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 •Incentives for engaging in QI •Intentionally manage change •“Deselect” resistant leaders 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 •Membership in ASQ •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 •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 •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 • 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 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 FOUNDATIONAL CHARACTERISTICS: 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”)