Accelerating Quality Improvement with Dashboards - IHI

1 Accelerating Quality Improvement with Dashboards : The use of visual management to align, prioritize, monitor, transfer knowledge and spread Improvement Jennifer Quaglietta, Amanda Bell, Stephanie Robinson, Arun Dixit, Anne Speares North York General Hospital; Toronto, Canada Setting up for Success Implementing Quality Improvement (QI) initiatives across the organization and building a Quality -driven culture starts with a shared vision. At North York General Hospital (NYGH), Quality care and patient safety is directly linked to our core value of putting patients first in everything we do. NYGH chose Health Quality Ontario s (HQO) Quality Matters framework to support the overarching Quality and safety strategy and the delivery of high Quality care.

2 Quality Improvement at NYGH Supporting Successful QI with Visual Management The QI Office (QIO) aims to identify a framework to manage, prioritize, demonstrate, and sustain impact for all QI projects implemented and align the objectives, Improvement activities, and performance metrics to NYGH s corporate strategy and frameworks. The strategy must enable easy identification of opportunities for alignment and collaboration across NYGH, and build accountability and transparency for QI projects, outcomes, and corporate Quality indicators. The Journey from HQO s Quality Matters Framework to a QIO Strategy Health Quality Ontario s Quality Matters Framework VISION: Guide transformations to achieve excellence in innovative Quality Improvement (QI).

3 MISSION: Work collaboratively to achieve impactful change and build upon our culture of continuous QI to provide an excellent patient experience. VALUES: Excellence, Respect, Integrity, Compassion Setting up for Success In one and a half years of testing the framework, model, and alignment, the QIO has achieved: Results Through the process of aligning to the guiding principles of NYGH, the QIO has learned that clear, simple visualization improves external engagement with QI work and prompts more frequent inquiries into the work implemented. Evolving our culture of Quality and safety requires building on our history of organizational excellence, respect, integrity and compassion.

4 NYGH continues to be focused on the pursuit of excellence in patient safety, Quality of care and patient experience, and our future success in QI will rely on focused monitoring, sustainability and a QI mindset. 60 QI projects implemented between April 2016-March 2017 8 kaizen events held with 45 of 94 change ideas implemented 3 abstracts submitted to national conferences 2 additional programs using a QI dashboard Balancing perspectives and outcomes without compromising excellence and Quality Continuously improving and innovating Building capacity to enable frontline driven change Evidence-based decision making Shared work responsibilities and accountabilities Transparent, collaborative.

5 Relationship building for alignment and synergy GUIDING PRINCIPLES OBJECTIVES Quality Mandate AREAS OF FOCUS DRIVERS MECHANISMS FOR CHANGE Quality and Safety Capacity Building Transparent Reporting Recognition and Profiling Rigorous Delivery Improvement Methodology Team Communication Accountability and Transparency Benchmarks Patients and Families Sustainability Consensus and Integration Stakeholder Engagement Communication and Leadership Education and Capacity Building Innovation Recognition Project Overview: depicts whether the projects are on track, whether they align with the corporate Quality Improvement Plan Project Highlight: outlines the methods, key insights and lessons learned from a recent project Program Alignment Chart: shows number of active projects in each NYGH program Through iteration, the QI dashboard evolved from an internal workload tracker to a stakeholder-facing dashboard that: Improves equity and transparency by showing how QI resources are used and where future QI support is needed.

6 Improves accountability by ensuring all decision-makers see and commit to projects. Assists in the prioritization of work according to a balance of workload, priority, program alignment, and associated risk. Supports our organizational initiative to build a Quality -driven culture. Implementation Status Chart: shows status of Plan-Do-Study-Act cycles and change ideas from QI Projects The QIO dashboard Project Pipeline: shows overall workload of the QIO