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IHQC Staff or the Presenter.
9/27/2016A project of Community Partners
Project Charters for RUHS PRIME Workgroups
September 27, 2016
Webinar Recording will be available on www.IHQC.org
The RUHS PRIME Program
Geoffrey Leung, MD
Gary Thompson, MD
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Agenda
1. Project Charter Overview
2. In-depth on First 3 Sections of Charter• Aim Statement/Goals
• Team
• Measures
3. Calendar and Next Steps
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How to Create Change?
Diagnosing what’s missing
Project Charter = Road Map to Change
• Clearly outlines what the project hopes to achieve - what’s the destination and what routes you’ll take to get there
• It helps ensure that other key stakeholders know where you’re going - that the project scope, goals, team responsibilities, activities, and constraints are clear and understood
PRIME Project Charter ElementsPRIME Project Charter Template can be found at www.IHQC.org
• Section 1 – Project Overview
• Section 2 – Team Members, Roles, Responsibilities, and Meeting Plan
• Section 3 – Project Measures
• Section 4 – Key Success Factors
• Section 5 – Project Deliverables, Key Activities and Timeline
• Section 6 – Resource and Expertise Needed for Project Implementation
• Section 7 – Signatures
Section 1 – Project Overview
• This section will provide an executive overview of your PRIME Project.
• The following items should be considered and included:– Aim Statement
– Project Goals, Objectives, and Outcomes
– Project Assumptions
Section 2 – Team Members, Roles, Responsibilities, and Meeting Plan
• A listing of the Core Team members – effective improvement teams have at a minimum:– Clinical Champion
– Operations Champion
– Clinical Care Team Member(s)
• Defined Roles and Responsibilities – be clear about what each person is expected to do (attend meetings, pull reports, etc.)
• Meeting Plan – How often will team members meet? How will you keep track of activities and deliverables?
Section 3 – Project Measures
• This section lists measures that the team will commit to tracking throughout your project (those required by PRIME and others that will help inform your improvement efforts)
• Consider Process, Outcomes, and Balance measures
• Create a Measures Collection Plan by defining the measures (numerator/denominator), the data collection plan, baseline data for each measure, and the desired target/goal.
• Who will monitor your project measures?
Section 4 – Key Success Factors• This section lists the Key Success Factors (both internal and
external) that are central to attaining your objectives and successfully completing your project.
• Be as specific as possible as they will guide your action planning on how to address potential challenges– Resources that need to be secured (staff time, funding, etc.)
– Staff or leadership buy-in
– Innovation or Technology
– Patient Engagement
– Leadership Engagement
Reference Assumptions Listed in Section 1
Section 5 – Project Deliverables, Key Activities and Timeline
• Describe the overall project deliverables and key activities to get to these deliverables.
• While PRIME is a 5-year initiative, we’re really focusing here on things that will be prioritized over the next 12-18 months.
• The following items should be considered and included:– What products, programs, documents, processes will be
created by your project?– What key activities are required to complete the deliverables?– Who will be responsible for these activities – team members,
staff, consultants, vendors, etc.?– Note the timeline associated with completing the activities
and creating the project deliverables.
Section 6 – Resource and Expertise Needed for Project Implementation
• What resources, expertise, and/or coaching does your team need to accomplish your PRIME Project goals? – It’s helpful to start by listing the resources that you’ll need to
use/leverage to be successful in your project. Then highlight which resources or skills already exist within the team or at RUHS that you can leverage.
– This will give your team clarity about the resources and expertise gaps that exist.
Creating a project logic model or map can be a useful exercise to help identify some of these needed resources
Due Oct 20th: Drafts of Sec 1, 2, 3
• Email drafts to Teresa Hofer ([email protected]) and Jill Meyer ([email protected]) by Oct 20.
• IHQC will provide high-level feedback by Oct 28.
• Bring drafts of your project charter (at least sections 1-3) with your team to the November 8th
workshop.
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Section 1 – Project Overview
• This section will provide an executive overview of your PRIME Project.
• The following items should be considered and included:– Aim Statement
– Project Goals, Objectives, and Outcomes
– Project Assumptions
A) The Aim Statement
• Like an organization’s mission statement, the Aim Statement sets the tone for the improvement project:– Defines the purpose of the project, what you hope to
accomplish
– Identifies what system you want to improve
– Identifies what patient population the improvement will impact, and sets a time frame to complete the project
• Results from identification of a problem (Problem Statement)
• Becomes the key communication piece/message for your project
Elements of Descriptive Aims & Goals
The Who – What population are you targeting?
The Where – at which site(s)? Or with which provider’s patients?
The What and the When –– What system(s) or processes are you trying to improve?– Be SMART in the description – Specific, Measureable,
Attainable, Relevant, Time-bound
The How – High-level description of how you’ll make these improvements
SMART Statements
Aim Statement Example
Main Street clinic will increase the percentage of our diabetic patients (type 1 and 2, ages 18-75) with HbA1c under control (<8.0%) from 65% to 75% by March 31, 2017though improved case management and health coaching programs
Where Who and What
When
How
PRIME example aim statement
Through improved screening tools, implementation of behavioral health integration (BHI) teams, and staff trainings (care planning, health coaching), the Integration of Physical and Behavioral Health team will improve access and coordination of behavioral health servicesacross RUHS by December 2017.
Where Who and WhatWhen
How
Examples of SMART Project Goals
• By redesigning patient flow and implementing a new care team model, Main Street Clinic will decrease our average cycle time from 95 to 70 minutes by December 2016.
• Through improved pre-visit planning and patient outreach efforts, East Region clinics will increase from 60% to 95% the percentage of patients that are notified of an abnormal Pap test and have follow‐up appointment scheduled within 5 days of our clinic receiving the Pap results by July 1, 2016.
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Section 1 Checklist
Aim Statement – Any parts of the aim statement missing? Would it make sense to someone not familiar with the project? What can be clarified?
Goals – Are they clear? Do they include the SMART elements? Are the targets motivating? Is there a goal that is missing from this list?
Section 2 – Team Members, Roles, Responsibilities, and Meeting Plan
• A listing of the Core Team members –– Are there any skills or expertise gaps that would be
helpful to add to the team?
• Defined Roles and Responsibilities – be clear about what each person is expected to do (research best practices, attend meetings, pull reports, pilot new workflows or checklists, etc.)
• Meeting Plan –– Important to meet more often in the early states of your
project. Successful teams usually meet at least 2x per month in person, and 1-2x per week informally.
Section 2 Checklist
Core Team – Looking at your project goals, are there any additional RUHS staff that should be added to the core team? Are responsibilities distributed/shared across the core team?
Meeting Plan– How often is the core team meeting formally and informally? Who will remind team of action items and to do’s?
Section 3 – Project Measures
• This section lists measures that the team will track throughout your project (those required by PRIME andothers that will help inform your improvement efforts)
• Consider Process, Outcomes, and Balance measures
• Create a Measures Collection Plan by defining the measures (numerator/denominator), the data collection plan, baseline data for each measure, and the desired target/goal.
• Who will monitor your project measures?
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Types of Measures to Track
1. Outcome Measures (e.g., HbA1C <8)
• What effect are we trying to have? Actual results of care we provide
• Most required PRIME metrics are these Outcomes measures
2. Process Measures (e.g., % had blood test in last 12 mo.)
• Are we doing what we should be doing to achieve these outcomes?
3. Balancing Measures (e.g., Cycle time, Third Next Avail.)
• As we complete our improvement work, how are we impacting on the rest of the clinic?
10/7/201528
Adapted From: Health Quality Ontario’s System Transformation through Quality Improvement Worksheet
Aim: What are we trying to accomplish? How much by when?
Outcome Measure What effect are we trying to have? Actual results of care we provide What’s important for the customer? This is the “so what” piece
Process Measure Are we doing what we should be doing to
make improvements in the outcomemeasures?
Shows if care guidelines proven to benefit patients are followed.
How long does it take us? Is it useful?
Balancing Measure Are we inadvertently impacting other
parts of the system through our action?
If you are trying to improve it, then it’s an outcome measure. If you want it to stay the same, it’s a balancing measure (e.g. client satisfaction)
PDSA Measures How long does it take to complete the
form? (Quantitative data on the impact of a particular change to work flow)
Is it difficult to complete? (qualitative data to help refine the change)
Intended to inform the next cycle/identify areas of process to “tweak”
Types of Improvement Measures
Types of Improvement MeasuresAim: Improve colorectal cancer screening rates
Outcome Measure• % of patients that completed a
colorectal cancer screening (HEDIS-defined measure)
Collected/monitored monthly using a patient registry report
Process Measure• % of eligible patients seen that complete
FOBT• % of patients referred for colonoscopy
that have completed
Collected/monitored weekly (manually) using tracking log
Balancing Measure• Cycle Time
Collected/monitored weekly using EHR report
PDSA Measures• Patient education materials are easy to
understanding and helpful to patients (qualitative)
• % of patients that complete FOBT (tracked weekly)
Collected/monitored daily & weekly usingtracking logs and patient feedback
The Measurement Plan
• Measures Definitions
– Name the measure
– Define the numerator and the denominator
– Define the data elements or ranges (patient population, age, condition, time frame, etc.)
– Define the current status – the baseline
– Set a goal or a target
• Intended to motivate, to improve
The Measurement Plan
• Measures Definitions Example - Controlled Blood Pressure for diabetic patients
• Numerator = # of active patients (1 visit in last 24 months) ages 18-75 at Main Street Clinic with diabetes (type 1 and type 2) whose last blood pressure reading in the last 12 months was less than or equal to 139/89
• Denominator = # of active patients ages 18-75 at Main Street clinic with diabetes (type 1 and type 2)
Section 3 - Checklist
Clear Measures Definitions - If you handed this page to another team member, would they be able to collect data and generate reports in a consistent manner? If not, clarify.
Are there baseline measures? Even for the measures that aren’t required by PRIME?
Do the goals make sense? Are they motivating? Are they realistic?
Have the data collection tools (registry reports, surveys, forms) been created and vetted?
http://ihqc.org/what-we-do/initiatives/riverside/
Next Steps1. Webinar Recording and slides will be available at
www.IHQC.org. Share with other team members who weren’t able to attend today
2. Complete QI Capacity Survey by Friday, Sept 30th.
– https://www.surveymonkey.com/r/IHQC_RUHS_PRIME_QIcapacitysurvey
3. Email draft of Sections 1, 2 and 3 of Project Charter to IHQC and Jill Meyer by October 20th
4. Register for Kickoff Session (November 8th).
– https://www.surveymonkey.com/r/MKWD8M8
– Bring updated drafts of Project Charter.
10/7/201535
IHQC Staff Contact Info:
- Bridget Hogan Cole, MPH - [email protected]
- Chris Hunt, MPH – [email protected]
- Teresa Hofer, MPH – [email protected]
- Sirisha Gummadi, MHA – [email protected]
- Sharon Lau – [email protected]
www.IHQC.org
