getting started with quality improvement: clear kick-off event
DESCRIPTION
This presentation was delivered by Mary Lou Lester, a quality leader with the BC Patient Safety & Quality Council, at the kick-off event for CLeAR on October 9, 2013. The aim of CLeAR – our Call for Less Antipsychotics in Residential Care – is to achieve a reduction in the number of seniors in residential care on antipsychotic medications by 50% across BC by December 31, 2014 through a province-wide, voluntary initiative that supports participating sites. Learn more at www.CLeARBC.ca.TRANSCRIPT
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GETTING STARTED WITH QUALITY IMPROVEMENT
CLeAR Kick Off Event October 2013
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Improvement Basics
• Know your system – map it out
• Collect baseline data – how much of a problem is this?
• Get leadership awareness and approval – use data
• Form a multidisciplinary team – people in the process
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Improvement Basics
• Use the Improvement Model to find out what works – SMALL TESTS of CHANGE
• Communicate widely your learning
• Spread proven changes/change principles to other areas
• Never stop learning and improving
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Know Your System – How?
• Collect baseline data• Complete a process map with your
team • Understand your resident population
– Diagnosis – Behaviors – Others?
• Ask those you work with where are the biggest areas of concern?
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Team Members• Identify team members–Process map • Who is a part of the process you are working to
change/improve?–Roles and Responsibilities–Don’t forget about the resident/caregiver!• Valuable insight and input
–Mental Health team
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Team Members
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Model for Improvement
What are we trying to accomplish?
How will we know that a change is animprovement?
What changes can we make that will result in improvement?
Act Plan
Study Do
Thinking
Doing
The Improvement Guide, 2nd ed.
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Model for Improvement
What are we trying to accomplish?
How will we know that a change is animprovement?
What changes can we make that will result in improvement?
Act Plan
Study Do
Thinking
Doing
The Improvement Guide, 2nd ed.
AIM
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CLeAR’s Aim Statement
To achieve a reduction in the number of seniors in residential care on antipsychotic medications
by 50% across BC by December 31, 2014 through a province-wide, voluntary initiative that
supports participating sites.
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Model for Improvement
What are we trying to accomplish?
How will we know that a change is animprovement?
What changes can we make that will result in improvement?
Act Plan
Study Do
Thinking
Doing
The Improvement Guide, 2nd ed.
AIM
Measures
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Model for Improvement
What are we trying to accomplish?
How will we know that a change is animprovement?
What changes can we make that will result in improvement?
Act Plan
Study Do
Thinking
Doing
The Improvement Guide, 2nd ed.
AIM
Measures
Test Ideas
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“Plan Do Study Act” Cycle
• Power of the model – learning in action
• Trial and learn format• Small test of change• Increases degree of belief• Helps prevent resistance
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PDSA• Plan– Be innovative– Develop ideas– Make predictions
• Do– Test the idea– Involve front-line staff• Use the 1:1:1 rule – one provider, with one
resident, on one day• Failure IS an option!
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PDSA
• Study– Was the outcome as expected?– What did you learn?
• Act– Adopt, Adapt or Abandon
• Leads to implementation of successful ideas
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Examples
• Test a transfer Medication Reconciliation form with the next resident who is sent to the ER
• Have an RCA attend a care review
• After an incident with harm – try a debrief on one case
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Why Develop an AIM Statement?• Helps everyone to think through all
aspects of the work• Helps in team selection to make the
improvements• Keeps team efforts focused
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What Makes a Good AIM Statement?
• Clear and Concise• Results oriented• Align aim with organization goals• Set numerical targets• Deadline• Include what will keep the team focused
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Components of an AIM Statement
Direction
Process
Measure
Timeline
Focuses the team on improvement
Keeps the team on topic
Defines what success looks like
Ensures an urgency to continue
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Examples
• Decrease the number of residents on a regularly scheduled antipsychotic by 50% by December 31, 2014.
• Decrease the % of residents on an antipsychotic to a target of 30% by December 31, 2014.
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Information YOU Need – Setting Your AIM
• Understand your local facility/unit resident population– Diagnosis – Who it may be “appropriate” to be on
antipsychotics• Baseline % of residents who are on
antipsychotic (tied to CLeAR measures)
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Questions?
After the Break:Your Team…Your Turn…Take Aim and Charter Your Course!