Flying in a Learning Collaborative

Adapted from: The Game Guide: Interactive Exercises for Trainers to Teach QualityImprovement in HIV CareNew York State Department of Health AIDS InstituteHealth Resources and Services Administration HIV/AIDS Bureau

Plan: for changeDo: make changesStudy: impact of changeAct: on changes that work

Learning Collaborative

What are we trying toWhat are we trying toaccomplish?accomplish?

How will we know that aHow will we know that achange is an improvement?change is an improvement?

What changes can we make that willWhat changes can we make that willresult in an improvement?result in an improvement?

Act Plan

Study Do

Model for improvement

Aims

Measurement

Langley, Nolan et al 1996

Change Ideas

Trial & Learning

Current State

–Divide into 10 teams

–Select a Flight Engineer- design and fly plan

–Select a Manager- measure the distance and keep time

–Select a Quality Improvement Consultant- team satisfaction

–Remaining Team members Observers

– 10 minutes or less to fly the plane or disqualified

Time

Min

ute

s

Day

Distance

Fee

t

Day

Satisfaction

% T

hu

mb

s U

p

Day

Run Charts

• Include observers in your Team

• Test Idea(s) using PDSA cycles

• Record: Distance, Satisfaction and Time

Learning Session 1: Action Period 1

PDSA Cycle

Plan:•State objectives. •Make predictions•Make conditions explicit.•Develop plan (5 W’s, How)

Do:•Carry out the test.•Document problems, surprises, and observations.•Begin analysis.

Study:•Complete analysis, synthesis•Compare data to predictions.

•Record under what conditions results could be different.

•Summarize what was learned.

Act:•Adopt, adapt or abandon based on what was learned.•Build knowledge into next PDSA Cycle

To Be Considered a PDSA Cycle

The test or observation was planned (including a plan for collecting data)

The plan was attempted (do the plan)

Time was set aside to analyze the data and study the results

Action was rationally based on what was learned

• Share PDSAs and other Change Ideas

• Profile Success

• Discuss Challenges

• Network

Learning Session 2: Action Period 2

Change that Worked

• Short flight distances

• Nose dives

• Wanders off-target

• Use heavier paper• Change launch angle

• Add tape weight to rear

• Reinforce plane body with clips

How do we stay the course and help others?

• Making your system reliable

• Standardizing work changes, forms and other supporting documents

• Auditing and Measurement

• Spread

Learning Session 3

What are we trying to accomplish (aim)?– To have maximum distance, in the least amount of

time, with the highest team satisfaction

How will we know that a change is an improvement (measures)?– Time– Distance– Team Satisfaction

What changes can we make that will lead to improvement?– Colleagues, Faculty, Change Package, GSK, CoP,

Chartering Your Course

The Game Guide: Interactive Exercises for Trainers to Teach Quality Improvement in HIV Care, August 2006, New York State Department of Health AIDS Institute Health Resources and Services Administration HIV/AIDS Bureau.

Langley, G.J., Nolan, K.M., Nolan, T.W., Norman,C.L., ProvostL.P. (1996). The Improvement Guide; A Practical Approach to Organizational Performance, 1996.

Debbie Barnard, MS, CPHQ; Quality and Improvement Consultant; Improvement Model Seminars, 2007.

Michael Murray, PhD; Small Steps; Big Changes Seminars, 2006.

Acknowledgements