Quality Improvement in Action Using the FOCUSPDSA Method

Quality Improvement in Action: Using the FOCUS-PDSA Method to Conduct a QI Project November 22, 2003 © 2013 American College of Cardiology 1

Learning Objectives After viewing this presentation, you will be able to: 1. State each step of the FOCUS-PDSA method 2. Draft a QI project plan 3. Build a QI project team 4. Conduct a QI project step-by-step © 2013 American College of Cardiology 2

Getting started can feel like… Who’s in charge? Are we there yet? Haven’t we done this before? By going step-by-step, you can make sense of your QI project © 2013 American College of Cardiology 3

FOCUS-PDSA Method • • • Find a problem Organize a team Clarify the problem Understand the problem Select an intervention © 2013 American College of Cardiology 4

Commonly Used QI Tools* 1. 2. 3. 4. 5. 6. Stakeholder analysis Brainstorming Dot voting Prioritization matrix Flow chart Root cause analysis * Refer to the “QI Tool Box” for details © 2013 American College of Cardiology 5

Step 1. Find a Process to Improve 1. 2. 3. 4. 5. 6. Assemble QI project team Identify potential problems Identify primary stakeholders Select specific problems to improve Draft a problem statement Develop a project charter © 2013 American College of Cardiology 6

Step 2. Organize a Team 1. Form project team 2. Select a team leader and facilitator 3. Conduct kick-off meeting Helpful hint: Make sure your team includes a representative of everyone affected by your QI problem © 2013 American College of Cardiology 7

Step 3. Clarify Current Knowledge of the Process 1. Develop understanding of situation 2. Establish measurement process 3. Collect data Helpful hint: Use a flow chart to document what is actually going on © 2013 American College of Cardiology 8

Step 4. Understand Process Variation 1. Graphically present data 2. Identify patterns of variation 3. Identify sources of variation Helpful hint: Use a fishbone diagram or another root cause analysis tool to figure out the cause(s) of the problem © 2013 American College of Cardiology 9

Step 5. Select the Intervention 1. Identify potential interventions 2. Prioritize potential interventions Helpful hint: Your team should brainstorm all the possible solutions to your QI problem and vote to pick one © 2013 American College of Cardiology 10

FOCUS-PDSA Method Act Plan Implement the intervention and determine its success Study Do © 2013 American College of Cardiology 11 11

Step 6. Plan How to Implement 1. 2. 3. 4. 5. 6. Develop clear objectives Develop implementation plan Make a prediction about the impact Determine data and assess impact Plan the test cycle Seek buy-in from key stakeholders © 2013 American College of Cardiology 12

Step 7. Do – Implement the Plan 1. Test your intervention 2. Document what happens 3. Begin analysis of test data Helpful hint: Test your intervention on a small scale with a few providers or patients. . . make it simple! © 2013 American College of Cardiology 13

Step 8. Study the Results 1. 2. 3. 4. Analyze data Compare the results to your predictions Reflect on what happened Determine if modifications are needed Helpful hint: Look for the unintended consequences to your intervention © 2013 American College of Cardiology 14

Step 9. Act – Continue or Change 1. Apply the lessons learned 2. Change the project or implement again as-is 3. Prepare a plan for the next test Helpful hint: A lesson learned may be that you need to change your implementation plan or just start over © 2013 American College of Cardiology 15