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This assignment is a QIP Project

My QIP is “To improve preventive care for patients with diabetes”

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The QIP Aim CAN NOT be “We will provide foot exams to 100% of our diabetes patients who came for an office visits by the end of July 31 2016.

You will have to choose a different Aim.

Everything you need is in the attachments below.

Sheet1

CriteriaExceptionalGoodMinimalBasicWeak
Identification of the Problem2018161412
All components of the criterion are addressed in a comprehensive and thorough manner.While all components of the criterion are addressed well, one component needed a more thorough discussionWhile all components are addressed adequately, 2 components require a more thorough discussion.Although all components are present, the content is superficial or not well developedDid not address one or more components or was off topic.
1. Identify the organization for whom the QIP is being prepared (hospital, physician office, etc)
2. Use data to support the determination of the problem, such as rate of foot exam, or rate of flu vaccine as related to the organization (e.g rate of flu vaccination among nurcing home residents) Discuss the impact/potential impact of the problem
3. Does this problem has any financial impact on reimbursement (e.g Medicare non-reimbursement of care related to infections acquired in the hospital), and pay for performance program (i.e. the organization will have financial penalty if teh rate is above acceptable threshold of Pay for Performance Program.
Application of PDSA Methodology15131197
1. Address the three discovery questions:All components of the criterion are addressed in a comprehensive and thorough manner.While all components of the criterion are addressed well, one component needed a more thorough discussionWhile all components are addressed adequately, 2 components require a more thorough discussion.Although all components are present, the content is superficial or not well developedDid not address one or more components or was off topic.
a. What is the team trying to accomplish?
b. How will the team know that a change has been effective?
c. What changes can the team make that will result in improvement?
Use of the PDSA quality improvement3023211917
methodology, formulate a quality improvement process to address the problem identified . b. Select three evidence-based interventions that will be implemented to address patient falls with injuries and include any budgetary considerations that would be needed based on the interventions you selected. 2. Do: Strategies used to implement the selected evidence-based intervention.All components of the criterion are addressed in a comprehensive and thorough manner.While all components of the criterion are addressed well, one component needed a more thorough discussionWhile all components are addressed adequately, 2 components require a more thorough discussion.Although all components are present, the content is superficial or not well developedDid not address one or more components or was off topic.
1. Plan: a. Analyze the problem; evaluate the current literature to determine factors that are associated and contribute to the problem
Present two interventions that will be implemented to address the problem. Discuss any resource and budgetary considerations that would be needed for the interventions
2. Do: Strategies used to implement the selected evidence-based intervention. Survey of patients, change in process, alerts and reminder for flu vaccination
3. Study: Criteria the team will use to determine if the evidence-based interventions have been successful. a. Include information that will be analyzed to determine the success of the intervention. Types of data that will be collected and how the data will be analyzed. And the measures such as 20% change in follow-up calls from the current rate, 100% of foot exam for patients with diabetes
Act: Discuss the proposed action based on the results of the study. What the action will be if the results show and improvement and if otherwise. Will the intervention be spread to other units or modify and retest the team’s prediction of success with the new actions.
Team Process15131197
All components of the criterion are addressed in a comprehensive and thorough manner.While all components of the criterion are addressed well, one component needed a more thorough discussionWhile all components are addressed adequately, 2 components require a more thorough discussion.Although all components are present, the content is superficial or not well developedDid not address one or more components or was off topic.
Discuss the commuication strategies used by your team to manage team dynamics and for making decisions
What types of teamwork tools were used? (Brainstorming, flowchart etc)
Were the teamwork tools used beneficial? What would the team do differently ?
Scholarly writing108642
The paper is exemplary and meets all 3 components of the criterion.While the paper is well done and addressed all 3 components of the criterion, one component had limitations.While the paper is good and addressed all 4 criterion components of the criterion, two components had limitations.Although the paper is acceptable and addressed all 3 components, all the components had limitations.The paper did not contain one or more of the required components.
Paper is well written, organized within the paper limitation.
Grammar, spelling, punctuation are correct.
Conforms to APA standards for headings, citations and reference page
Member contribution108640
Member met all the three criteria and contributes to writing more than one section and also review of the QIPMember participated in the team meeting and contributes to writing at least a section and the review of the QIPMember participated in the team meeting and contributes to writing one section of the QIPMember participated in team meetings but did not contribute to writing the QIPMember did not meet any of the criteria, participated is very few of the team meetings but did not contibutes to writing the QIP
Member participated in team meeting and deliberations
Member wrote at least a section of the QIP
Member reviewed the QIP

Quality Improvement Plan Project Instructions

Use the Grading rubric as a guide for the information and what to include in the QIP

Review the QIP ppt slides and the resources listed in this document to better understand the Model for Improvement (MP) that you will use in developing your Quality Improvement Plan (QIP)

The QIP should include the part1 and part 2 of the MP: Three questions for improvement and the PDSA.

PART 1:

1. 1. What are we trying to accomplish (aim)?

In this section describe the organization for whom your QIP is intended such as “nursing home, physician practice, hospital  etc.to  provide a context for your targeted population. Then state your aim. Your aim should aligns with the organization’s quality Improvement goal.

The aim should

· Specify a time time-specific

· Be measurable (quantitative or qualitative)

· Applies to a defined patient population

· Include what will be achieved

Examples

 Organization’s goal of a physician practice is “To improve preventive care for patients with diabetes”

The QIP Aim may be “We will provide foot exams to 100% of our diabetes patients who came for an office visits by the end of July 31 2016.

2. How will we know that change is an improvement (measures)?

In this section, describe the measurable outcome(s) you intend to see. You should literature review of the problem, how the problem is been measured.

For example, for the aim listed above, you will provide a background on how foot exam is been measured in the literature. Is a 20% change in foot exam considered a significant improvement? Whose perspective is important, the patient, the management, health plans or reporting agencies. Will an improvement in this measure negatively impact other parts of the organization? Consider any relevant structure, process and outcome measures.

3. What change can we make that will result in an improvement?

Describe the processes currently in place that may show any gaps.

Identify opportunities for improvement that may exist (Use process analysis tool such as flow chart, matrices (chapter 3 in your textbook) to identify gaps in the processes of your organization, look for causes of problems that have occurred and opportunity for improvement. Identify the cause of the problem and constrains to any proposed solutions.

For example, in the example used above, some questions to consider during brainstorming to determine the change to make are: Is there a checklist of what services should be provided to diabetes patients during office visit? Is foot exam listed on the checklist? If listed, who is responsible?  If foot exam is added to the things the nurse should check when they take vitals, will it cause a lag in the time it takes the nurse to process patients and consequently increase wait times?

After you identify the cause, decide what should be change in the process to achieve your aim. What you decide to change is your intervention, and should be based on your analysis.

· Review the literature, guidelines and reports to determine what has worked

· Consider what has worked at other organizations that you can adapt to suit your organization

PART 2: PDSA

The information and decisions you obtained in PART 1 will be used in PART 2.

· Plan it- What exactly are we going to do?

· Do it –When and how do we do it?

· Study – What are the results?

· Act – What do we do with the results (lesson learned)

PDSA ItemActions
Plan  1.     What change are you testing with the PDSA cycle(s)?2.     Who will be involved in this PDSA? (e.g., one staff member or resident, one shift?).3.     What do you predict will happen and why?4.     What is the small test of change?5.     How long will the change take to implement?6.     What resources will be needed?7.     What data need to be collected? List your action steps, who will be responsible (where applicable) and the time frame for completionExample:Creating a checklist of expected services for diabetes patient for the nurses during an office visit. Foot exam is required for patients with diabetes in addition to checking or getting their A1C data and getting their vitals.The checklist will ensure that foot exam is performed for all diabetes patient.A pilot test of the updated checklist will be tested first with two nurses for a month.  This will allow to test the process and determine if the change will result in achieving the aimNo new additional resources is expected for this change beside additional time for the nurses with diabetes patient.We will collect data on number of patients each nurse worked with? The number with diabetes? Total time spent with each patient. A benchmark of total time spent with and without a foot exam 
DoCarry out the test on a small scale. Document observations, including any problems and unexpected findings.Collect data you identified as needed during the “plan” stage.Describe how you will actually ran the test.In this section describe the process of implementing the test. Describe any potential problems that may occur
StudyStudy and analyze the data. Determine if the change resulted in the expected outcome.Were there implementation lessons?Summarize what was learned. Look for: unintended consequences, surprises, successes, failures.Describe how you will prepare the data and analyze the data. What estimates do you plan to get? E.g. the proportion of all patient with diabetes that had foot exam during a visit. A bar chart of the time the nurses spent when foot exam was performed compared to when it was notWhat results and lessons do you anticipate? 
ActBased on what was learned from the test: Adapt – modify the changes and repeat PDSA cycle.Adopt – consider expanding the changes in your organization to additional residents, staff, and units. Abandon – change your approach and repeat PDSA cycle.Describe what modifications to the plan will be made for the next cycle from what you learned. Describe what you will do with the lesson learned if it was positive (i.e. if the change results in and improvement); and if it was negative (i.e. the aim was not achieved, or cost and time spent was more than expected etc.

Summary:

Key sections you should note to include in the QIP. Part 1 and Part 2 of the Model for Improvement, and the Team process

1. Part 1- Evidence-based literature review on the issue, potential solutions and problems, measures to assess and determine if the change will an improvement if implemented; types of data to collect and analysis strategies. Use the APA format for your citation and references.

2. Part 2- the worksheet for the PDSA cycle, two columns similar to what is in your instructions.

3. Team Process description: Describe the process the team used in decision making, assigning responsibilities for tasks that contributes to the development and completion of the QIP. Each member’s contribution in completing the QIP.

What strategies implemented in your teach that facilitate the success or otherwise of the processes leading to the development of the QIP?

References:

http://www.hrsa.gov/quality/toolbox/methodology/qualityimprovement/part3.html
http://www.ihi.org/resources/Pages/HowtoImprove/ScienceofImprovementHowtoImprove.aspx
http://www.hrsa.gov/quality/toolbox/508pdfs/qualityimprovement.pdf
http://www.ihi.org/education/IHIOpenSchool/resources/Pages/Activities/WilliamsMoreThanOnePDSA.aspx

http://patientsafetyed.duhs.duke.edu/module_a/introduction/introduction.html  (great resource with examples on aspects of Model for improvement

http://www.ahrq.gov/professionals/prevention-chronic-care/improve/system/pfhandbook/mod14.html
https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityMeasures/Core-Measures.html

Quality Improvement Plan Project Instructions

.

Use the Grading rubric as a guide for the information and what to include in the QIP

Review the QIP ppt slides on Blackboard and the resources listed in this document to better understand the Model for Improvement (MP) that you will use in developing your Quality Improvement Plan (QIP)

The QIP should include the part1 and part 2 of the MP: Three questions for improvement and the PDSA.

PART 1:

1. What are we trying to accomplish (aim)?

In this section describe the organization for whom your QIP is intended such as “nursing home, physician practice, hospital etc.to provide a context for your targeted population. Then state your aim. Your aim should aligns with the organization’s quality Improvement goal.

The aim should

· Specify a time time-specific

· Be measurable (quantitative or qualitative)

· Applies to a defined patient population

· Include what will be achieved

Examples

Organization’s goal of a physician practice is “To improve preventive care for patients with diabetes”

The QIP Aim may be “We will provide foot exams to 100% of our diabetes patients who came for an office visits by the end of July 31 2016.

2. How will we know that change is an improvement (measures)?

In this section, describe the measureable outcome(s) you intend to see. You should literature review of the problem, how the problem is been measured.

For example, for the aim listed above, you will provide a background on how foot exam is been measured in the literature. Is a 20% change in foot exam considered a significant improvement? Whose perspective is important, the patient, the management, health plans or reporting agencies. Will an improvement in this measure negatively impact other parts of the organization? Consider any relevant structure, process and outcome measures.

3. What change can we make that will result in an improvement?

Describe the processes currently in place that may show any gaps.

Identify opportunities for improvement that may exist (Use process analysis tool such as flow chart, matrices (chapter 3 in your textbook) to identify gaps in the processes of your organization, look for causes of problems that have occurred and opportunity for improvement. Identify the cause of the problem and constrains to any proposed solutions.

For example, in the example used above, some questions to consider during brainstorming to determine the change to make are: Is there a checklist of what services should be provided to diabetes patients during office visit? Is foot exam listed on the checklist? If listed, who is responsible? If foot exam is added to the things the nurse should check when they take vitals, will it cause a lag in the time it takes the nurse to process patients and consequently increase wait times?

After you identify the cause, decide what should be change in the process to achieve your aim. What you decide to change is your intervention, and should be based on your analysis.

· Review the literature, guidelines and reports to determine what has worked

· Consider what has worked at other organizations that you can adapt to suit your organization

PART 2: PDSA

The information and decisions you obtained in PART 1 will be used in PART 2.

· Plan it- What exactly are we going to do?

· Do it –When and how do we do it?

· Study – What are the results?

· Act – What do we do with the results (lesson learned)

PDSA ItemActions
Plan1. What change are you testing with the PDSA cycle(s)?2. Who will be involved in this PDSA? (e.g., one staff member or resident, one shift?).3. What do you predict will happen and why?4. What is the small test of change?5. How long will the change take to implement?6. What resources will be needed?7. What data need to be collected?List your action steps, who will be responsible (where applicable) and the time frame for completionExample:Creating a checklist of expected services for diabetes patient for the nurses during an office visit. Foot exam is required for patients with diabetes in addition to checking or getting their A1C data and getting their vitals.The checklist will ensure that foot exam is performed for all diabetes patient.A pilot test of the updated checklist will be tested first with two nurses for a month. This will allow to test the process and determine if the change will result in achieving the aimNo new additional resources is expected for this change beside additional time for the nurses with diabetes patient.We will collect data on number of patients each nurse worked with? The number with diabetes? Total time spent with each patient. A benchmark of total time spent with and without a foot exam
DoCarry out the test on a small scale. Document observations, including any problems and unexpected findings.Collect data you identified as needed during the “plan” stage.Describe how you will actually ran the test.In this section describe the process of implementing the test. Describe any potential problems that may occur
StudyStudy and analyze the data. Determine if the change resulted in the expected outcome.Were there implementation lessons?Summarize what was learned. Lookfor: unintended consequences, surprises, successes, failures.Describe how you will prepare the data and analyze the data. What estimates do you plan to get? E.g. the proportion of all patient with diabetes that had foot exam during a visit. A bar chart of the time the nurses spent when foot exam was performed compared to when it was notWhat results and lessons do you anticipate?
ActBased on what was learned from the test: Adapt – modify the changes and repeat PDSA cycle.Adopt – consider expanding the changes in your organization to additional residents, staff, and units. Abandon – change your approach and repeat PDSA cycle.Describe what modifications to the plan will be made for the next cycle from what you learned. Describe what you will do with the lesson learned if it was positive (i.e. if the change results in and improvement); and if it was negative (i.e. the aim was not achieved, or cost and time spent was more than expected etc.

Summary:

Key sections you should note to include in the QIP. Part 1 and Part 2 of the Model for Improvement, and the Team process

1. Part 1- Evidence-based literature review on the issue, potential solutions and problems, measures to assess and determine if the change will an improvement if implemented; types of data to collect and analysis strategies. Use the APA format for your citation and references.

2. Part 2- the worksheet for the PDSA cycle, two columns similar to what is in your instructions.

3. Team Process description: Describe the process the team used in decision making, assigning responsibilities for tasks that contributes to the development and completion of the QIP. Each member’s contribution in completing the QIP.

What strategies implemented in your teach that facilitate the success or otherwise of the processes leading to the development of the QIP?

References:

http://www.hrsa.gov/quality/toolbox/methodology/qualityimprovement/part3.html
http://www.ihi.org/resources/Pages/HowtoImprove/ScienceofImprovementHowtoImprove.aspx
http://www.hrsa.gov/quality/toolbox/508pdfs/qualityimprovement.pdf
http://www.ihi.org/education/IHIOpenSchool/resources/Pages/Activities/WilliamsMoreThanOnePDSA.aspx

http://patientsafetyed.duhs.duke.edu/module_a/introduction/introduction.html (great resource with examples on aspects of Model for improvement

http://www.ahrq.gov/professionals/prevention-chronic-care/improve/system/pfhandbook/mod14.html
https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityMeasures/Core-Measures.html

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