Presentation on theme: "PERFORMANCE IMPROVEMENT"— Presentation transcript:
1 PERFORMANCE IMPROVEMENT “What is it and how is it done? “2002Presented by:John F. Neale, DDS, MPHCAPT, USPHS (ret.)
2 Course Outline Introduction NNMC PI program Process/Outcomes Dimensions/FunctionsIdentifying projects/indicators for your departmentTools
3 Learning ObjectivesAt the completion of this session, participants should be able to do the following:Define & discuss the the varying definitions of qualityDefine FOCUS-PDCA & apply to daily tasks & departmental PI activitiesDefine process/outcome & how you apply to your PIDefine the Dimensions of Performance & apply to PIDescribe various PI tools and how they are used
4 What is QUALITY?Meeting or exceeding the customer’s expectations the first time and every timeIn Healthcare: The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge
5 What is QUALITY? How do you define quality? How do you think your department’s customers define quality?
6 CustomersWho are your department’s customers?ExternalInternal
7 What is Performance Improvement? JCAHO defines PI as: “The continuous study and adaptation of a healthcare organization’s functions and processes to increase the probability of achieving desired outcomes and to better meet the needs of individuals and other users of services.”
8 What Performance Improvement is NOT Peer ReviewCustomer Satisfaction SurveysQuality Control ActivitiesRoutine Monitoring and EvaluationAll of the above activities are ways to gather data to identify where performance can be improved
9 What is a Process?“A goal directed, interrelated series of actions, events, mechanisms, or steps. An interrelated series of events, activities, actions, mechanisms, or steps that transform inputs into outputs.”
10 What is an OUTCOME?“The result of the performance (or non-performance) of a function(s) or process(es).”
21 The PI Mindset Doing whatever it takes to ensure the best service the best outcomecustomer satisfactionemployee satisfactionfinancial success
22 The PI MindsetContinuously examining processes and seeking opportunities for improvement that will:benefit customersimprove our resultsmake us more efficientmaximize the quality of everything we doIt is no longer “if it ain’t broke, don’t fix it,” it is now “even if it ain’t broke, improve it.”
23 If 99.9% were good enough Every year there would be: 20,000 prescription errors made15,000 newborn babies dropped during delivery32,000 missed heartbeats per person.Every month there would be:1 hour of unsafe drinking waterEvery week there would be:500 incorrect surgical procedures performedEvery day there would be:2 unsafe landing at O’Hare airportEvery hour there would be:22,000 checks deducted from the wrong bank accounts.16,000 pieces of mail lost by the US Postal Service
24 Hospital Corporation of America Performance Improvement Methodology F ind an opportunity for improvementO rganize a teamC larify the processU nderstand variationsS elect the improvementP lanD oC heckA ct
25 Find an opportunity to improve How or where do we find opportunities for improvement?Ongoing monitoring activities such as: Safety/RM/IC/PICustomer feedback (patient or staff satisfaction surveys)OutcomesStrategic PlanningNew services
26 Organize a teamSize – large enough to include all disciplines or departments involved, but small enough to be workable.Membership – include all knowledge/skills/departments needed to address the process in questionResources – money, time, materials, training, etc.roles/responsibilities – see team guidelines in the Service Unit PI plan
27 Clarify current knowledge of the process Break the process down into its component parts or steps in order to better understand how it works and to find areas where the process varies from its purpose.Flow chartCause & effect or fishbone diagramResearchLiteraturePast experience
28 Potential Sources of Variation - Why things don’t turn out as planned People *Not trained or oriented to a procedure*Forget to perform a step in a complex processMachinery *Machine malfunctions*Different machines usedMaterials *People use different proceduresMethods *Missing steps or unpredictable sequenceor tasksConditions *Different environments such as changes inweather, shift work
29 Understand causes of process variation Collect and analyze data on the various steps in the process identified in the previous step to see where problems or inefficiencies occurPareto diagrams – the 80/20 ruleRun chartsControl chartsHistograms
30 Select the step(s) in the process that will be improved Use the results your “C” and “U” activities to identify the step or steps in the process that contribute the majority of the process variation.
31 Plan How will the improvement be done? Who will do it? What is the Timeline for implementation?What Outcomes are desired?How much will it CostWhat Training or Education is needed?Is a Trial Period or Pilot Program indicated?What data will need to be collected to monitor the changes?
32 Do Implement the Plan Schedule needed training Collect the needed data Pilot Test the plan if appropriate
33 Check Collect and Analyze data to determine the following: Did the action work?Did you achieve the desired outcomes?Is the process working as predicted, or is further refinement needed?
34 ActChange processes or further tweak the Plan if needed to achieve desired outcomesRepeat the PDCA cycle as needed to maximize improvementFinalize and implement full scaleDevelop New flow chart and/or New P/P for the redesigned processEducate/orient patients and staffStory board & report to communicate results to staff and customers
35 Identifying opportunities for improvement in your department OutcomesProcessStrategic PlanningPrioritizingStaff/Customer feedback