GHA
Hospital Engagement Network
Learning Collaborative
Webinar ~ May 23, 2012
Kelley Dotson, RN
Georgia Hospital Association
Learning Objectives
• Education
o Documenting a Small Test of Change
• Questions & Answers
Learn. Act. Improve. Spread.
Keep the Drum Beat Going.
Small Test of Change
EDUCATION
Learn. Act. Improve. Spread.
Keep the Drum Beat Going.
What have you ALREADY done???
 Collect baseline data
 Complete Root Cause Analysis
 Complete Process Flow Map (Chart)
 Select specific focus to address
 Prioritize your “cause”
Learn. Act. Improve. Spread.
Keep the Drum Beat Going.
What to do NEXT???
Develop Corrective Actions & A Follow-up
• Determine workable solutions for the root
causes
• Re-visit any “quick fix” solutions that were
put in place
• Use other PI tools to assist
Learn. Act. Improve. Spread.
Keep the Drum Beat Going.
Team’s Role
• Team designs a plan (Plan)
• Team creates time-lined actions (Do)
• Team/assigned individuals measure (Study)
• Team acts on the outcome of measurements (Act)
Learn. Act. Improve. Spread.
Keep the Drum Beat Going.
Science of Improvement ~
Testing Change
Depending on the aim, your team should
choose PROMISING CHANGES and use
Plan-Do-Study-Act (PDSA) cycles to:
1. Test a change quickly on a small scale
2. See how it works
3. Refine the change as necessary before
implementing it on a broader scale
Learn. Act. Improve. Spread.
Keep the Drum Beat Going.
Performance Improvement Team Should
Ask Three Questions:
AIM
MEASURES
CHANGES
• What are we trying to accomplish?
• How will we know that a change is improvement?
• What changes can we make that will result in improvement?
Key changes are then
implemented in a
cyclical fashion
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Think SMART
Your Goal should be SMART
S pecific
M easurable
A greed to
R elative
T ime-based (becomes standard process)
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Keep the Drum Beat Going.
Small Test of Change Worksheet
• GOAL: Overall goal you would like to
reach
• Every goal will required multiple smaller
tests of change
Learn. Act. Improve. Spread.
Keep the Drum Beat Going.
Small Test of Change Worksheet
Describe your first (or next) test of change
PLAN
Describe your first (or next) test of
change
Person
Responsible
When to
be done
Where to be
done
Provide non-slip/skid socks to
patients at risk for falls
Materials
Manager
4 weeks
Med-Surg
Unit
Learn. Act. Improve. Spread.
Keep the Drum Beat Going.
Small Test of Change Worksheet
List the tasks
PLAN
List the tasks needed to set up this test Person
of change
Responsible
When to
be done
Where to be
done
1. Research most appropriate product available
Materials Mgr. &
Med-Surg RN
Mgr.
10 days
Department
2. Obtain three quotes on product
Materials Mgr.
14 days
Department
3. Determine number needed for trial period
Med-Surg RN
Mgr.
7 days
IT
4. Place order
Materials Mgr.
21 days
Department
5. Educate staff on use of non-slip/skid socks
Med-Surg RN
Educator
14 days
Med-Surg Unit
6. Add to Order/Entry System
RN/IT Liaison
21 days
IT
7. Stock in Pyxis
Materials Mgr.
24 days
Med-Surg Unit
8…….
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Small Test of Change Worksheet Predict
what will happen
PLAN
Predict what will happen when the
test is carried out
Measures to determine if prediction
succeeds
1. Falls will decrease by 75% in one
month
1. Monitor falls daily on Med-Surg unit
 Track weekly rate x 4 weeks
2.
2.
3.
3.
Learn. Act. Improve. Spread.
Keep the Drum Beat Going.
Small Test of Change Worksheet
Do Study ACT
DO
Describe what actually happened when you ran the test of
change:
STUDY
Describe the measured results and how they compare to the
predicted results:
ACT
Describe what changes to the plan will be made for the next
cycle from what you learned:
Learn. Act. Improve. Spread.
Keep the Drum Beat Going.