IHI: Leading Quality Improvement

What is the order of the four steps teams typically follow to get to a place where they are running smoothly?

Forming, storming, norming, performing

In designing a performance improvement team, it is helpful to:

Have a mix of different types of people on the team

Personality and work style profile assessments can help to:

Identify the personalities present and work to everyone's strengths.

Sandy and her improvement team test the new pain control idea in the cardiac unit over the course of six weeks. The results continue to show improvement. What phase will the project enter next?

Implementation

What are the four phases of an improvement project?

Innovation-Pilot-Implementation-Spread

You're on a team seeking to improve the process for treating patients with sepsis. (Sepsis occurs when chemicals released into the bloodstream to fight infection trigger inflammatory responses throughout the body). Which of the following is an example of "advocacy"?

Stating your idea for updating the sepsis protocol.

How should Sandy and her improvement team try out the new process for improving pain control?

Test the new process with one patient and closely review the results.

What improvement project phase have Dr. Gonsalvez and her team just completed?

Pilot

The four steps for testing a change are:

Plan-Do-Study-Act

What would be a good way for the team to respond to the resistance to the change?

Share data that shows the process change is associated with a decrease in adverse events.

Which of the following represents a culture change?

The belief that a planned nap can support patient safety

What's the likeliest reason the program failed?

The culture of the organization did not support napping during a shift.

In the example, which of the following is a process change?

The planned nap

Sandy and her improvement team begin to test the change using PDSA. Assuming their early testing is successful, how will their PDSA cycles change over time?

The team will utilize more staff and resources.

Which of the following is a mechanism for "hardwiring" an innovation during the implementation phase?

Training all staff to use a new process

Which of the following are strategies to help members of a QI team establish common goals?

create a team roster, share stories, write down a shared work plan

Dr. Gonsalvez and her team continue to test the new idea. Assuming things continue to go well, what might they eventually do?

share the innovation with other units and/or hospitals utilize the IHI framework for spread develop a communication and dissemination plan

According to Herbert Kaufman, which of the following are reasons health care workers commonly resist change?

the expected autonomy of health care workers a real or perceived limit on resources an accumulation of policies, procedures, regulations

After a successful pilot, which of the following should Sandy's improvement team undertake as a next step?

work on seeing that the change is widely adopted by the unit, such as making it a formal policy and training new staff on it continue to run PDSA cycles