more information © 2015 denver public health using the qi roadmap to create a culture of quality...

© 2015 Denver Public Health

Using the QI Roadmap to create a culture of Quality Improvement

Public Health in the Rockies 2015

Heather Weir & Rebekah Marshall


Acknowledgments

• National Association of City and County Health Officials– Pooja Verma

• Public Health Foundation– Jack Moran


QI Roadmap

6. 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


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• Incentives for engaging in QI• Intentionally manage change • “Deselect” resistant leaders

EXIT 1NO KNOWLEDGE OF QI

EXIT 1

QI Roadmap


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• Membership in ASQ• Market QI thru successes

NOT INVOLVED WITH QI ACTIVITIES

EXIT 2

QI Roadmap


Characteristics• Data not routinely used• Discrete QI efforts• “Pseudo-QI”• QI not part of organization’s strategy• Few lessons learned and sharing• Anxiety of

• Doing it wrong or• 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

QI Roadmap


Characteristics• 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• Results-sharing is the norm• More working across silos• Data use/access increases• Talk of systematic Performance Management• Draft a comprehensive QI plan• Join ASQ• Report results to local governance

FORMAL QI ACTIVITIES IMPLEMENTED IN SPECIFIC AREAS ONLY

EXIT 4

QI Roadmap


Characteristics• 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

QI Roadmap


Characteristics• 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

QI Roadmap


Foundational Characteristics

People:• Selecting employees who are well-suited to learn and teach QI

techniques • Collaborative AND learning culture• Data analysis skills AND problem solving skills • Engaged and knowledgeable leadership • Flexibility in decision-making (at all levels)• Supervisors coach to improve processes (rather than fire fighting)


Foundational Characteristics

Process:• QI integrated into strategic plan• Theoretical vs. practical balance (50,000 ft and 5 ft view)• Customer focus• QI should be integrated into funder requirements (expected as

program work, not “extra”)


Group Activity

1. Select what phase you think your organization is in2. Move to your phase in the room 3. Select one person to write on the white paper4. As a group discuss:

• Why you think you are in this phase? (5 minutes)• What is keeping you from moving to the next phase? (10 minutes)• What transition strategies might work to move to the next phase? (10

minutes)

Report out on one of your top transition strategies


Examples Using the Roadmap

Denver Public Health• Annual QI Survey used to inform Departmental strategic plan

– Goal 10: Continuous Quality Improvement throughout the department – Strategy: Develop a culture of quality improvement at Denver Public

Health

• Quality Committee develops – Action items– Implementation strategies– Metrics


Examples Using the Roadmap

CDPHE Transition Strategies:– QI Plan – Training – Participation in QI Projects– Communication– Aligning performance measures/dashboards– Implement the customer satisfaction policy


QI Roadmap

www.qiroadmap.org

http://www.qiroadmap.org/


Resources and Next Steps

– COQuIP – Social Networking site for CO LPHAs• http://coquip.ning.com

– ECHO Learning Community: QI in Colorado • www.PublicHealthPractice.org/training

3Case-based

Learning

2Expert

Presentation

1Multiple

Sessions via Video Case

• Relates to topic

• Example from work

• Challenges

• Peer input

AgendaExpert :10-15

Case :10-15

Discussion :30

Jan Feb

Mar Apr

http://coquip.ning.com/



http://www.publichealthpractice.org/training


Questions?


Contact Information

Heather WeirDirector, Office of Planning, Partnerships and Improvement Colorado Department of Public Health and [email protected]

mailto:[email protected]

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