HS460 Project Design and Management for

Healthcare

Lori Seargeant, MA, RHIA

Overview of Syllabus Term: 1105B 

Grading Work submitted on time will be graded within 5

days New Grading Scale effective this term:

No longer have C-, D+, or D grades given Rubric for Discussion Board and Project  

Netiquette Plagiarism

Calendar Updates

Course ends February 21, 2011  Winter Break - December 21 – January 2

No “Class” or Seminar during break Work for Unit 3 will be due at the same time as

Unit 4 Martin Luther King Jr. Day – January 14-16

No Seminar on January 16 No modification to due dates

Submission of Assignments

In most cases your work is due the EOD on Tuesdays

Initial Discussion Board Post is due on Saturday (2 follow up / responses by EOD Tuesday).

Please submit in this format: username-HS460- section-unit5 Assignment.doc 

Unit 1 Assignments

Read Chapters 1 and 2 Discussion Board Posts Assignment – Read and submit a 150-200

word discussion on “The Urgent Need to Improve Health Care Quality: Institute of Medicine National Roundtable on Health Care Quality.” 

Quality Improvement Group Project

Peer Review Criteria (Unit 2) Project Selection (Unit 3) Annotated Bibliography (Unit 4) Process Tools Application (Unit 4) Detailed Project Outline (Unit 5) Progress Report (Unit 7) Final Project (Unit 9)

Revised Project Plan Project Selection - Identify an opportunity to improve, real or

hypothetical Determine team members necessary to solve this real or

hypothetical opportunity Flow chart the current process Collect and analyze data about the process, brainstorm, explore

the root cause, and work to determine where the breakdown in the process is.

Conduct a literature search on the problem, potential solutions, regulatory considerations, etc.  and do an annotated reference

Complete a detailed project outline - all steps of PDCA Model Create final presentation in PowerPoint 

Seminar Discussion

Much of the quality management literature emphasizes on reducing variation in processes. What about the natural variation that occurs in all patients due to personal differences in genetic makeup, age, gender, and developmental conditions? How can CQI deal with this relatively high variability?

Chapter 1Defining Quality Improvement

Text: Continuous Quality Improvement in Health Care, 3rd Ed.

McLaughlin and Kaluzny, 2006

TQM/CQI for Health care

A structured organizational process for involving personnel in planning and executing a continuous stream of improvements in systems in order to provide quality care that meets or exceeds customer expectations.

Simultaneously a philosophy of management and a method of applying it.

Emphasis is on avoiding personal blame 85% of the time it is the system, not the people at

fault

Key Elements of CQI

Philosophical: Supports the organization’s mission, values and objectives Emphasizes customer satisfaction and outcomes Includes analysis of total delivery system Data driven / evidence based analysis Establishes ownership of all components of the system Identifying multiple root causes Seek solutions that enhance the overall system

performance

Key Elements of CQI

Philosophical Cont.: Emphasizes implementation regardless of

territories and fiefdoms Requires continuous analysis after a solution is

found. Emphasis on organizational learning to improve

ongoing (best) practice

Key Elements of CQI

Structural: Promotes employee & team empowerment Use of the seven quality tools

Flow charts Cause and Effect diagrams Histograms Pareto charts Run charts Control charts Correlation analysis

Key Elements of CQI

Structural Cont.: Development of separate management structure

for setting priorities and monitoring Top management leadership & involvement Use of statistics to measure and reduce

unnecessary variation Monitoring of customer satisfaction Benchmarking to identify best practices Process re-design

Key Elements of CQI

Health Care Specific Elements Epidemiological and clinical studies; insurance

and medical record data to support activities Medical staff governance process Risk adjusted outcomes Cost effective analysis Use of quality assurance and risk management

data

Chapter 2Does TQM/CQI Work in Health Care?

Text: Continuous Quality Improvement in Health Care, 3rd Ed.

McLaughlin and Kaluzny, 2006

Advantages of CQI in Health Care Managerial:

Intrinsically motivating Workers support the concept of quality

Capturing and refining intellectual capital Front line workers know the process best

Reducing managerial overhead Groups have taken responsibility for the process

Increasing capacity More professionals to contribute

Advantages of CQI in Health Care

Managerial: Encouraging lateral linkages

Gets people out of their silos and working together Encourages multidisciplinary approaches

More and more tied to survival Competitive value will shift from price to value

Supporting more open marketplace Consumers will seek out centers that show the best

results

Disadvantages of CQI in Health Care

May have other process changes going on in parallel

Does not incorporate external skills except through benchmarking or a re-engineering approach

Contrary to administrative styles of many actors

Time value of money may be against you