Pablo Moreno Franco

2nd year fellow CC-IM.

Practice Chief Fellow

Intro• What is QI?

• Quality Improvement is a formal approach to the analysis of performance and systematic efforts to improve it. There are numerous models used. Some commonly discussed include: – Lean– PDSA– Six Sigma (DMAIC)

Lean

Act! Plan

DOStudy

Six Sigma: D M A I C

QI vs QA

QI in Health Care

QI at Mayo

QI Classes

• August to November

• Curt Hale and Gene Dankbar• Noon- 1

• PRN QUIZ

• QRB app

What will QI bring to you?

• Mindfulness:– Attention to details– Accountability– Learn from defects

• Connection:– Communication– Support each other– Have Qs and receptive attitude

• Excellence

Fair and Just Culture– Human Error:

• Inadvertent action

• Console-Learn

– Risky Drift: • Unrecognized/justified risk

• Coach-Learn

– Reckless: • Conscious Disregard/ Unjustified risk

• Corrective Action - Lean

What will QI bring to you?

• Safety– Creates trust– Eliminates Preventable Harm

• System competencies• Behavioral competencies

– Transitions and Hands off

What will QI bring to you?

• Patient and Staff Satisfaction– Transparent– Celebrate Success

• Outcomes:– Working in “crisis mode”– Quick response

• Affordable Care

What will QI bring to you?

• Long term:– Boards– QI in you CV– QI in your day-to-day

patient care– Intensivists as

• Leaders and• Health Care Managers

What will QI bring to you?

The Teams:

• Each team will have 3-4 fellows

• Maybe an RN or PharmD

• Each team should look for a Champion– Consultant, (ie Timothy Aksamit, Kaiser Lim)– Second Year Fellow (ie John, Pablo)

• Choose projects by November

• Tracking on monthly bases

Report to:

• MICU QI Committee• CC QI panel presentations:

– 3 times– The last is a competition

• Poster presentations:– Mayo QI conference – National – International

Step 1: Science of Quality Step 1: Science of Quality EducationEducation

• PurposePurpose– To bring everyone on the unit on the same page with regard to To bring everyone on the unit on the same page with regard to

concepts and knowledge.concepts and knowledge.– To highlight how they can make a differenceTo highlight how they can make a difference

• ProcessProcess

Step 2: Staff Identify DefectsStep 2: Staff Identify Defects

• PurposePurpose– Tap into expertise and knowledge of front-line providers Tap into expertise and knowledge of front-line providers – Empower and engage in QualityEmpower and engage in Quality

• ProcessProcess

• ChallengesChallenges

Step 3: Senior Executive Step 3: Senior Executive PartnershipPartnership

• PurposePurpose– Connect senior management with frontline providersConnect senior management with frontline providers– Address Quality issues and remove barriers for implementing Address Quality issues and remove barriers for implementing

improvementsimprovements

• ProcessProcess

Step 4: Learning from DefectsStep 4: Learning from Defects

• PurposePurpose– Investigate why system (s) failed and implement improvement Investigate why system (s) failed and implement improvement

effortsefforts

– For eliminating sources of potential harm at a steady but sure For eliminating sources of potential harm at a steady but sure

pacepace

• ProcessProcess

Step 5: Teamwork Tools to Step 5: Teamwork Tools to ImproveImprove

•Purpose•Practical tools to implement improvements•Enable culture conducive to quality improvement

•Examples of tools