The Model for Improvement

The 'Model for Improvement' is the framework we are using to drive continuous improvement. It is essentially a method for structuring an improvement project ... SEARCH LIFEQI STORIES EVENTS SEARCH LIFEQI STORIES EVENTS LIFEQI Allresources Pages Collection Developingastrategyandchangeideas, ImprovementScienceinAction, Category ImprovementScience Tags TheModelforImprovement UsetheModelforImprovement The‘ModelforImprovement’istheframeworkweareusingtodrivecontinuousimprovement. Itisessentiallyamethod forstructuringanimprovementproject.IfyouarelookingtocarryoutaQIproject,wewillhelpguideyoutodevelopyourideaandtestitoutusingthissimpleframework. Themodelconsistsoftwoparts.Thefirstthreequestionshelpusdefinewhatwewanttoachieve,whatideaswethinkmightmakeadifference,andwhatwe’llmeasuretohelpusunderstandifchangeisanimprovement. ThesecondpartisthePDSA(PlanDoStudyAct)cycle–outliningthestepsfortheactualtesting ofthechangeideas. Thecyclicalnatureallowsthechangetoberefinedandimprovedthroughrepeatedcyclesoftestingandlearning.Thisprovidesavehicleforcontinuousimprovement. ModelforImprovement–Part1–TheFramework Whatarewetryingtoaccomplish? Takethequalityissueyou’veidentifiedandturnitintoanaim.SomethingthatisSMART(Specific,Measurable,Achievable,Realistic,Timebound).Weneedtobeabletosayhowgoodwhatitisweareimprovingisandbywhen.Thatwaywe’llbeabletoshowwhetherourqualityimprovementprojectisworking. ModelforImprovement–Part2–The Engine Howwillweknowthatachangeisanimprovement? Weallmeasurethingsinourdaytodayjobsandinqualityimprovementthisisnodifferent. Thereare3typesofmeasuresweuseinimprovementprojects: Outcome–Thisisoftendirectlylinkedtoyouraime.gIfyourQIprojectwasfocusingonfallsreductionthenyouroutcomemeasurecouldbethenumberoffallsoccurring.Thereisoftenatangiblelinkbetweentheoutcomemeasureandthepatient. Process-Yourimprovementprojectwilllikelyinvolvechangingormodifyingdifferentprocessesorsystemstohopefullyimprovethequalityissueyou’veidentified.Itsimportanttomeasurethereliabilityoftheseprocessessoyoucantrackthembackagainstyouraim.Forexamplegoingbacktoyourfallsproject,youmaywanttofocusontheprocessofriskassessmentwhichwillthenhelpreducethenumberoffalls. Balance–Thesecanhelpshowwhetherunintendedconsequenceshavebeenintroducedelsewhereinthesystem Moreaboutmeasures OutcomeMeasures Howdoesthesystemimpactthevaluesofpatients,theirhealthandwellbeing?Whatareimpactsonotherstakeholderssuchaspayers,employees,orthecommunity? Fordiabetes:AveragehemoglobinA1clevelforpopulationofpatientswithdiabetes Foraccess:Numberofdaysto3rdnextavailableappointment Forcriticalcare:IntensiveCareUnit(ICU)percentunadjustedmortality Formedicationsystems:Adversedrugeventsper1,000doses ProcessMeasures Aretheparts/stepsinthesystemperformingasplanned?Areweontrackinoureffortsto improvethesystem? Fordiabetes:PercentageofpatientswhosehemoglobinA1clevelwasmeasuredtwiceinthepastyear Foraccess:Averagedailyclinicianhoursavailableforappointments Forcriticalcare:Percentofpatientswithintentionalroundingcompletedonschedule. BalancingMeasures (lookingatasystemfromdifferentdirections/dimensions) Arechangesdesignedtoimproveonepartofthesystemcausingnewproblemsinotherpartsofthesystem? Forreducingtimepatientsspendonaventilatoraftersurgery:Makesurereintubationratesarenotincreasing Forreducingpatients’lengthofstayinthehospital:Makesurereadmissionratesarenotincreasing Foreveryprojectyouwillneedbetween5-8measures.   Whatchangescanwemakethatresultinimprovement? Inordertoimprovequalitywe’llneedtomakechanges,thoughnoteverychangewillresultinimprovement.Onewayoftryingtothinkaboutchangesandalsotounderstandthesysteminwhichyouareworkinginistouseadriverdiagram.         Formoredetailsaboutthemodelforimprovement, visittheIHIwebsite.   Sharethis: RelatedResources ModelForImprovementClip1 ModelForImprovementClip2 Measures DriverDiagrams WhiteboardDriverDiagrams QualityQuarters–PDSA ELFT_QIonTwitter VisitourTwitterpage@ELFT_QI EastLondonNHSFoundationTrust VisittheTrustwebsite OurOnlinehomeforQIProjects AccessQILifehere... ELFTQIYouTube VisitourYouTubechannel Twitter Youtube LifeQI ELFT ContactUs Copyright©2022EastLondonFoundationTrust.Allrightsreserved. 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