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Quality Improvement: Initiating Project Work in Your Community Monday, March 26, 2018
Quality Improvement: Initiating Project Work in Your Community
Monday, March 26, 2018
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Objectives
• Connect and support one another as leaders in the Open
School community
• Highlight local work from the Chapter Network
• Share and discuss best practices – and challenges – that
come with launching, leading, and sustaining QI project
work.
Today’s Agenda
• Welcome and Introductions
• IHI Open School Overview
• Initiating and Leading QI Work: A Timeline
• Chapter Presentations
• Questions/Discussion
• IHI Open School Announcements
Type into the chat box:
Select “All Participants” as the recipient:
1. Name
2. Chapter Name (University/Organization)
3. What is your Chapter currently working
on?
4. What would you like to learn from today’s
call?
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Introductions
Gina DeitzCommunity Manager,
IHI Open School
Sarah Jasim, MPH, PhD Chapter Network Coach
Meghan Cowden, RNChapter Network Coach
Open School
Mission: To advance health care improvement and patient
safety competencies in the next generation of health
professionals worldwide.
• 32+ online courses, including set
of GME courses
• More than 4 million courses
completed
• More than 600,000 learners have
completed a course
• More than 120,000 learners have
earned the Basic Certificate
• More than 1,500 universities and
health care organizations using
the courses
IHI Open School Courses
Activities Library
IHI Open School Community
• 500,000 students
and residents
registered
• More than 900
Chapters started in
90 countries
• Over 50% of our
Chapters are
interprofessional
Project-Based Learning
Leadership & Organizing for ChangeQuality Improvement Practicum
Initiating QI Projects in Your Community
Overview
• Where does our Chapter start?
• Initiating Projects
• Forming teams
• Project work
• Sustainability
Where to begin?
How do I know if my Chapter is ready to get involved with
QI projects?
Chapter is established
Chapter members have a rudimentary understanding of
both QI and patient safety
Chapter members have at least 3 months to 1 year to
commit to this project
My Chapter is ready, now what?
Forming Teams
• Be realistic!
In smaller Chapters, an entire Chapter may be able
to work on one project
In larger Chapters, only a certain number of people
may be able to participate in projects
• Define team roles and set norms
• Consider forming sub-teams, if needed
• Establish a clear line of internal communication
Team Roles
• While every project team is different, here are some
roles you should be considering for your team!
Team Lead: someone to coordinate the team
internally and keep everyone accountable
Communication Coordinator: one individual to
streamline communication between your chapter
and contact at the institution
Finance Coordinator: grant applications, budgets,
reimbursement
Secretary: meeting minutes and schedule
coordination
Establishing Connections
• Map out possible institutions and individuals to reach
out to regarding project work
• Network, network, network
• Being well-organized and professional is essential!
• Your faculty advisor(s) are an invaluable resource
• Look into:
Local hospitals and medical centers
Institution based health resources
Community events
Underserved populations
Defining the Project
• Meet with your contact
• Explicitly define a timeline and expectations
• Make sure you are discussing the following: How long will the project run for?
Is there a deliverable or report the institution is expecting from
your team?
What kind of access does your team need to do project work?
e.g. computer log-on, institution based training, badge
access?
When and where is your team allowed to be on site?
Project Work
1. Research/define the problem
2. Create an AIM statement
3. Measures
4. Brainstorm changes that may result in an improvement
5. Plan your first small scale PDSA cycles!
6. Following PDSA cycle, revisit ideas, see what worked,
and plan the next one
Both Leadership and Organizing for Change and the QI
Practicum are GREAT resources for completing project
work.
Project Work
• Be considerate as an external team coming into an
organization to complete a QI project
• Be open to the project transforming over time
• Change can be really hard for a lot of
organizations.
Sustainability
• Know your timeline
How long will your Chapter be there to test and
implement changes?
Will any of your changes reach policy? If so, what are
your steps to solidify that?
• What tools are you leaving with the institution to sustain
improvement?
• Maintaining relationships is critical, from start to
finish
Sustainability
Strong, organized transitions are critical
• Who will be taking over your work when your Chapter
is no longer involved?
• Ensure your team's improvements are both
sustainable and realistic for the organization
• There is a lot of variability when it comes to this stage
Brock UniversityJulie Finnigan, Chapter President and I-EQUIP Student
Test the Change
What is I-EQUIP?
• Interprofessional Education for Quality Improvement Program
• A course-based model for engaging students in QI created by Dr. Madelyn Law
• Connects students with a project identified by the community or an organization
Visit iequip.ca for more information
Test the Change
Time to R.E.A.C.T. (Revolutionize Efficient and Accurate Care Transitions)
Literature Review
Focus Groups & Impact vs
Effort Matrix
Creation of New TOC
Form
Revised TOC Form
Gap Analysis & Chart Audit
Meeting with Quality & Safety Specialist
Meetings with Discharge Nurses
Meetings with Nurse Practitioner Liaison
Meetings with LTC Homes
Meetings with Nurse Unit Managers
-Communication barriers-Lack of standardization
-30% form completion-Time wasted, unsuccessful phone calls
-Phone extensions-New transfer of care (TOC) form
Test the Change
Forming the Interprofessional Team
GIVEN
• Brock University faculty advisor and student
• Facilitator based at Niagara Health hospitals (Quality & Patient Safety Specialist)
ACQUIRED
• Hospital-LTC liaison nurse practitioner
• Discharge and front-line nurses
• Discharge planners• Hospital unit managers• LTC facility managers• LTC front-line nurses
TIP: visit your team regularly and keep them updated
Test the Change
Project Continuation
• Currently:– 85% completion of the Transfer of Care form– 90% successful phone calls and improved
satisfaction
• Forms approval process– Engaging all stakeholders
• Phased roll-out• Sustainability plan
– Nurse education
Wake Forest UniversityThomas Fitzpatrick
What DEAC offers
Run by student leaders and volunteers
Ongoing QI work
Serving Winston-Salem population meeting financial criteria
<200% below poverty level
Shares patients at Community Care Clinic site
Offers weekly laboratory, pharmacy, general and specialty
medical services
Student High Value Care (sHVC) Initiative: Project Based Learning Curriculumat the Icahn School of Medicine at Mount SinaiAdam Reisman
sHVC Initiative: Six Core Elements
1. Student leadership
2. Peer learning
3. Mentorship
4. Institutional support
5. Value improvement curriculum
6. Scholarship
sHVC Leadership
● Faculty Leads: Dr. Harry Cho (founder) and Dr. Mona Krouss
Spearhead sHVC and recruit faculty mentors
● Faculty Mentors: One faculty member per group project
Provide guidance, support, and mentorship
● Student Leadership: One student co-chair per group project
Lead group project and work with faculty on sHVC development & operations
Team Formation
● Faculty mentors pitch project ideas to sHVC student body
● Students join project that is most interesting to them, ultimately forming
groups of 4-5 students
● Students interested in project leadership are interviewed and selected by
previous student leadership, electing one leader per project group
● Norms and expectations are developed (e.g. frequency of team meetings,
accountability)
Project Initiation: Define and Understand the Problem
● Process Mapping
● Fishbone Diagrams
Project Initiation: Develop Intervention
Selecting Changes
Setting Aims
Establishing Measures
Project Work: Intervention Implementation
Sustainability: PDSA Cycles
Project Example: Reduction of Unnecessary Amylase Lab Orders
Problem: While amylase is not indicated for the diagnosis
of acute pancreatitis, it is often co-ordered with lipase
Project Example: Reduction of Unnecessary Amylase Lab Orders
Intervention
Questions and open discussion
• What best practices
can you share from
your experience?
• What brought you to
this call?
• What questions can
we answer before we
sign off?
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When chatting:
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or comment
• Please use chat to “All Participants” for questions
Wrap up and Announcements
Upcoming Calls
Preparing for the International Forum in Amsterdam
1:00 PM ET, Monday, April 23, 2018
Looking ahead:
What topics would you like to see covered in the next few
months? Please share in the chat!
http://www.ihi.org/education/IHIOpenSchool/Chapters/Pages/GlobalCall.aspx
We encourage you
to connect with one
another through the
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As you look ahead to leadership team transitions at the
end of the year, be sure to update your Chapter’s contact
information!
Look for the link Chapter homepage on the IHI Open
School website or email us at [email protected].
Global Chapter Leaders are just an email away
• New Chapter Coaches:
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Thank you!
