1. Practice Key Driver Diagram
We are focusing on Key Driver 6 in this session….
Conducting tests of change to address implementation of evidence based ADHD care

2. Chapter Quality Network ADHD Project Jen Powell, MPH, MBA
Team Meeting #2: Developing the First Plan-Do-Study-Act Cycle Accelerating Improved Care for Children with ADHD
Chapter Quality Network ADHD Project
Jen Powell, MPH, MBA

3. Commercial Interests Disclosure
Jen Powell I have no relevant financial relationships with the manufacturer(s) of any commercial product(s) and/or provider of commercial services discussed in this CME activity. I do not intend to discuss an unapproved or investigative use of a commercial product/device in my presentation.

4. Objectives
Articulate one goal for our QI team to make our systems of ADHD care more reliable.
Describe how a PDSA worksheet can be used to improve ADHD care
Review the mehealth PDSA wizard

5. Our overall model. Our simulation with Sam which introduced us to the PDSA cycles and iterative testing.

6. Revisiting your Workflow
Questions for your discussion:
Is the right person completing the appropriate tasks?
Are there any missing steps?
Are there steps that should be more detailed or broken into smaller pieces?
Are there places in your workflow where you are unclear HOW they will work in your practice?
These are the questions you discussed during your first Team Meeting. Now, as your review the notes from that discussion, where are there opportunities for ‘testing’ something new? For example:

7. You are here
Review the key components of the ‘plan’ part of the cycle.
Their task is to focus on one PDSA cycle that pertains to a change related to their mehealth workflow. They will fill in the PDSA worksheet with the details of the test they are planning. The duplicate sheet will stay with the chapter leadership team.

8. Remind them to press hard when they write so the duplicates work well
Remind them to press hard when they write so the duplicates work well. Walk through the top and the left side so they understand all of the parts they need to fill in. They are welcome to do more than one if they finish early.

9. Remind them that testing is an iterative process – that they can be thinking about next tests after this first one. Before we implement something, we want to test is thoroughly.

10. The First PDSA Cycle
Our first PDSA cycle will be focused on enrollment using an instruction sheet.
See sample of a completed PDSA worksheet
Use the worksheet provided to develop your own PDSA on enrollment
Keep it simple
Make it very specific
Reference the instruction sheet template and the PDSA example instruction sheet worksheet (in Word) , both found in the participant packet.
Team time:
10 minutes: review of instruction sheet and PDSA worksheet example and reminder to select team members to scribe, facilitate and time keeper
20 minutes: team time (w/ 8 minutes left, prompt them to move to a second PDSA topic)
10 minutes: report out and reflections, tying back to Sam simulation and MFI 3 questions.

11. Second PDSA Cycle
Ideas for testing that focus on diagnosis and/or early f/up:
Testing around a daily huddle with your QI team…
Testing around use of the portal…
i.e., how often you’ll check the Daily Report Card
Using a new form to capture information during a visit
Process for follow-up within 7-14 days on new prescriptions or new doses

12. ? Report Out What is your team’s
Give each team 2 minutes to report out.

13. PDSA Cycles in mehealth
We used a hard copy today to allow you all to see the entire structure of a PDSA cycle, and so we could keep a copy of your cycles for our first and second practice webinars.
Using the meHealth PDSA wizard is the preferred method for documenting PDSA cycles going forward.
We will continue to review using the wizard on our monthly webinars. It will allow you to annotate the data chart with what you did and what worked, and ties each PDSA to a measure and problem.