Pam Sakamoto, Sr. Public Health Nurse, CCS ProgramCynthia Coutee, Office Assistant III, TB Control Program

May 1, 2012

The Phases of Continuous Quality Improvement

What is Continuous Quality Improvement (CQI)

Review of Plan Do Study Act (PDSA) Cycle

Flow Charting Exercise.

Objectives

What is Continuous Quality Improvement?

Continually improving our services to reach the most people in the most effective manner

Quality a word used throughout our lives in our homes, in entertainment and in work.

Important to our customers (both internal and external)

Reducing costs and improving efficiency and effectiveness

Attracts and retains quality staff

Quality: A degree of excellence

Continued…..

Continuous Quality Improvement is a transformational change in organization culture.

The Plan, Do, Study, Act (PDSA) cycle is the basic tool to guide continuous quality improvement.

The cycle is executed by a team of the frontline staff with their collective experience and knowledge, to improve work related processes and outcomes.

Managers, supervisors and employees sometimes introduce solutions to the workflow process without knowledge of what is the real problem. So the solution doesn’t fix the problem.

CQI Prevents…

Improved staff morale Flexibility to meet service need changes Ability to determine & track program integrity and

effectiveness  Allows creative/innovative

solutions.

What are the benefits of CQI?

Who benefits from CQI?

Clients and customers All levels of agency staff, volunteers,

and students.

What can be accomplished by

using CQI?

Improved quality of care

Improved health outcomes

Streamlined program and clinic operations

Enhanced sense of teamwork and ownership.

CQI Tool

PDSA WheelPlanDoStudyAct

Plan-Do-Study-Act Wheel

Tools Within the Tool

Brainstorming-process of generating ideas, causes or solutions to address an issue.

Root cause analysis-a systematic approach used to get to the true “root” of a problem.

Prioritization-process of quickly and easily reducing all the options to a manageable number by either multivoting or nominal group technique.

Continued…..

Force field analysis is a structured process that helps a group identify, discuss, evaluate, and understand the various forces for (driving forces) and forces against (restraining forces) a proposed change.

Flow chart diagrams are graphic representation of a process in sequential order.

Flow Charting

What it Does: It promotes an understanding of a process pictorially, showing variations in a process its complexity, and it promotes standardization.

Why Should it be Used? To help staff or a CQI team gain a common understanding of the steps in a process; and it aides in training employees.

When should you use a flow chart? When steps in a process need to be clarified for the purpose of planning, and when members of a team do not know a process.

STANDARDIZED SYMBOLS

Step in Process

Decision Point

Stop

Flow Line

Start or End

Steps to Creating a Flow Chart

1. Identify process2. Have the right players involved3. Agree on amount of detail4. Define where process starts and ends5. Start with the big picture6. Begin to draw flow chart7. Brainstorm list of all event, activities and decisions on a flipchart8. Arrange steps in the order they occur9. Draw flow chart using appropriate symbols10. Use arrows to show flow in process11. Team must agree upon all steps12. Once steps are listed and all agree; you can evaluate the process

Exercise

Managers, supervisors and employees sometimes introduce solutions to the workflow process without knowledge of what is the real problem. So the solution doesn’t fix the problem.

CQI Prevents…

Current Check Request Process

11

Ministry Leader or appointee comes to Finance office and

requests a check for an upcoming event.

2 Request is given to Treasurer; Treasurer okays for Financial Secretary to make check in

requested amount.

3Ministry Leader receives check

make purchases and return receipts to Treasurer.

4 Treasurer reviews receipts (if available). If amount exceeds

initial amount received, a reimbursement is issued in

cash.

5

Reimbursement disbursed

with.

Revised Check Request

Request is given to Treasurer

for review

Treasurer reviews amount of

request and checks availability

of funds.

Treasurer forwards request to

Board of Trustee forConsideration allow 7 day

response time)

Treasurer or Board approves

requested amount

Request is denied Ministry Leader

notified.

Treasurer reviews date ofsubmissionGo to step 5

1

Does request exceed $200.00?

2

3

4 4a

4b

5

No

Yes

Is request 1 month in advanceof event?

5a

No

Yes

5b

Check is issuedwith signed request

form of approvaland instruction forreceipt handling

6

Ministry Leader submits dated request to Finance Office with

event/program information

Questions

SOLANO PUBLIC HEALTH Mission Statement:

To optimize the health of the community through individual and population-based services which promote health and safety through prevention and treatment of disease and injury.