Accelerating Improvement: Planning Next Steps

1 Accelerating improvement : Planning next Steps Plan-Do-Study-Act Team Time PDSA Cycles PDSA Cycles help us execute true tests by helping QI teams: THINK SMALL Develop detailed plans to implement the tests of change (who, when, ) Be methodical and make predictions Allow rapid adaptation and implementation of changes in busy healthcare settings PLAN Identify your improvement opportunity Make a prediction List the tasks necessary to complete this test Who will be responsible for which step ? When and where will each task be carried out? Plan for collection of data New to QI? Do a Personal PDSA! Smart Aim To reduce Andrea s morning routine time from 90 to 75 minutes by November 1, 2011 Key Driver Diagram Project Name: Reducing Morning Routine Time Project Leader: Andrea Hoberman SMART AIM KEY DRIVERS INTERVENTIONS (LOR) To reduce Andrea s morning routine time from 90 to 75 minutes by Nov.

2 1, 2011 Adequate night s sleep Readily available information (weather, schedule, ) Decisive clothing choices Streamlined/efficient morning routine Effective routine established for Talia Pick out appropriate clothes the night before (based on next day forecast and schedule) Arrange workday items in the same location daily and prepare items needed for next day the night before Go to sleep earlier in evening Good organization and Planning Key Dotted box = Placeholder for future additions Green shaded = what we re working on right now Revision Date: 10-18-11 Improve workday efficiency to gain more free time with Talia and Alan GLOBAL AIM Pick out Talia s clothes and prepare breakfast night before PDSA Ramp TEST 1 What:Pick out clothes the night before Who (population):Andrea Where:Spare Bedroom When: From 9/26/11 To 9/28/11 Who executes:Andrea Results:Pre- Planning was effective but still spent some time changing outfit in morning.

3 TEST 2 What:Pick out and try on clothes the night before Who (population):Andrea Where:Spare bedroom When: From 9/29/11 To 9/30/11 Who executes: Andrea Results: Reduced number of mornings outfit was changed and decreased getting ready time, however outfit was not always appropriate for weather. TEST 3 What: Pick out and try on clothes the night before to choose two outfits for different weather Who (population): Andrea Where:Spare bedroom When: From 10/1/11 To 10/2/11 Who executes: Andrea Results: Did not change outfit in morning, however too much time spent night before to choose two outfits. TEST 4 What:Check weather night before to inform clothing choice; try on clothes and pick out one outfit; implement Who (population): Andrea Where: Spare bedroom When: 10/3/11 - current Who executes:Andrea Results: Reduction in morning getting ready time Do Study Act Plan Do Study Act Plan Do Study Act Plan Do Study Act Plan Run Chart PDSA #1 PDSA #2 0204060801001201409/12/20119/13/20119/14 /20119/15/20119/16/20119/19/20119/20/201 19/21/20119/22/20119/23/20119/26/20119/2 7/20119/28/20119/29/20119/30/201110/3/20 1110/4/201110/5/201110/6/201110/7/201110 /10/201110/11/201110/12/201110/13/201110 /14/201110/17/201110/18/201110/19/201110 /20/201110/21/201110/24/201110/25/201110 /26/201110/27/201110/28/2011 Time (Min) Weekday Dates Personal Weekday "Getting Ready" Time September - October 2011 Daily Weekday "Getting Ready" TimeMedianGoal (75)

4 Key Points for PDSAs initial PDSAs on smallest scale possible A cycle of one usually best Failed cycles are good learning opportunities, particularly when small move to implementation, test under as many conditions as possible Think about factors that could lead to breakdowns, supports needed, naysayers Key Points for PDSAs (cont d) identify the prediction or hypothesis before testing the change Allows improved learning from failures and refinement of your theory a study measure specific to the PDSA Usually not one of the project measures Usually not collected beyond the PDSA cycle Qualitative results are very valuable in early PDSAs Accelerate your improvement PDSA Ramps Team Time Brainstorm: come up with a plan for your next PDSA Complete the PDSA Worksheet from the top through the Steps of your P (Plan cycle ) What is the first step you will take when you return to your hospital tomorrow?

5 Remember! Do initial PDSAs on the smallest scale possible; a cycle of one usually is best Steal Shamelessly (Use Storyboard Session for ideas) Finished? Don t go anywhere yet!..We will have a brief report-out prior to break.