2. Quality Improvement: Putting It All On Paper --Small, Baby Steps-- Candi Ramos, MPA/MHA candi.ramos@hsc.utah.edu, 801-585-6480 Quality Improvement Specialist, UPIQ

3. What is Quality Improvement? Quality Improvement is an approach that enables clinicians affect changes in their practices. The aim of Quality Improvement narrows the gap between what clinicians know and what they do.

4. What is Quality Improvement? Every system is perfectly designed to give you exactly the results you get from it. In order to get better results that are sustainable, we must change the system.

5. Model for Improvement will result in improvement? What change can we make that change is an improvement? How will we know that a What are we trying to accomplish? AIM MEASUREMENT CHANGES ActPlan StudyDo

6. Plan-Do-Study-Act (PDSA) Test ideas that you think may create an improvement Begin with a well-defined, manageable AIM statement (goal/objective) Medical record reviews (chart audits) are an integral part of PDSA use in clinical practice Become integrated into clinical practice

7. Rapid Cycle Improvement A series of Plan-Do-Study-Act (PDSA) cycles … over time P DS A P DS A P DS A P DS A P DS A P DS A P DS A P DS A P DS A P DS A P DS A Things may get worse before they get better. Don’t give up! March 28 th April 18 th

8. Start small…don’t take on everything at once SMALL, BABY STEPS Be Practical What Gets Measured Gets Done

9. Multiple PDSA Cycles… can occur at the same time A P S D A P S D A P S D D S P A A P S D A P S D A P S D D S P A A P S D A P S D A P S D D S P A A P S D A P S D A P S D D S P A Referrals Family Partner Medical Home Coordinator Meetings & Huddles … and on … !

10. Remember to start with… SMALL, BABY STEPS

11. Now let’s go to work making a plan for your newly created vision! P DS A P DS A P DS A P DS A P DS A P DS A P DS A P DS A P DS A P DS A P DS A March 25 th April 18 th

13. Making a change by next Tuesday!! In Quality Improvement we often talk about…

14. Developing Changes – PDSA Cycles Plan  Questions & Predictions  Who, what, where, when  Measurement Do  Just do it!  Document problems and unexpected observations Study  What worked? What didn’t?  Compare data to predictions  Summarize what was learned Act  Note what to do differently in the next cycle  Next steps ActPlan StudyDo

15. Rapid Cycle Improvement A series of Plan-Do-Study-Act (PDSA) cycles … over time P DS A P DS A P DS A P DS A P DS A P DS A P DS A P DS A P DS A P DS A P DS A Things may get worse before they get better. Don’t give up! March 28 th April 18 th

16. Make a change by next Tuesday!!

17. Site Visit Schedule Clinic NameDate/Time Intermountain Hemophilia & ThrombosisTuesday, April 26 th 9 – 10am Intermountain HillcrestWednesday, May 4 th 12 – 1pm Intermountain Mount ViewTuesday, April 19 th 12 - 1pm Intermountain Northern Utah PediatricsTuesday, May 24 th 12:30 – 1:30pm Medical Genetics Midtown Community Health CenterFriday, April 29 th 12 – 1pm Pediatric NeurologyWednesday, April 27 th 1– 2pm South Main ClinicTuesday, April 26 th 12 – 1pm South Point Summit PediatricsThursday, April 28 th 1 – 2pm Utah Valley Pediatrics, AFTuesday, May 17 th 12:30 – 1:30pm Willow Creek Pediatrics DraperWednesday, May 11 th 12:30 – 1:30pm