Sarah Pavelka, MHA, OTR/L, CPHQ, FNAHQ PDSA.pdf · 2/26/2018 · Review the System –Think big picture Form a team –Those that do the work Define the Problem –Everyone on the

CHAD Quality Improvement Feb 26, 2018

Pavelka's Point Consulting, LLC 1

Sarah Pavelka, MHA, OTR/L, CPHQ, FNAHQFaculty, Iowa Healthcare Collaborative

Pavelka’s Point Consulting, LLC

Background and Context: The Leadership & Quality Processes

Change in the PDSA Process

Breaking down the PDSA for Performance Improvement ◦ Tools of Continuous Improvement

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Leadership and Quality Process

PDSA

Lean

Six Sigma

Others…

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Improve Quality…

Increases Productivity

Decreases Cost

Increases Profit Margins

Decrease Price/ Increases Value

Increases Market Share

Opportunity to Stay in Business

Jobs and More Jobs

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Deming repeatedly reminded us that we must continue to improve quality

as the first step towards creating organizational performance.

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Easy to use

Cycle of improvement - continuous

Part of everyday life problem solving

Provides a framework for improvement

Can use multiple tools

Reduces the “Ready- Fire – Aim” or “trial and error”

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1. Define the System & the Problem2. Study the Current State3. Analysis of the Root Causes4. Theory of Improvement5. Implement Theory6. Study the Results7. Standardize the Improvements8. Continuous Improvements9. Celebrate Improvements

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*Source:

Langley GL, Nolan KM, Nolan TW, Norman CL, Provost LP. The Improvement

Guide: A Practical Approach to Enhancing Organizational Performance (2nd

edition). San Francisco: Jossey-Bass Publishers; 2009. 2/26/2018 10

http://www.ihi.org/knowledge/Pages/Publications/ImprovementGuidePracticalApproachEnhancingOrganizationalPerformance.aspx



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Steps Sub-Steps, Questions to Ask, & Tools Steps Sub-Steps, Questions to Ask, & Tools P

lan

1) Define the problem in a general

statement a. What process do we need to

improve? b. What do we expect or hope to gain? c. What employees can work on the

team? d. Communicate the purpose and goals

of the team/problem solving!

Tools: A3 (part 1)

2) Understand the current problem and situation

a. What is the CURRENT process (how work is being done)? Currently happening?

b. What is the current situation?

Tools: Value Stream Mapping, Checklist, Brainstorming

3) Study the Root Cause

a. What is the underlying reason for the problem?

b. Why does the problem exist?

Tools: Fishbone, 5 Why, Waste Identification

Do

4) Create an action plan for improvement: a. What is going to happen (steps for

improvement)? b. What do you hope to gain or improve

(results)? Tools: A3 (part 2), Brainstorm, Action Plan (where, what, when, who, how, why)

5) Do / Complete the action plan: 1. Trial with timelines and communication

Tools: 5S (space needs), Hot Dot, Waste Identification

Steps Sub-Steps, Questions to Ask, & Tools

Stu

dy 6) Study results of the action plan

a. Are we meeting the expected measures or results that were expected?

b. What did we gain? Tools: A3 (part 3), Observations, Run Chart, Control Charts

Steps Sub-Steps, Questions to Ask, & Tools

Act

7) Put new process in place

a. What do we need to communicate to the staff about improvements?

Tools: Checklists, Check sheets, Dashboards

8) Define the next steps of the cycle of improvement a. What are the next improvements?

Tools: A3 (part 4), Huddle boards, Dashboards

9) Celebrate the improvements Tools: Newsletters, Dept/Leaders meetings

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Review the System – Think big picture

Form a team – Those that do the work

Define the Problem – Everyone on the same page

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Gains team support

Clearly defines the situation/problem for team and organization

States a BEGINNING and an END◦ Scope of work

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Who is your customer?

What does the customer want? (“it”)

Where do they want it?

When do the want it?

How do they want it to perform?

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Value Added ◦ Any activity that increases the market for

or function of the service (the products the customer is willing to pay for)

Non-Value Added◦ Any activity that does not add form,

function, or is not necessary

Necessary Non-Value Added◦ “Keeping the doors open”

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Understandable to everyone

Can move forward with data driven decisions

Create goals and metrics for “improvements”

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Discover the underlying reason problem exists

Create solutions so the problem does not return

Focuses on the current state moving to future state

Should not point blame Remember: the process is broken –not the people

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Step 4 – Plan for Improvements

Action Planning

Step 5 –Implementation

Project Management

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Creates opportunity to see if process is “broken”

Assists in training and cross-training

Creates platform to everyone to understand process

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Definition: The best arrangement of people, materials, work stations, and methods within a work area to eliminate waste ◦ Creating a consistent method for work

flow to improve quality, speed, and cost in addition to reducing variation

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Never an end

Lower the water level (iceberg)

Next phase or cycle

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Audits◦ Surveys

◦ Focus Groups

◦ Sampling

Parking Lot issues

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Past FuturePresent

Sarah Pavelka, PhD, MHA, OTR/L, CPHQ, FNAHQ

Pavelka’s Point Consulting, LLC641-780-0810

[email protected]@ihconline.org

Documents

Sarah Pavelka, MHA, OTR/L, CPHQ, FNAHQ PDSA.pdf · 2/26/2018 · Review the System –Think big picture Form a team –Those that do the work Define the Problem –Everyone on the