research cp webinar 3-quality...
TRANSCRIPT
Dimensions of quality -‐Berwickhttps://www.youtube.com/watch?v=5vOxunpnIsQ or tinyurl.com/researchcp-‐qi1
• Safety • Effectiveness • Patient Centeredness • Timeliness • Efficiency • Equity
Dr. Mike Evans https://www.youtube.com/watch?v=jq52ZjMzqyI or tinyurl.com/researchcp-‐qi2
Assumptions We all have room for improvementKnowing the right thing to do and doing the right thing are not the sameSome is not a number and soon is not a timeTo change a result we have to change a system
Three questionsWhat are you going to improve?How will you know a change is improvement (measureable)?What changes will lead to improvement?
Quality Improvement Activities and Research –How to tell the difference? Version: 01 June 2009
Research QI Purpose Test a formal hypothesis. Assess a process, program, or system. Starting Point A prospectively designed, formal, written
research hypothesis. Testing of issues that are beyond current science.
An established set of standards.
Benefits Knowledge sought may not benefit subjects involved in study.
Knowledge sought directly benefits process/program/system. The majority of patients exposed to the intervention expect to benefit from the knowledge gained.
Risks/Burdens May put subjects at increased risk beyond the standard practice.
No increased risk or burden for participants, with exception of possible privacy/confidentiality concerns.
Data Collection Systematic data collection. Systematic data collection.
Office of Research Compliance and Regulatory Affairs | Cincinnati Children’s Hospital 3333 Burnet Avenue, Cincinnati, OH 45229-‐3039 | MLC 7040
Adapted from George Washington University (GWU). Guidance on Research vs. Quality Improvement/Quality Assurance, May 2004.with additions from Hastings Center Report, p. S30 and JHMI, 2006
Quality Improvement Activities and Research –How to tell the difference? Version: 01 June 2009
Research QI End Point Answer research question. Improve the program/process/system.
Testing/Analysis Determine validity of hypothesis. Compare the program/process/system to established set of standards.
Monitoring the Changes & Feedback to Participants
All the data is collected and then analyzed before the benefits of an intervention or project are determined
Ongoing, reiterative process so the procedures are constantly being improved during the implementation.
Intended Result Share findings with individuals associated with the investigation and individuals not associated with the investigation
Share findings with only those individuals associated with the process/program/system. Information learned has immediate benefit for the program and/or clients receiving the program.
Office of Research Compliance and Regulatory Affairs | Cincinnati Children’s Hospital 3333 Burnet Avenue, Cincinnati, OH 45229-‐3039 | MLC 7040
Adapted from George Washington University (GWU). Guidance on Research vs. Quality Improvement/Quality Assurance, May 2004. with additions from Hastings Center Report, p. S30 and JHMI, 2006
Quality Improvement starts with an
AIM
Global AIMS
Improve the care and health of all children and adolescents with Crohn’s disease.
Improve outcomes, experience and value for families and individuals experiencing CP.
SMART AIM
Specific (clearly stated)Measurable (measurable numeric goals)Actionable (within the control/influence of your team)Relevant (aligned with your organizations priorities)Time bound (specific-‐time frame)
What is not a SMART Aim…..• Develop & implement a ????? Program.• Design a training course.• Roll out a new IT system.• Implement a project plan.• Collect data & analyze it.
Writing SMART Aims
Answers the first question:• What are trying to accomplish?
Includes the measure which answers the second question:• How will you know a change is an improvement?
Examples of SMART Aims
We will increase/decrease M (the key measure of our project) within the P (the group, unit or population) from X (baseline % or value) to Y (goal % or value) by Z (target date).
Remission rate for children and adolescents with Irritable bowel disease IBD at XX institution will increase from xx % as of ________to ___% as of _______
ExamplesOverall Outcome/Global Aim Eliminate delays in our system and ensure the availability of the right bed at the right time for any patient admitted to Children’s hospital.
SMART AimWe will increase the percentage of patients discharged from A3North by the predicted time from 65% to 80% by April 30, 2008
We will increase the % of ear tube cases performed at the main operating room in which Ciprodex drops are administered from 35% to 80% by Dec 1, 2013
Possible SMART AIMS for CPRN Increase the number of centers contributing data to the DCC from xx to xx by a specific date
Decrease hip dislocations at ________ (location) from xx to xx by specific date.
Decrease infections from Intrathecal Baclofen Pump at _______location from xx to xx by specific date.
Work we will do together in person……
• What do WE want to improve?
• How will we know an improvement has occurred?
Readings
Langley, Gerald J., et al. The improvement guide: a practical approach to enhancing organizational performance. John Wiley & Sons, 2009.Clancy, Carolyn M., Peter A. Margolis, and Marlene Miller. "Collaborative networks for both improvement and research." Pediatrics 131.Supplement 4 (2013): S210-‐S214.Berwick, Donald M. "A user’s manual for the IOM’s ‘Quality Chasm’ report." Health Affairs 21.3 (2002): 80-‐90.