[PDF] - 10/26/2016 Dan Bronson-Lowe, PhD, CIC Baxter Healthcare Generates PDF Document

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Dan Bronson-Lowe, PhD, CIC Baxter Healthcare

 Generates knowledge  Structured study design  Generalizable results

Example

 RCT of different central line dressings and CLABSI

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 Evaluates knowledge  Provides foundation for high-quality practice  Focused on specific practice question

Example

 Assess research and expert opinion about timing of

central line dressing changes

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 Incorporate knowledge  Make changes to improve processes/outcomes  Focused on specific group

Example

 Modify timing of central line dressing changes and

assess the impact

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Plan Do Study Act

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 Identify / Describe the problem  Generate a Hypothesis  Select a Change / Intervention  Prepare for Implementation

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Project Ideas

 CAUTI, CDI, or SSI rates are high  Hand hygiene or flu vaccination rates are low  PPE isn’t being used in isolation rooms right  Terminal cleaning of rooms is mediocre  Too much time is being spent compiling data

for internal meetings/dashboards/etc. (Complete Section A)

 What do you really want to look at?

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Outcome Process

 What kind of analysis are you going to do?  What can you actually obtain?  Examples:

Observations
Surveys
Clinical Chart Reviews
Administrative / Claims

Plan: Data Collection

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Reliable but not Valid Reliable and Valid

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 Data Collection Tool  Measuring Devices  Collection Process / Procedures  Training

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Population

Sample

Population Sample Size <30 All 30 - 100 30 101 - 500 50 >500 70 The Joint Commission PI Project Guidelines3

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 Selection bias  Interviewer bias  Recall bias

(Complete Section B)

 Implement the change  Collect data

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 Analyze the data  Assess the impact of the change

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 Display data to make process performance visible  Determine the impact of change  Determine if the impact is sustained4

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+1

Total number of data points on the run chart that do not fall

n the median

Lower limit for the number of runs (less is too few) Upper limit for the number of runs (more is too many) 12 3 11 18 6 14 24 8 18 30 11 21 36 13 25 Run Chart: Number of Runs Test for Random Data4 Total number of data points on the run chart that do not fall

n the median

Lower limit for the number of runs (less is too few) Upper limit for the number of runs (more is too many) 12 3 11 18 6 14 24 8 18 30 11 21 36 13 25 Run Chart: Number of Runs Test for Random Data4 10/26/2016 24

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 Something didn’t work. What?

Suggestions

 The changes weren’t followed

Education? Ability? Logistics?

 The changes didn’t impact the outcome  The outcome got worse  The changes were followed and the outcome got

better… but something detrimental happened as a consequence (Complete Section C)

 Communicate the findings  Refine the change  Prepare for the next PDSA cycle

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(Complete Section D)

There’s no such thing as a problem without a gift for you in its hands. You seek problems because you need their gifts.

Richard Bach, Illusions

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Plan Do Study

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