HQO Quality Improvement Framework. Sandie Seaman & Lynn Dionne - - PowerPoint PPT Presentation

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HQO Quality Improvement Framework. Sandie Seaman & Lynn Dionne - - PowerPoint PPT Presentation

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HQO Quality Improvement Framework. Sandie Seaman & Lynn Dionne www.HQOntario.ca www.HQOntario.ca Objectives Participants will be able to: Apply HQOs QI Framework in planning activities that will contribute to the achievement of Health

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www.HQOntario.ca

HQO Quality Improvement Framework.

Sandie Seaman & Lynn Dionne

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www.HQOntario.ca

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Objectives

www.HQOntario.ca

Participants will be able to: Apply HQO’s QI Framework in planning activities that will contribute to the achievement of Health Link year one goals and objectives Briefly describe 3 evidence informed improvement packages that can be used by Health Links.

.

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How to Participate Today

  • Open and

close your Panel

  • View, Select,

and Test your audio

  • Submit text

questions

  • Raise your

hand

www.HQOntario.ca

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How to use this time well

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Presenter Disclosure

www.HQOntario.ca

Presenter(s)

  • Sandie Seaman
  • Lynn Dionne

Relationships with commercial interests:

  • Grants/Research Support: Not Applicable
  • Speakers Bureau/Honoraria: Not

Applicable

  • Consulting Fees: Not Applicable
  • Other: Not Applicable
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Disclosure of Commercial Support

www.HQOntario.ca

  • This program has received no commercial
  • r financial support
  • This program has received no in-kind

commercial or financial support

  • Potential for Conflict(s) of interest:
  • No speaker has received payment or

funding from any for-profit organization

  • No organization has a product that will

be discussed in the program

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Who is joining the call today?

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Health Links: Partnering Around Patients

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Ministry of Health and Long Term Care, June 25, 2013

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Health Links: A New Way of Working Together

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Ministry of Health and Long Term Care, June 25, 2013

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Healthcare: The Current State

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Ministry of Health and Long Term Care, June 25, 2013

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Health Links’ initial focus

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Indicators of success

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Health Links: Work-planning & the Path Forward July 2013 Ministry of Health & Long-Term Care

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bestPATH & Health Links

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bestPATH

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  • Build quality improvement capacity
  • Help to identify and address gaps in the quality
  • f care & services
  • Facilitate discussions health link teams about

implementing patient & family engagement strategies

  • Provide leadership and support in measurement

and implementation of evidence supported change ideas

bestPATH – A Support to Health Links

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bestPATH – A Support to Health Links

www.HQOntario.ca

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Sustainability Theory

Phillips-Kirkpatrick Model

Teams

Why HQO developed a framework

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Sources Reviewed

  • The Improvement Guide: A Practical Approach to

Enhancing Organizational Performance (Langley, et al.)

  • Leading Change: Why Transformation Efforts Fail

(John P. Kotter)

  • NHS Sustainability Model
  • IHI Spread Model
  • Adult Learning Principles
  • Dr. W. Edwards Deming body of work
  • Lean literature
  • Kaoru Ishikawa
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www.HQOntario.ca

PLAN ACT STUDY DO What are we trying to accomplish? How will we know that a change is an improvement? What change can we make that will result in an improvement?

MODEL FOR IMPROVEMENT

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Overview

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  • Implement

Spread Plan

  • Communicate

broadly

  • Collect

Measures, Look for Slippage

  • Sustain Change
  • Assemble Team
  • Create Project

Charter

  • Set Aims
  • Capture Voice of

Customer

  • Create and

Validate Current State Map

  • Identify

Measures

  • Create and Test

Measurement Plan

  • Gather and

Share Baseline Data

  • Create List of

Improvement Opportunities

  • Define

Opportunity

  • r Problem
  • Analyze Data
  • Share Results
  • Future State

Map

  • Update Charter
  • Prioritize

Opportunities

  • Brainstorm

Change Ideas

  • Create Sub-

aims that Align with High-level Aims

  • Create PDSA

Plan

  • Test Changes -

PDSA

  • Collect

Measures – is there improvement?

  • Share Results

Broadly

  • Formalize and

Standardize Changes

  • Collect

Measures, Look for Slippage

  • Sustain Change
  • Implement

Sustainability Plans

  • Engage

“Spread” team members GETTING STARTED DEFINING THE PROBLEM

UNDERSTANDING YOUR SYSTEM DESIGNING AND TESTING SOLUTIONS IMPLEMENTING AND SUSTAINING CHANGES SPREADING CHANGE

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Poll

Using the HQO framework- where do you think your Health Link is in the QI journey? (use the #s below) OR- use zero, “0”, if your HL is not yet in the getting started phase.

www.HQOntario.ca

GETTING STARTED DEFINING THE PROBLEM

UNDERSTANDING YOUR SYSTEM DESIGNING AND TESTING SOLUTIONS IMPLEMENTING AND SUSTAINING CHANGES SPREADING CHANGE

1 3-4 5-6 2

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Poll Results

How can I apply the Quality Improvement Framework to Health Links?

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Getting started

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  • Assemble Team
  • Create Project

Charter

  • Set Aims
  • Capture Voice of

Customer

  • Create and

Validate Current State Map GETTING STARTED DEFINING THE PROBLEM

UNDERSTANDING YOUR SYSTEM DESIGNING AND TESTING SOLUTIONS IMPLEMENTING AND SUSTAINING CHANGES SPREADING CHANGE

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GETTING STARTED

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www.HQOntario.ca

GETTING STARTED

People with respiratory disease who are high risk for (re) admission to hospital. People with congestive heart failure who find it challenging to cope at home.

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By September 1, 2014 we will reduce the number of people with COPD who require hospital admissions by 25%.

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GETTING STARTED

Set AIM Statement

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GETTING STARTED

Map the value stream Understand the experience

  • r voice of the customer
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  • 1. Have you included a Value Stream Mapping

(VSM) exercise in the beginning stages of your Health Link planning?

  • Yes, No, Unsure

Poll

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  • 2. Have you included patients and their family

members in the VSM exercise?

  • Yes, No, Unsure

Poll

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Defining the problem

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  • Identify

Measures

  • Create and Test

Measurement Plan

  • Gather and

Share Baseline Data

  • Create List of

Improvement Opportunities

  • Define

Opportunity

  • r Problem

GETTING STARTED DEFINING THE PROBLEM

UNDERSTANDING YOUR SYSTEM DESIGNING AND TESTING SOLUTIONS IMPLEMENTING AND SUSTAINING CHANGES SPREADING CHANGE

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DEFINING THE PROBLEM

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Understanding your system

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GETTING STARTED DEFINING THE PROBLEM

UNDERSTANDING YOUR SYSTEM DESIGNING AND TESTING SOLUTIONS IMPLEMENTING AND SUSTAINING CHANGES SPREADING CHANGE

  • Analyze Data
  • Share Results
  • Future State

Map

  • Update Charter
  • Prioritize

Opportunities

  • Brainstorm

Change Ideas

  • Create Sub-

aims that Align with High-level Aims

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www.HQOntario.ca UNDERSTANDING YOUR SYSTEM

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Future state map depicts a newly designed process that provides maximum value to the person who requires care, is effective and efficient

UNDERSTANDING YOUR SYSTEM

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Identify Change Ideas

Change concepts and ideas can come from a variety of places, including:

  • Evidence based guidelines and improvement

packages

  • Improvement Guide
  • Peers – what have others implemented?
  • Patients, clients, residents
  • Staff
  • Other stakeholders

www.HQOntario.ca UNDERSTANDING YOUR SYSTEM

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www.HQOntario.ca

GETTING STARTED DEFINING THE PROBLEM

UNDERSTANDING YOUR SYSTEM DESIGNING AND TESTING SOLUTIONS IMPLEMENTING AND SUSTAINING CHANGES SPREADING CHANGE

  • Create PDSA

Plan

  • Test Changes -

PDSA

  • Collect

Measures – is there improvement?

  • Share Results

Broadly

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www.HQOntario.ca DESIGNING AND TESTING SOLUTIONS

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www.HQOntario.ca

Use teach back at every discharge – ensure the person knows how to recognize worsening respiratory symptoms and how to manage at home. Use teach back at every primary care visit – ensure the person knows how to recognize worsening respiratory symptoms and how to manage at home. Enable patients to email their primary care provider(s) with questions about their symptoms and /or treatment. At time of admission to hospital, phone primary care provider to discuss plan

  • f care and notify of admission.

Sample Change Ideas

DESIGNING AND TESTING SOLUTIONS

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Is your PDSA working?

www.HQOntario.ca DESIGNING AND TESTING SOLUTIONS

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www.HQOntario.ca

GETTING STARTED DEFINING THE PROBLEM

UNDERSTANDING YOUR SYSTEM DESIGNING AND TESTING SOLUTIONS IMPLEMENTING AND SUSTAINING CHANGES SPREADING CHANGE

  • Formalize and

Standardize Changes

  • Collect

Measures, Look for Slippage

  • Sustain Change
  • Implement

Sustainability Plans

  • Engage

“Spread” team members

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Hierarchy of Controls to Sustain Changes

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Automation Fundamental Change of the Process Visual Control, Error Proofing, Standard Work Checklists, Audits, Signs, Memos

IMPLEMENTING AND SUSTAINING CHANGES

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www.HQOntario.ca

GETTING STARTED DEFINING THE PROBLEM

UNDERSTANDING YOUR SYSTEM DESIGNING AND TESTING SOLUTIONS IMPLEMENTING AND SUSTAINING CHANGES SPREADING CHANGE

  • Implement

Spread Plan

  • Communicate

broadly

  • Collect

Measures, Look for Slippage

  • Sustain Change
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Where can you find more information about the QI Framework on our website? http://www.hqontario.ca/qua lity-improvement/quality- improvement-framework

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Objectives

www.HQOntario.ca

Participants will be able to: Apply HQO’s QI Framework in planning activities that will contribute to the achievement of Health Link year one goals and objectives Briefly describe 3 evidence informed improvement packages that can be used by Health Links.

.

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Some helpful resources: HQO improvement packages

Supporting Health Independence

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Transitions

  • f Care

Chronic Disease Management

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Transitions improvement package

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Individualized care planning

Health literacy

Risk assessment and follow-up care planning Medication Reconciliation

Client

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Transitions improvement package

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Change Concept Guest Speakers Date

Individualized care planning Dr.Jocelyn Charles & Dr.David Kaplan. Thursday November 28th 12-1 Medication Management Kimindra Tiwana, BSc(Pharm), Project Leader Institute for Safe Medication Practices Canada (ISMP Canada) Thursday December 5th 12-1 Health literacy Kelly O'Halloran, RN(EC), MScN Project Manager, HHS Health Links & HNHB LHIN Discharge Transitions Bundle Wednesday December 11th , 12-1 Risk assessment and follow-up care planning Dr Tara O’Brien, Internal medicine physician at Women’s College Hospital Toronto. Wednesday December 18th, 12-1

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Q&A

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www.hqontario.ca