Key Driver Diagram Interventions Need to go from

Key Driver Diagram

Interventions • Need to go from conceptual to specific, actionable ideas • The difference between “standardization” and making a specific order set the default • Change concepts can include eliminating waste, manage variation, manage time, design systems to avoid mistakes, improving work flow, enhance the hospital/customer relationship

Global Aim To optimize inpatient care strategies for mothers with opiate use disorder* and opiate exposed newborns. Primary Drivers Identification and Assessment of Opiate Exposed Newborns SMART Aims By March 1, 2022, in infants born at ≥ 35 w GA with NOWS: 1) Reduce length of stay by 20% 2) Reduce exposure to pharm care by 20% 3) Increase the % of mothers and infants discharged with Plan of Supportive Care to 95% Population Mothers with opiate use disorder and opiate exposed newborns in the state of Alabama Inpatient Management of Infants with NOWS Plan of Supportive Care for Mother and Baby *Positive self report screen or toxicology, use of non-prescribed opioids, use of prescribed opioids >1 month, newborn screen positive for opioids, newborn affected by maternal use of opioids Secondary Drivers Interventions Strengthen Family/Care Team Relationships Stigma education as part of ongoing education procedures Withdrawal scoring consistency Standardize education for all staff on withdrawal scoring Non-pharmacologic care standardization Non-pharmacologic care guidelines for opioid exposed newborns Pharmacologic care consistency: initiation, weaning, and cessation Pharmacologic treatment guidelines Keeping mother-baby dyad together Establish hospital policy for infant transfer and rooming in Hospital specific Plan of Supportive Infant Discharge Establish hospital specific supportive discharge package Hospital specific Plan of Supportive Maternal Discharge Establish hospital specific supportive discharge package

Global Aim Primary Drivers. SMART Aims Population Secondary Drivers Interventions

Constructing a Key Driver Diagram Interventions: What changes can you test to target primary and secondary drivers? What changes can you make that will result in improvement? Global Aim: The project’s “North Star. ” What is your ultimate goal you’re trying to achieve? Possible interventions may be identified by considering evidence based practices, the voice of the customer, process observation, conducting a simplified FMEA. SMART Aim: Should have an aim that is Specific, Measurable, Achievable, Realistic, and Timely. Population: Be specific regarding which patients will be included in the project. Key Drivers: What are the key items that will help you achieve your SMART Aim? To help map out drivers, conducting a FMEA may be helpful. Identify changes that will redesign the system causing impact far in the future. Work on fire prevention rather than fire fighting. Should be specific. E. g. how can you operationalize standardization?