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Create Solutions © Wayne Fischer, PhD Manager, Research Institute for Healthcare Excellence (713) 794-4340 “Measure & Maintain” a.k.a. “Hold the Gains!”

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Presentation on theme: "Create Solutions © Wayne Fischer, PhD Manager, Research Institute for Healthcare Excellence (713) 794-4340 “Measure & Maintain” a.k.a. “Hold the Gains!”"— Presentation transcript:

1 Create Solutions © Wayne Fischer, PhD Manager, Research Institute for Healthcare Excellence (713) “Measure & Maintain” a.k.a. “Hold the Gains!”

2 Shewhart Cycle … P-D-C-A (some call it the “Deming Cycle”) ŒPlan Do ŽCheck Act Adopt / Modify / Abandon the change Discuss & Capture “Lessons Learned” “Job done!”  Not yet !

3 Second Cycle ! S – D – C – A Standardize – Do – Check – Act “Hold the Gains!” (Joseph Juran) 2 nd Law of Thermodynamics: è“Any system left unattended will naturally seek its state of maximum disorder.” èAt maximum disorder, a system requires the minimum energy to maintain! ÜSo, to hold the gains you must expend purposeful energy…in the form of a “standardized” quality control method

4 “Quality Control” Method Purpose: Make the “new way” the “usual way” (permanent) How: Everyone involved in the process uses the same procedures Procedures: Document ‘em Train ‘em Measure ‘em In writing Flowchart Visual cues Team together More ideas Capture & Test Okkaaayyyy…but How? When? Where? Who?

5 Measurement – Metrics Think back over your P-D-C-A cycle What were the key indicators of your process’s “health” (its vital signs)? And even before you started your Create Solutions journey…What were the symptoms that prompted action? Qualitative / Quantitative indicators Flowchart? Where are the critical junctures? Handoffs Decision Points Error-checking

6 Measurement – Standards ŒSet the control standard for each process measure (“target” from the new process) Quantitative? Numerical value with its range Qualitative? Descriptive criteria (Operational Definitions) Set the control standard for each person Expectations are defined, described Performance is known…and compared … Enabled? Empowered? Stimulated? ŽDefine the corrective actions (when results are outside range of control standard)

7 Measurement – Audit Audit the controls! (“Check the checks!”) Are they working? What are your results? (compared to “targets”) To whom are the results reported? Document the QC method “Attentiveness” (part of that purposeful energy)

8 What else? / How else? ●Implement changes that make the new way easy, the old way difficult ( and test ‘em!) ● poka yoke = physical and mental “just one way” ● visual cues for the new way ( remove old way cues ) ● EMEA as contingency planning tool ●Design, implement job aids: manuals, diagrams, flowcharts, computer programs, etc. ●deployment flowchart ●expert system ●Positive rewards for conformance, negative consequences for non-compliance (tread lightly!) ●And communicate, communicate, communicate !

9 Error Mode & Effects Analysis


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