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WHA Improvement Forum For May    “Strategies for ‘in-process’ Measurement”   Travis Dollak

WHA Improvement Forum For May    “Strategies for ‘in-process’ Measurement”   Travis Dollak. Courtesy Reminders: Please place your phones on MUTE unless you are speaking (or use *6 on your keypad) Please do not take calls and place the phone on HOLD during the presentation.

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WHA Improvement Forum For May    “Strategies for ‘in-process’ Measurement”   Travis Dollak

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  1. WHA Improvement Forum • For May    • “Strategies for ‘in-process’ Measurement” •   • Travis Dollak • Courtesy Reminders: • Please place your phones on MUTE unless you are speaking (or use *6 on your keypad) • Please do not take calls and place the phone on HOLD during the presentation.

  2. Measurement Outcome Measures **Process Measures** Balancing Measures Monitoring Measures Disclaimer information here…

  3. The Process and Outcome Measure Relationship Process improvement leads to outcome improvement, but it can take time to see outcome results.

  4. Why Measure Processes? • Insuring that the evidence based processes are being done is what drives positive outcomes • Assuming key processes are completing leads to regression and slippage • Anecdotally declaring processes work can cause waste, frustration and confusion • Measuring processes help you uncover obstacles in our system that block progress

  5. Two Sides of Process Measuring

  6. Measuring in Time Measuring Quarterly or Yearly will not lead to “rapid cycle improvement”. Measuring in short timeframes will lead to • More changes in a short period • Quicker implementation • Achieve results more rapidly Disclaimer information here…

  7. Measuring Effectively • Seek usefulness, not perfection • Use sampling • Plot data over time • Don’t wait for the information system Disclaimer information here…

  8. Characteristics of Process Improvement Measurement • Used during small tests of change • Can be very informal or highly formal • Focuses on the ability to complete the needed process • Should be easy to accomplish

  9. Improvement Measurement Examples: High-Tec • RFID on Badges that identify hand washing hygiene • In door – wash hands – Before leave wash again – out door • Completion of a Risk Assessment: Falls/PUP/VTE in medical records • Completion of required prophylaxis through EMR • Med Rec on Discharge Recorded on EMR

  10. Improvement Measurement Examples: Lo-Tec • A short checklist that improvement testers use to determine prevalence of hourly rounding • Having a HUC walk by rooms 3 times a day to record if patients are positioned on the designated side and keeping a tab • Auditing 5 High Risk Falls patient rooms a week and completing a checklist that records if falls protocol is in place

  11. Improvement Data Collection Tools Many times you will need to invent a data collection tool. OR use an existing tool (such as those provided at the kick-off for time at the bedside, etc) Here are a couple of inventions based on this example: Disclaimer information here…

  12. Data Collection Tools * Create the tool for your staff – no matter how simple it is

  13. Focus on good process measurement • Ask: • How does the work get done? • How would I know? • What is important to know? • What is the easiest way to know? • What is already collected? Is it good enough?

  14. At first, keep measurement simple • Use Simple Visuals • Use Tic and Tally Sheets • Make your measures easy to track on a daily or weekly basis

  15. Characteristics of Sustaining and Maintenance Measurement • Focuses on the key processes that drive desired outcomes • Auditing is calendared throughout the year • Sampling is used to get snap-shot of the system • Generally speaking, the process auditing plan is not widely communicated

  16. Examples of Process Maintenance and Sustaining Measuring

  17. Use Sampling Benefits: • Lower cost • Saves time (receive information faster) • With smaller data set, its easier to improve the accuracy/quality of the data Example: Sample 20 pts/month to identify ADEs yields the same results as sampling entire population http://www.1000livesplus.wales.nhs.uk/sitesplus/documents/1011/T4I%20%284%29%20How%20to%20use%20Trigger%20Tools%20%28Feb%202011%29%20Web.pdf

  18. Seek Usefulness, Not Perfection • Usefulness means measuring just enough to tell you what direction you are headed • Perfection can lead to paralysis by analysis • Reporting requirements can cause us to focus efforts on perfect data and less on improvement

  19. Next Month:

  20. References • WORKBOOK SECTION • The Improvement Guide: A Practical Approach to Enhancing Organizational Performance, Langley, Moen, & Nolan • WHA Quality Center Tools and Templates http://www.whaqualitycenter.org/PartnersforPatients/PfPTools.aspx

  21. Thank You! Questions Please complete 3 question survey when closing webinar window.

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