tell The Story“Rear view thinking is always much clearer.” Jack Moran The story telling process about the journey adds clarity and forces reflection.
41 Overall Accomplishments Systems/InfrastructureCultureQI PlanPHAB Standard 9.2Trained staff
42 Looking Ahead What SCHD expects to be doing in the next two years: Targeted performance improvement projects using QI toolsImproved communicationContinuous training that meets changing needsQualitative assessment of “culture of quality” and use of QI tools to improveMeasures development—more meaningfulMeaningful use of results from assessments like the Performance Management Self-Assessment Tool
43 ResourcesDeveloping a Health Department QI Plan white paper _Department_Quality_Improvement_Plan.aspxSedgwick County Health Department QI Project ansas_Health_Department_QI_Project.aspxPHF’s QI Learning Series Catalog (courses offered on preparing a quality plan, accreditation preparation, team building, quality culture, strategic planning, and more at basic, intermediate, or advanced levels) _Learning_Series_Catalog.aspxAdditional resources on this topic availablePublic Health Improvement Resource Center -Public Health Performance Improvement Toolkit - improvement-toolkit-2