1. PGY-3 Service Projects David E. Kolva, MD Practice Management Seminar

2. Service Projects Part of Instruction on Leadership and Practice Improvement Mandated by ACGME/RRC Part of Instruction on Leadership and Practice Improvement Mandated by ACGME/RRC Serve as a Model for YOUR Future Role as Practice Administrator and/or Group Member Serve as a Model for YOUR Future Role as Practice Administrator and/or Group Member

3. Service Projects Format Individual PGY-3’s Individual PGY-3’s Each Resident Selects ONE Project Each Resident Selects ONE Project Work Independently, But Subject to Defined Schedule of Task Completion Deadlines Work Independently, But Subject to Defined Schedule of Task Completion Deadlines

4. Service Projects Format Follow “FOCUS-PDCA” Format Workbook Follow “FOCUS-PDCA” Format Workbook Complete “Fish-Bone” Chart Complete “Fish-Bone” Chart Eventual Presentation to FMC Management Committee for Implementation Eventual Presentation to FMC Management Committee for Implementation

5. Service Projects Format Formal Presentation to Fellow PGY-3’s in March Formal Presentation to Fellow PGY-3’s in March Discuss Implementation and Follow-up Discuss Implementation and Follow-up Faculty Advice and Regular Progress Checks during Thursday Seminar Series Faculty Advice and Regular Progress Checks during Thursday Seminar Series

6. Project Schedule Deadlines Deadline #1: Group Meeting to Select Topics and Initial Workbook Presentation See Workbook Page 1 for Deadlines for Section Completion

7. Project Rules Equal Participation by ALL GROUP MEMBERS Equal Participation by ALL GROUP MEMBERS Final Product is only Part of the Learning Process Final Product is only Part of the Learning Process Team Faculty always available. Team Faculty always available. Practice Management Faculty Supervisor available for initial brainstorming sessions Practice Management Faculty Supervisor available for initial brainstorming sessions Deadlines are ABSOLUTE Deadlines are ABSOLUTE

8. Project Key Components FOCUS-PDCA Workbook FOCUS-PDCA Workbook Cause/Effect Fishbone Chart Cause/Effect Fishbone Chart Concise and Convincing Mission Statement Concise and Convincing Mission Statement Detailed Action Plan Timeline Detailed Action Plan Timeline Must Accompany Final Proposal Must Accompany Final Proposal

9. Project Goals Experience for Future Problem Solving Experience for Future Problem Solving Learn Mechanics of Process Improvement Learn Mechanics of Process Improvement Pride in contributing back to the Residency Program that was patient with you during your learning period Pride in contributing back to the Residency Program that was patient with you during your learning period

10. FOCUS-PDCA Basics Since 1920’s, best tool for continuous quality improvement and problem solving. Since 1920’s, best tool for continuous quality improvement and problem solving. Forces you to consider ALL variables Forces you to consider ALL variables -AND- -AND- Not Jump to Solutions Prematurely Not Jump to Solutions Prematurely SEE WORKBOOK for questions and tasks for each FOCUS-PDCA step. SEE WORKBOOK for questions and tasks for each FOCUS-PDCA step.

11. FOCUS-PDCA F : FIND a problem/process to improve. F : FIND a problem/process to improve.  From complaints, observations or frustrations  From surveys, media reports, litigation  Brainstorming sessions  Formal Data Collection

12. FOCUS-PDCA O: ORGANIZE the team. O: ORGANIZE the team.  Who knows the problem?  Consider the customers needs.  LISTS and Checklists!

13. FOCUS-PDCA C: CLARIFY Current knowledge of the problem. C: CLARIFY Current knowledge of the problem.  This is the research phase!  Who, what, where, when?

14. FOCUS-PDCA U: UNDERSTAND or Uncover the problem. (The Why?) U: UNDERSTAND or Uncover the problem. (The Why?)  Ishikawa “Fish-Bone” Chart organizes the causes and effects.  Your topic is the HEAD of the fishbone.

15. FOCUS-PDCA S: SELECT the improvement. State your goals. S: SELECT the improvement. State your goals.  Mission Statement that all group members can recite.  Start the PDCA cycle.

16. FOCUS-PDCA P: PLAN the improvement. P: PLAN the improvement.  This is the most important step.  Think carefully and seek out past successes.  Borrow other organizations work.

17. FOCUS-PDCA D: DO the change! D: DO the change!  Think of contingencies  Need BOTH Leader skill and Manager skill

18. FOCUS-PDCA C: Check the results. C: Check the results.  Monitor data and analyze the impact.  How did things work out?

19. FOCUS-PDCA A: Act on the information A: Act on the information  Hold the Gain  Adopt, Adjust, Abandon  Think of the Future