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Plan−Do−Study−Act!Plan−Do−Study−Act!Using the PDSA Cycle to Improve Your Using the PDSA Cycle to Improve Your

Performance Improvement ProjectsPerformance Improvement Projects

March 18, 2014

Presenter:

Christi Melendez, RN, CPHQAssociate Director, Performance Improvement ProjectsHealth Services Advisory Group, Inc.

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Performance Improvement Principle

• Your current systems and improvement strategies have resulted in your current outcomes.

• What you’re doing is getting you the results you have.

• To GET different results, you have to DO something different.

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Selecting Changes

While all changes do not lead to improvement, all improvement requires change.

What changes can you make that will

result in improvement?

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PDSA Cycle

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Identifying Barriers

• Conduct an initial barrier analysis to identify possible barriers.

– Brainstorming and the “Five Whys”

– Fishbone Diagram

– Key Driver Diagram

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Prioritizing Barriers

• Request data related to identified barriers.

• Evaluate whether data support barriers’ relevance.

• Rank barriers—from highest to lowest priority.

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Plan Interventions

Development of Interventions

Avoid “Passive” Interventions•Mailers•Reminder letters•Newsletter articles•Postcards, flyers, and brochures•Updating Web site/portals•Robot calls

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Plan Interventions (cont.)

Develop “Active” intervention(s) that directly address prioritized barriers and will impact indicator outcomes.•Face-to-face education efforts (enrollee and provider)•Outreach events—“boots on the ground”•Policy/process changes•Performance report cards•Incentive programs (enrollee and provider)

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PDSA Cycle

• Develop a strategy to implement the interventions.

• Develop a plan to test the intervention (Who? What? When? Where? What data need to be collected?)

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PDSA Cycle (cont.)

• Try the intervention on a small scale.

• Carry out the intervention as designed.

It’s better to do a few interventions well!

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PDSA Cycle (cont.)

• Evaluate the effectiveness of the intervention.

• Analyze your results.

• What did you learn?

• What were the results compared to your prediction?

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PDSA Cycle (cont.)

• Use what you learned from the evaluation/analysis.

• Refine or revise.

• Determine next steps.

– If successful, how will the intervention be rolled out on a larger scale?

– If unsuccessful, repeat the cycle.

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What It Takes to Get Improvement

Improvement will not happen without these components:

WillIdeasExecution

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Setting Goals

What are you trying to accomplish?

The goal should be “S-M-A-R-T”.

Specific

Measurable

Attainable

Relevant

Time-bound

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Important Dates

DATE TASK

March 21, 2014Non-clinical PIP topics due to the Agency for Health Care Administration (AHCA) contract managers

May 20, 2014Quarterly Meeting—Tallahassee

May 21, 2014On-site, one-on-one technical assistance, as requested

August 1, 2014PIPs due to AHCA with first six activities completed (Study Design)

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Questions