Kendiss Olafson MD FRCPC MPH Assistant Professor Section of Critical Care University of Manitoba What is Quality Improvement Quality improvement is a formal approach to the analysis of performance and systematic approach to improving it ID: 411619
Download Presentation The PPT/PDF document "How to Design a Quality Improvement Proj..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
How to Design a Quality Improvement Project
Kendiss Olafson MD FRCPC MPH
Assistant Professor
Section of Critical Care
University of ManitobaSlide2
What is Quality Improvement?
Quality improvement is a formal approach to the analysis of performance and systematic approach to improving it.Slide3
Institute of Medicine
To Err is Human (1999)
Brought issue of patient safety and medical errors to for front
2% of all deaths are due to preventable medical errors
Crossing the Quality Chasm (2001)
Urgently calls for changes to health care processes to improve quality of care
Sets up framework for healthcare quality improvementBrings importance of patient and family centered healthcare to frontlineSlide4
Quality Improvement versus Research
Traditional Research
Goal is to attain new generalizable knowledge
Trial new methods
Data for publishing
Quality Improvement
Goal to improve careBased in established knowledge and applying this to local siteData internal use (usually but not always)Slide5
How to Design a Quality Improvement Project
Identify Gap in CareSlide6
Quality of Care Indicators (STEEPS)
SAFE
Hospital
Acquired Infections (VAP, C.
Dificle
, CLI, Post-op Infection)
Medication Errors
TIMELY
Waiting
times (See specialist, start chemo)
EFFECTIVE
Patient Mortality
Organ Donation rates
ASA use post MI
EFFICIENT
Hospital LOS
Health
care Costs
PATIENT-CENTERED
(FAMILY CENTERED)
Patient/Family
Satisfaction
STAFF
WORKLOAD
Staff turnover
and burn outSlide7Slide8
How to Design a Quality Improvement Project
Identify Gap in Care
Review Literature – Identify Evidence based practicesSlide9
Use Pre-existing Bundles and ToolboxesSlide10
How to Design a Quality Improvement Project
Identify Gap in Care
Review Literature – Identify Evidence based practices
Quality Improvement ToolsSlide11
Quality Improvement Strategies
Continuous Improvement (PDSA)
Total Quality Management
Six Sigma
Lean
Quality Improvement Tools
Process map
Cause-Effect Diagram
Pareto Chart
Control Charts
Scatter Diagram
Fishbone Diagram
Decision Matrix
Strategies and tools to help organize, analyze and impact change within a processSlide12
Develop protocols and Bundles of CareSlide13
Educate and EngageSlide14
Reminders and Forced Function
Antibiotic Auto-stop
Automatic orders
Surgical ChecklistsSlide15
Address Infrastructure
Workplace Design
Equipment
Human Resources
Audit
and
FeedbackSlide16
How to Design a Quality Improvement Project
Identify Gap in Care
Review Literature – Identify Evidence based practices
Quality Improvement Tools
Measuring ImpactSlide17
Quality Improvement StudiesChallenges to Measuring Impact
Involves Healthcare Systems and Health Care Delivery Not just single intervention
Randomized Controlled trials of Health care systems
Multiple interventions are tested over time
Empiric Research with repeated measurements over timeSlide18
Traditional
Medical Research
Data collection
Data collection
Time
Measure
Outcome
Measure
Outcome
Intervention
Measure
Differences
in
Outcomes
Time Consuming
Expensive
Only One intervention testedSlide19
Quality Improvement Model
Data collection and Measuring Outcomes
Time
Measure
Difference
Intervention
Measure
Difference
Intervention
Measure
Difference
Intervention
HOW ?Slide20
Statistical Process Control
Statistical Process Control measures the variation associated with the outcome of a process
Process required to make a nut and bolt
Process required to make a sick person well
Manufacturing
HealthcareSlide21
Statistical Process Control
Differentiate common cause variation from extraordinary variation
Goal is to optimize outcomes:
Identify extraordinary variation early and act on it
Limiting variation associated with a process
Process required to make a sick person well
Type of Illness
Severity of Illness
Co-morbidities
Demographics
Health Care Workers
Resources
Treatment given
Complications occurring
Variation in OutcomesSlide22Slide23
Creating a Quality Improvement Project
Identify Gap in Care
Review Literature – Identify Evidence based practices
Quality Improvement Tools
Measuring Impact