QI Skill Assessment and Roadmap to a Culture of Quality Improvement

Transcription

1 QI Skill Assessment and Roadmap to a Culture of Quality Improvement COUNTY OF LOS ANGELES (LAC) DEPARTMENT OF PUBLIC HEALTH (DPH) Draft only

2 Background We chose to adapt NACCHO s Roadmap to a Culture of Quality, which was developed in 2012,* in recognition that when initiating QI activity in Local Health Departments, a natural evolution of change tends to occur, reflecting impact on both the people and processes within the organization. The QI Roadmap provides high-level guidance on progressing through six phases, or levels of QI integration, until a culture of QI has been reached and can be sustained. Each phase is built around six foundational elements that are critical to building a culture of quality. *National Association of County & City Health Officials (NACCHO): Roadmap to a Culture of Quality Improvement -2012

3 Purpose Goal: To assess QI Team members knowledge, skills, behaviors and motivate them to apply the six phases into their QI activities. QI Team- 1 to 2 staff from each program who are trained to track performance measures and initiate QI projects for their program.

4 Methods Introduce Team members the six phases of NACCHO Roadmap. Conduct a QI skill assessment to determine team members levels of phase 1 Employee Empowerment depending on the length of time being on the QI Team. Survey was distributed in the week of June 19 to June 30, responses, 64% response rate

5 A Culture of Quality s Foundational Elements Employee Empowerment Continuous Process Improvement QI Infrastructure Quality Culture Teamwork & Collaboration Leadership Commitment Customer Focus Source: NACCHO s Roadmap to a Culture of Quality

6 1.Employee Empowerment Leaders must enable employees by: Designating resources to QI Granting authority Establishing clear expectations Employees must have access to: QI related trainings and resources Mentors and coaches Meaning feedback systems Opportunities to voice concerns and apply QI skills

7 2. Teamwork & Collaboration Create effective team performance by: Defining team expectations Carefully selecting team members Holding teams accountable Break down silos: Communication of lessons learned Formal/informal learning and problem solving groups Eliminate redundancies and create alignment

8 3. Leadership Commitment Transform the culture (the human element): Defining and selling the QI vision QI Coaching and mentoring Transparent, 2-way communications about QI Manage QI resistance Realize the vision (the technical element): Seeking out and designating resources for QI Incorporate quality into policies, plans, procedures, & values Any major change takes courage and patience

9 4. Customer Focus Exceed customer expectations: Understand customer needs and values Collect and use customer satisfaction data Empower employees to exceed customer expectations Customer input informs organizational planning and improvement efforts

10 5. QI Infrastructure QI Committee: Cross-sectional Early adopters Oversee QI initiatives Performance Management: Meaningful performance measures Performance targets and standards Reporting performance Prioritize areas for improvement QI Planning: Assess QI culture QI plan

11 6. Continuous Process Improvement Incremental Improvement: QI project prioritization process Use of defined method of improvement Document/monitor improvement Celebrate success!!!

12 Results Length of being in the QI Team (N= 35) 31% 43% 26%

13 Percent of QI Specialists with a thorough understanding of each PDSA step, by years on QI Team 100% 89% 89% 80% 73% 73% 80% 80% 64% 60% 55% 55% 55% 40% 20% 0% Plan Do Study Act < 1 year 1-3 years > 3 years

14 How comfortable the team members feel about using each tool by year on the QI Team Percent Answering "Yes" Radar chart Nominal group technique Pareto chart Affinity diagram Run chart Control & Influence matrix Scatter diagram Prioritization matrix Five whys Aim statement Flowchart Histogram Cause & Effect diagram 9% 9% 13% 18% 18% 18% 27% 27% 33% 33% 40% 40% 47% 45% 45% 45% 56% 56% 56% 56% 53% 56% 60% 55% 60% 55% 67% 67% 67% 67% 78% 78% 80% 73% 80% 73% 89% 100% 100% Brainstorming 82% 100% 0% 20% 40% 60% 80% 100% > 3 years 1-3 years < 1 year

15 I feel comfortable leading a QI project 90% Percent Answering "Yes" 80% 78% 70% 64% 60% 50% 40% 40% 30% 20% 10% 0% 0-1 Year 1-3 Years > 3 Years

16 Discussion Change knowledge, skills, behaviors by providing QI Team: Training & implementation tools Technical assistance for projects Communicate progress/results Motivation for organizational change Leadership leads the Quality Improvement Roadmap Incentives Pilot projects Change is mandatory. Progress is not!

17 Paving a Road toward Quality Improvement New resources to help Programs reach their own Quality improvement goals: Tools to improve staff knowledge of quality improvement principles, roles, and resources Streamlined process for providing QI support, tools, training and technical assistance

18 Conclusion Utilize the knowledge and experience in our Public Health Department to improve performance Tailor Technical Assistance (TA) and support to specific needs and resources for the team members Finally, strong leadership can play a crucial role in QI. Executive-level leadership can help sustain a culture focused on quality and provide constancy of purpose.

19 Acknowledgment & Contact Information QIAP would like to thank the Program Director, Dr. Karen Swanson and the QI Specialists in the QI Team for their cooperation and enthusiasm in making it possible to build a culture of QI in the DPH Quality Management System. Quan (Joseph) Truong, MPH, MPA. Karen A. Swanson, PhD, ScM Quality Improvement & Accreditation Program (QIAP) , qtruong@ph.lacounty.gov