Slide 1 : Thank You 39 Weeks 2009
Slide 2 : The purpose and use of data and measuring
The concept of Variation
Introduce a model for Improvement
And ask you that powerful anthropological question… who are you people and what do you want?
Might look something like this : Might look something like this M M M M M M
M M M M M M
M M M M M M
Our work is improving patient care …not data collection! : Our work is improving patient care …not data collection! The purpose of measuring is to answer critical questions and to guide intelligent action.
*Seek usefulness
*Keep it simple
*Use qualitative and quantitative data
*Build measurement into daily work
*Write down the definitions of measures
Intrauterine Growth Velocity : Intrauterine Growth Velocity 24 – 27 weeks 35 – 37 weeks
21 g/kg/d 12 g/kg/d
23 37 weeks
16 g/kg/d
Slide 6 : All improvement requires change; however not all change is an improvement. Process measures answer the question “How will we know that the change we made is an improvement?
If you have a written statement of the accomplishments expected from your teams efforts, collecting data as part of the changes you make toward that end lets you know if you’re on track.
Slide 7 : Attract more birds and more variety of birds to my backyard by July 2010 Have the right varieties of nutrients at the right time Possible “DRAFT” Interventions to test
*Determine natural species and their food preferences
*Install a bird baths
*Determine migratory habits and provide nutrients for migrating birds
*Decrease Netflicks budget to afford this new habit
Slide 8 : M
.95 x .80 x .95 x .95 x .95 x .80 =
How will you get there… : How will you get there… Define and map the processes
Reduce variability by testing
Participate in the re-design of a robust system that in Japan would include an abundance of
POKA-YOKE
Slide 10 : What are the three or four “buckets of work”
in this 39 Week Initiative?
Slide 11 : Eliminate scheduled deliveries under 39 weeks for non-medical reasons by May 2010 Awareness of risks and expected benefits by patients and consumers Culture of safety and improvement Possible “DRAFT” Interventions to test
*Inform consumers of risk/benefit
*Communicate to patient/clinic/hospital the results of any ultrasound
*Promote need for early dating
*Broad public awareness campaign
*Continuous monitoring of data and discussion among healthcare providers
*Project outcomes posted on units
*Develop ways to include staff and physician input about handoffs
*Connect with other organizational initiatives on safety and build on them
*Empower nurses and schedulers to require dating criteria in scheduling process
Slide 12 : “Not everything that is faced can be changed, but nothing can be changed until it is faced.”
James Baldwin
Why use a model? : Why use a model? Characteristics of good models:
Listen to the customers
Tap the knowledge of the system and people in it
Understand the processes and interactions in the system
Use disciplined methodology in successive cycles to test changes
Make and test changes on a small scale; then, move rapidly to improve
Measure to learn and understand variation
Slide 14 : Part 1:
define the Aim
determine Measures
articulate the work in each “bucket”
Part 2:
rapid cycle testing
Slide 15 : “learning”
“Keep on beginning and failing… until you have accomplished your purpose.”
Anne Sullivan
Slide 16 : Thank you!