Roadmap to QI
Ty Kane
Sedgwick County Health Department
KPHA Pre-Conference Session
September 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
.5 FTE for
APQI
PHAB
vetting
session
Launch
capacity
building
plan
First
Q-Team
meeting
6-month
leader
training
All staff
QI
meeting
FEB ‘11
Launch
QI plan
and
policy
Quality Improvement Plan
Key Elements
What is a QI Plan?
•A written description of how an
agency will manage and evaluate
QI efforts.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Description
Definitions
Administration
Project Selection
Training
Tools
Communication
Responsibilities
Evaluation
Sustainability
QI Culture Assessment
The Six Dimensions of a Department’s Quality Culture
And Radar Chart Rating Scale
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
Roadmap to an Organizational Culture of QI
Pooja Verma, NACCHO, APQI
pverma@naccho.org
Ty Kane, SCHD
tkane@sedgwick.gov
Roadmap to an Organizational Culture of QI
EXITS 4-5
EXIT 6
6. QI CULTURE
4. SOME FORMAL QI
ACTIVITIES
5. FORMAL AGENCYWIDE QI
EXIT 3
3. INFORMAL OR AD HOC QI
ACTIVITIES
EXITS 1-2
1. NO KNOWLEDGE OF QI
2. NOT INVOLVED IN QI
ACTIVITIES
Roadmap to an Organizational Culture of QI
Characteristics
Strategies for Transition
•Lack awareness/understanding of QI
•Overwhelmed with other issues
•Satisfaction with status quo
•Don’t value/link QI to PH practice
•Marketing QI to leaders
•Leadership & staff training
•Share stories of success
•Intentionally manage change
EXIT 1
NO KNOWLEDGE
OF QI
EXIT 1
Roadmap to an Organizational Culture of QI
Characteristics
Strategies for Transition
•Begin to embrace/understand QI
•Problems are ignored/buried
•Staff are viewed “hired hands”
•Data are not available or not used
•Mentorship
•Integrate QI in agency planning
•‘Firefighters’ to problem solvers
•Task-focus to QI project focus
•Market QI thru successes
EXIT 2
NOT INVOLVED WITH QI
ACTIVITIES
Roadmap to an Organizational Culture of QI
Characteristics
Strategies for Transition
•Data not routinely used
•“Pseudo-QI”
•QI not part of organization’s strategy
•Few lessons learned and sharing
•Afraid of finding problems
•Share stories organization-wide
•Build learning communities
•Performance management
•Demystify QI
•Celebrate all improvements
•Address resistance to change
EXIT 3
INFORMAL OR AD HOC QI
ACTIVITIES
Roadmap to an Organizational Culture of QI
Characteristics
Strategies for Transition
•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
•QI division or function
•Sharing QI results externally
•More working across silos
•Increase reliance on data
•Performance Management
•Draft a comprehensive QI plan
EXIT 4
FORMAL QI ACTIVITIES
IMPLEMENTED IN SPECIFIC
AREAS ONLY
Roadmap to an Organizational Culture of QI
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
EXIT 5
FORMAL AGENCY-WIDE QI
Roadmap to an Organizational Culture of QI
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
EXIT 6
QI CULTURE
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, MPH
Community Health Analyst
Sedgwick County Health Department
tkane@sedgwick.gov
office phone - (316) 660-7368