HSC 450 QI 102

Which of the following statements is true?

All of the above

Brenda, the office manager at a dental practice, noticed many patients were missing their appointments. With the support of her colleagues, she decided to conduct a small improvement project to improve the process for reminding patients of upcoming visits, with the goal of having fewer "no shows." During a team meeting, Brenda's team members review her aim statement. Which of the following comments from a team member would most strongly suggest Brenda has selected an appropriate aim?

"It feels like a very meaningful project for both the patients and the practice."

Having a clear aim statement is important in quality improvement work because:

Aim statements provide a clear and specific goal for the team or organization to reach.

After several tests, you decide to try implementing a modified version of the protocol at your institution. Which of the following might you do within the "S" portion of your next PDSA cycle?

Analyze information collected

What additional information is most important for them to add to the graph to best explain the work they've done?

Annotations to show when specific changes were tested

The care protocol was successful at the other hospital. Why would it be important to test this proven change at your hospital?

Because this change may not be as effective in your hospital

Which of the following changes falls under the heading of "eliminating waste"?

Clinicians type all notes directly into a computer rather than writing them in a patient's chart, thus saving paper.

As an office manager, you notice there's a high rate of "no shows" for appointments at your practice. People often tell you they scheduled the appointment far in advance, and simply forgot to go. You decide it's worth a try to improve this problem by sending reminders via text message. Which change concept are you using?

Design Systems to Prevent Errors

Defining a family of measures helps you answer which of the three questions of the Model for Improvement?

How will we know that a change is an improvement?

Starting with small tests of change:

Improves the likelihood of buy-in from leaders and staff

An orthopedic clinic in a busy metropolitan area would like to improve its patient scheduling process. More specifically, the clinic wants to improve its efficiency and the satisfaction of its patients. Applying the Model for Improvement to the clinic's improvement goal, which of the following is the most reasonable aim statement?

Increase the number of patients reporting they are "very satisfied" with the clinic's scheduling by 50 percent within six months.

An orthopedic clinic in a busy metropolitan area would like to improve its patient scheduling process. More specifically, the clinic wants to improve its efficiency and the satisfaction of its patients. The orthopedic clinic plans the change to improve scheduling, and then it carries out a small test of change with three patients on Tuesday morning. What's the next thing the clinic's improvement team should do?

Measure to see if the change led to improvement

An aim statement should include the following:

Numeric goals, specific time frame, patient population or system affected

When trying to improve a process, one reason to use PDSA cycles rather than a more traditional version of the scientific method (such as a randomized, controlled trial) is that:

PDSA cycles provide a mechanism to adjust improvement ideas as the project progresses

Medical staff at a community health center were concerned about the oral health of many of their patients. To improve patients' oral and overall health, they wanted to improve the coordination between medical and dental services, with medical providers more reliably providing appropriate referrals for dental care based on patients' age and risk factors. What would you identify as the best outcome measure for the project?

Patients' oral health, as measured by caries risk assessment

You're a dental assistant at a small clinic. Sometimes patients with unresolved problems need to come in for recall appointments. However, you notice that it's a real challenge to schedule these recalls within a week of the initial appointments. Which of the following techniques might be most useful as you search for a good idea for change?

Review the process for scheduling these appointments with colleagues to identify opportunities for improvement.

As you recall, the IHI staff member's change idea involves leaving work by 5:30 PM each workday. Which of the following is an example of using technology to help her do so?

Scheduling a reminder into her work calendar that pops up daily at 5:15 PM with the message, "Leave!"

An orthopedic clinic in a busy metropolitan area would like to improve its patient scheduling process. More specifically, the clinic wants to improve its efficiency and the satisfaction of its patients. After assembling a team and working through the three questions of the Model for Improvement, the orthopedic clinic decides to implement an automated reminder phone call 24 hours prior to each clinical appointment. The clinic's improvement team hopes that this small change will improve scheduling. What is the team's next step?

Test their change plan using the PDSA cycle.

As a nurse manager of a medicine unit in an academic hospital, you're aware that your unit has a high rate of patient readmissions. In fact, 36 percent of the patients discharged from your unit are readmitted to the hospital within 30 days. After reviewing the literature, you become aware that this rate is quite high compared to national standards. Working with other members of your unit, you develop a plan to call patients on the phone within 48 hours of discharge, with the aim of cutting readmission rates to 18 percent. Which of the following is the best example of a process measure that the team may collect as part of this improvement effort?

The percentage of patients receiving a call within 48 hours of discharge

Why might an improvement team consider collecting balancing measures?

To make sure they didn't unintentionally introduce undesired changes

What's the main benefit of using change concepts to come up with improvement ideas?

Using change concepts can help you develop specific improvement ideas that might not have occurred to you initially.

A good aim statement helps improvement teams answer which question from the Model for Improvement?

What are we trying to accomplish?

Which of the following statements is true?

While not all changes lead to improvement, all improvement requires change.

Brenda, the office manager at a dental practice, noticed many patients were missing their appointments. With the support of her colleagues, she decided to conduct a small improvement project to improve the process for reminding patients of upcoming visits, with the goal of having fewer "no shows." Which of the following is the most effective aim statement for this project?

Within three months, 90 percent of patients will show up for their appointments.

Based on the recommendations in this lesson, what should you do next?

Work on improving both the schedule and communication at the same time