Over the span of this course, you have been developing components of a Quality Improvement Plan. During this week you will be incorporating the components you already have developed, as well as adding other components to complete the project plan. This completed healthcare quality improvement plan will constitute the final exam component of the course and is weighted at a higher level than the weekly assignments/mini-projects.
In the sections that follow, the specific deliverables required for this final assignment are presented as the lecture materials for the week. These will be the common, basic components found in many formats of a final project report. There is no single accepted format for final project reports so what is presented below is a somewhat generic approach that can be adapted and modified as you need in specific settings. Many organizations that do quality improvement efforts on a routine basis might have prescribed report templates or formats. In this academic setting, the primary objective of this approach is to ensure you are familiar with and able to produce the various components outlined below in a professional and effective manner.
As an introduction to the demonstration project, produce a one paragraph summary of the problem situation you are addressing. This will be a refinement of the problem statement you originally developed in week #1 of the course. Be specific but keep in mind you are trying to provide a context for the project activity, not giving a comprehensive history or synopsis of every aspect involved in the identification of the problem. Remember the old “Dragnet” TV series, where the no-nonsense Detective Friday would frequently utter some variation of the phrase “Just the facts please”? This problem statement should be fact-based. Avoid vague or general statements like, “Most patients experience wait times that are too long.” Instead, you might say “In satisfaction surveys, 67% of patients note that their wait times were too long.”
A key starting point for developing a comprehensive quality improvement plan starts with a clear understanding of the improvement objectives. In simple terms, this means defining the desired objective in both explicit and quantifiable terms. “Making things better” is an example of an inappropriate objective statement because it lacks specificity. An example of an appropriate objective statement would be “within one month, reduce patient wait time to a maximum of 15 minutes in 90% of all patient visits and ensure no patient waits for more than 30 minutes under extenuating circumstances .” With a clear objective statement, the final development of the project charter can begin. Based on the refined problem statement, you can now develop a succinct statement of what you want your project to achieve; this will become the project objective statement. The project objective statement should have the following characteristics:
The objective statement, along with the initial problem statement, will form the backbone or core basis of the project and the improvement plan you will develop.
For this section, briefly and specifically outline what the impact of the proposed improvement is (or would be, depending on the context of your situation). In one paragraph, describe why this quality improvement project is worth spending time and effort to achieve an outcome. Think in terms of this being sort of a descriptive ROI, or “Return on Investment,” perspective. If the project were really undertaken and implemented, you would want to avoid an end reaction of “So what?” or “Was this really worth the effort?” The goal is to improve quality in ways that will have a meaningful impact. This analysis is intended to challenge you to focus on worthwhile projects and prioritization of resources to support quality management and improvement efforts.
In Chapter 7 the project charter concept was introduced and described. The project charter you developed in week 4 should already contain most, if not all, of the required elements to ensure a focused and appropriately defined project scope. In light of the course work you have undertaken since week 4, refine your week 4 project charter to more closely conform to your updated and potentially re-focused problem statement and evolved objective statement. The format presented in figure 7.2 can be adapted and modified to meet your specific needs, but it is important that the final project charter has all the defined components in the chapter example and is structured similarly. When actual information (like names of individuals) or specific detail is not available, you can develop “simulated” entries and apply these to the other components of the project.
In this component, take each of the stakeholders that you have listed in the Project Charter and perform a stakeholder analysis, following the template outlined in Table 6.16 in the text. Be specific about the analysis components even if you are using simulated individuals. Describe what types of incentives, support levels and actions you would anticipate would occur if the situation were occurring.
In this part of the demonstration project, you will take problem identification into a simulated analysis and tools use phase. Based on the project direction outlined in the project charter, create a simulated analysis plan that describes in detail what analysis steps will be undertaken. Describe step by step how you would go about collecting data, what analysis tools would be applied and how the results of the analysis would be presented. Normally this would be one to two paragraphs with the potential use of additional bullet points, as opposed to extensive narratives.
In this part of the demonstration project, outline the data plan in terms of describing the sources of data, as well as any data collection tools (only if applicable to your project setting) you would use to collect performance evaluation data. Use the information from week #2 materials to describe what kind of information and data is needed to measure quality improvement in your setting. Be specific: what data is required to make good decisions and move the project along your defined path?
For this project, plan to display data (create simulated data if you don’t have actual data to work with) to illustrate how you would assess performance and progress, and achieve any fact finding goals that might exist in your setting. Use appropriate tools outlined in the chapter 4 examples to demonstrate how the project would be presented in quantitative terms. Effective presentation of data is critical to quality management, so ensure the data presented is logical and fundamentally supports the activities of your project. Illustrate your simulated projected with at least two data display techniques (e.g. control charts, graphs/histograms, pie charts, etc.).
Describe the specific changes you are proposing to achieve the desired outcomes and results. Describe the “What,” “Who,” “When,” “Where,” and “How” actions that you have undertaken or will undertake to achieve your improvement objective(s).
In this section, take the PDSA steps and briefly outline the specific actions you would take to achieve and sustain the improvement beyond the initial project activities. The purpose of this section is to offer opportunities to think about continuous improvement. The PDSA approach is a flexible mechanism to talk about the steps needed to sustain the needed improvement in this setting.
In one to two summary paragraphs, outline the findings and conclusions of your project. Describe the benefits and challenges that remain. Think of this as an Executive Summary. Keep it simple and maintain the flavor of the project, so it doesn’t become a dry recap of the problem, findings, and improvement efforts with some results thrown in. Use this section to focus attention on the results and the potential for improvement efforts in this or associated areas.
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