1. Process Improvement Concept Overview Regional Breast Health Improvement Initiative

2. 2 Some Concepts Based in Improvement Knowledge Every system is perfectly suited to produce the results it produces (Everybody is already doing their best). All work is a process. Improvement of processes requires change. But all change is not improvement.

3. Breast Health Measures Provider Teams Current Breast Cancer Screening Rates

4. All Work is a Process: Group Activity Know Your Processes Questionnaire

5. Scheduling Referral Appointments Example: Block Scheduling GBMS provider sees PT and records referral into EMR as WAH. GBMS staff schedules patient for one of the blocked appt slots. One week prior to blocked slots, GBMS will fax the completed appt list along with the referrals and required documents WAH. WAH will provide reminder calls 48 hours prior to the appointment. Following the appointment, WAH will fax the results to GBMS referral site. No shows will be closely monitored and communicated to GBMS. GBMS will reschedule the appt as appropriate. GBMS will be responsible for filling out the state application paperwork for diagnostic procedures.

6. Improvement of processes requires change Example of a Decision Aid

7. Reliable Screening: Identified Best Practices Process to:Examples Identify women for screening Flag Charts EMR Visit Planner Tool CMA documents during triage Schedule referral appointment Same day walk-in appointments Block Appointments with partner facility Centralized appointment system, PT calls from clinic Getting screening accomplished Quick turnaround between referral and screening PT reminder via phone Obtaining previous records prior to screening visit PT education about procedure Receiving and Acting on results Establishing relationships/Improving communication and handoffs Standardized protocol for follow-up for abnormal results

8. But all change is not improvement: Planning a Small Test PDSA Worksheet

9. The Improvement Guide, 2 nd Edition, Langley, Nolan, et.al., Jossey-Bass 2009

10. Sequential Building of Knowledge: Include a Wide Range of Conditions in the Sequence of Tests Breakthrough Results Theories, hunches, & best practices Learning and improvement AP SD Evidence & Data AP SD AP SD AP SD The Improvement Guide, 2 nd Edition, Langley, Nolan, et.al., Jossey-Bass 2009

11. Thank you!