This course provides students with a set of tools and methodologies to plan and initiate a Problem Solving or Quality Improvement project. The first module presents methods for selecting, scoping and structuring a project before it is even initiated. It also introduces the project classifications of implementation and discovery. The second module describes the A3 problem solving methodology and the tool itself. Further in that same module, the student is shown tools to identify problems in flow, defects, and waste and to discover causes, brainstorm, and prioritize interventions. Module 3 shows a methodology within the implementation class. These methods are designed to overcome emotional and organizational barriers to translating evidence-based interventions into practice. The fourth and last module looks at one more way to approach improvement projects in the discovery class. These tools are specifically for new, out-of-the-box design thinking.
The Work Must Matter
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From the course by Johns Hopkins University
Planning a Patient Safety or Quality Improvement Project (Patient Safety III)
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From the lesson
Project Selection Strategy and Tools You Can Use
In this module, you will see the process for defining, scoping, selecting and prioritizing improvement initiatives. Further, you will learn necessary team characteristics and organizational support structures.
Meet the Instructors
Bob Hody
Hello. We're now going to talk about your quality improvement work in
terms of that work that you do must absolutely matter.
So this is something that anonymous, let's say,
nobody wanted to volunteer their name here but,
"I'll be glad when we get this safety thing behind us."
Well, I hope this isn't your COO,
CEO or perhaps boss that's saying this, otherwise,
you're in for a rough ride because safety,
my friends, is here to stay.
It's so critical that we are working
on something that matters from a strategic standpoint.
It must link to your organization's strategic plan.
Where I work, these pillars are in place currently.
Patient safety, patient outcomes, patient experience,
staff satisfaction engagement, efficiency,
and value both for the patient as well as the organization.
So all these things where I work are very very important. So I'm a little fortunate.
It's a little bit like an old-fashioned black and white spaghetti western,
where a bunch of people got into a bar fight.
Happens in every movie, right?
They get into a bar fight no matter where they swing, they hit something.
So in my organization,
it's great that, you know,
virtually anything we do will interact one of these pillars, if you will.
However, in some of your organizations,
you may not have this many and maybe
the year perhaps of patient experience or you're trying to drive
efficiency and more lately value is
so important in healthcare in terms of the value of the patient,
the value of the organization.
So if that's the case,
you want to make sure the work you choose is linked to what matters in your organization.
If you do that, you're going to get alignment,
organizational alignment, which is going to lead to support.
If it's important for your organization,
strategic perhaps, the board of directors,
it's going to trickle down to the leadership,
it's going to trickle down to your boss and you.
In doing that, you're going to have a higher level chance of success.
It's like any other problem.
The first step is acceptance.
The same problem might be viewed through multiple lenses.
You have patients, family,
frontline staff and leadership all perhaps looking at
the same situation and making
their individual determinations about the extent of the problem,
the severity of the problem.
In some cases, the staff might not feel something's that urgent,
that big an issue.
However, maybe the patients feeling a little differently about that.
So part of this is really understanding when you're outlining what your problem is
to understand how it impacts each stakeholder group.
Sometimes, not everyone's even going to agree there's
a problem and that in of itself is a problem.
In some cases, you might be chasing the wrong thing.
If everyone agrees it's not a problem,
why are you going after it?
So we want to make sure that everyone's aligned.
Successful QI efforts require staff leadership agreement that A,
a problem exists, a significant problem.
And that B, that problem needs to be fixed immediately.
If you can get, that you're far and away better off.
Sometimes we don't get that early agreement.
Sometimes perhaps one stakeholder group feels that this is
a significant problem and it needs to be worked on and
perhaps maybe that doesn't trickle down to the frontline staff.
We frequently see this in areas of issues that involve money,
healthcare providers don't galvanize too much around money per se,
they're more concerned about quality of care.
If that's the case if you're up against a situation similar to this,
we're going to talk about something later on called
the burning platform and we're going to talk about
the value of data and demonstrating the urgency of a particular problem.
Now let's move on to the champion,
sometimes referred to as a sponsor.
This might be your boss,
this might be your boss's boss,
this might be your boss's boss's boss.
The key here is,
it's someone higher in,
let's just say, the food chain than you are within your organization.
It's a person that has the ability to move
barriers and get support to help you be successful because in some cases,
it might be cross departmental.
And if you're in one of those two departments,
you might have limited success in trying to get to the buy-in from the other department.
If you have that champion sponsor,
they will help you move those barriers.
That's why you want it to be a higher level and it's a trickle down effect.
Your champions, your organization's objectives will be
your champion's objectives and they should then
roll down to you in terms of your objectives.
Your champion absolutely, positively has to be on board with your improvement effort.
They need to sign off on your QI effort.
Sometimes even literally, we've had folks actually sign.
There's something very powerful about a signature in terms of saying, I support it.
One of the things we run into a lot is,
a lack of protected time to work on this project or work that you're doing.
So, if you have 100 things on your plate and
none of them come off and you have one more thing added on,
it's going to be problematic.
Protected time and actually data are two of the biggest issues you run into.
So your boss or your champion needs to provide you with
some level of protected time to do this work, to achieve success.
In turn, they also have to provide time with them to
discuss updates and possibly mentor you and help you along that path.
And last but not least,
we all need this from time to time.
If you're held accountable,
you're going to be more apt to hit your deadlines and stages along completion.
One of the most important issues,
I could have started with this one,
but it really needs to matter to you.
You have to be passionate.
I talked about that a little earlier.
You have to be passionate about what you're about to commit
to in terms of your energy as well as others because it takes a village,
it takes a team to be successful.
Do you really feel directly the result of the problem or witness others dealing with it?
If it's something tangential to you and you've never seen
the problem and maybe you're asked to go over to the Department of Surgery,
maybe you're in medicine and you're asked to go to
the Department of Surgery and fix a problem over there.
If you're not feeling the love,
if you don't understand what it's about,
it's going to be very hard for you to really engage in that problem to make it better.
Can you make a compelling argument in terms of why it's so important to do this work?
Because again, it takes a village, you need help.
Therefore, you need to be an articulate why this is so important.
Is it something you're curious about?
In terms of the two types of projects that are out there,
this would be the discovery piece.
You don't know what the issue is,
you don't know what's driving perhaps an infection rate or what's driving patient falls.
And you're really kind of curious,
you want to know what that answer is,
that will help you on that discovery path.
Are you willing to spend the necessary time to fix it?
Well, time, energy, and effort go into the equation.
Not only are you provided with the protected time,
you have to be willing to commit that protected time to fixing the problem.
And this is a tough one especially if you've been so-called
voluntold to do this project or improvement work.
If you can honestly say yes to the above, wow.
If you can pick another project to work on,
it will definitely help ensure
your success and it's going to be much harder if you can't.
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