Roadmap to QITy Kane
Sedgwick County Health Department
KPHA Pre-Conference SessionSeptember 20, 2011
Today’s Objectives:• Briefly describe SCHD’s initiative to begin developing a culture of QI • Reviewing the elements of a Quality Improvement Plan• Define “quality culture assessment” (with a framework provided) • Review the organizational “QI Continuum”
“15 SLIDES IN 15 MINUTES”
Building a QI Culture at a Local Health Department
NOV ‘08 MAR ‘09 NOV ‘09 MAR ‘10 AUG-DEC ‘11 JAN ‘11 FEB ‘11
.5 FTE for APQI
PHAB vetting session
First Q-Team meeting
6-month leader training
All staff QI meeting
Launch QI plan and policy
Launch capacity buildingplan
Quality Improvement Plan
Key Elements1. Description2. Definitions3. Administration4. Project Selection5. Training6. Tools7. Communication8. Responsibilities9. Evaluation10. Sustainability
What is a QI Plan?•A written description of how an agency will manage and evaluate QI efforts.
QI Culture Assessment
1. NOTHING IN PLACE
2. JUST GETTING STARTED
3. MOVING IN THE RIGHT DIRECTION
4. ADEQUATE – WE HAVE MADE GOOD PROGRESS OVER THE LAST YEAR
5. VERY GOOD PERFORMANCE AND HAVE PLANS IN PLACE TO EXPAND THE QI PROGRAM THROUGHOUT THE ORGANIZATION
6. WE HAVE INSTITUTIONALIZED QI
Source: J Public Health management Practice, 2010, 16(1), 72-78
The Six Dimensions of a Department’s Quality CultureAnd Radar Chart Rating Scale
Roadmap to an Organizational Culture of QI
Pooja Verma, NACCHO, [email protected]
Ty Kane, [email protected]
Roadmap to an Organizational Culture of QI6. QI CULTURE
4. SOME FORMAL QI ACTIVITIES
5. FORMAL AGENCY-WIDE QI
1. NO KNOWLEDGE OF QI
2. NOT INVOLVED IN QI ACTIVITIES
EXITS 1-2
EXITS 4-5
3. INFORMAL OR AD HOC QI ACTIVITIES
EXIT 3
EXIT 6
Roadmap to an Organizational Culture of QI
Characteristics•Lack awareness/understanding of QI•Overwhelmed with other issues•Satisfaction with status quo•Don’t value/link QI to PH practice
Strategies for Transition•Marketing QI to leaders•Leadership & staff training•Share stories of success•Intentionally manage change
EXIT 1NO KNOWLEDGE OF QI
EXIT 1
Roadmap to an Organizational Culture of QI
Characteristics•Begin to embrace/understand QI•Problems are ignored/buried•Staff are viewed “hired hands”•Data are not available or not used
Strategies for Transition•Mentorship•Integrate QI in agency planning•‘Firefighters’ to problem solvers•Task-focus to QI project focus•Market QI thru successes
NOT INVOLVED WITH QI ACTIVITIES
EXIT 2
Roadmap to an Organizational Culture of QICharacteristics•Data not routinely used•“Pseudo-QI”•QI not part of organization’s strategy•Few lessons learned and sharing•Afraid of finding problems
Strategies for Transition•Share stories organization-wide•Build learning communities•Performance management•Demystify QI•Celebrate all improvements•Address resistance to change
INFORMAL OR AD HOC QI ACTIVITIES
EXIT 3
Roadmap to an Organizational Culture of QICharacteristics•Greater reliance on data•Fewer ‘firefighter’ supervisors•People viewed as critical to success•QI is a part of the job•In-house QI TA available
Strategies for Transition•QI division or function•Sharing QI results externally•More working across silos•Increase reliance on data•Performance Management•Draft a comprehensive QI plan
FORMAL QI ACTIVITIES IMPLEMENTED IN SPECIFIC AREAS ONLY
EXIT 4
Roadmap to an Organizational Culture of QICharacteristics•More data-driven decisions•QI plan individualized to setting•Integration of measures into “system”•QI integrated in operational plans•QI becomes more visible•Standardization in processes•Learning/sharing culture•QI in position descriptions•Customer-focus•Demonstrate ROI•QI policies
Strategies for Transition•QI on all meeting agendas•Leadership that walks the talk•Supervisors are QI coaches
FORMAL AGENCY-WIDE QI
EXIT 5
Roadmap to an Organizational Culture of QICharacteristics•Distribution of results to staff, stakeholders and customers•QI champions throughout organization•Ongoing training and networking •Data and tools used daily•Customer is front and center•Integrate with strategic plan •Getting better all the time•Self-assessment•Problems are “gold”
Sustainability•Caution: Digression is easier than progression
QI CULTURE
EXIT 6
The following characteristics were identified throughout every phase in the roadmap:
• Selecting employees who are well-suited to learn and teach QI techniques • A Collaborative AND learning culture• QI should be integrated into strategic plan• Data analysis skills AND problem solving skills (tools)• Leadership (including governance) must be engaged and have knowledge• Theoretical vs. practical balance (50,000 ft and 5 ft view)• Flexibility in decision-making (at all levels) is seen as critical piece to
success• Supervisors are expected to engage in QI and see their job not as about
fighting fires but rather, improving processes• Customer focus• QI should be integrated into funder requirements (expected as program
work, not “extra”)
Questions and Comments
Ty Kane, MPHCommunity Health AnalystSedgwick County Health [email protected] phone - (316) 660-7368