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PLAN DO STUDY ACT
A Case Study of The Senior Alliance Area Agency on Aging 1-C
Kesia Cowan
Care Transitions Manager
The Senior Alliance, AAA 1-C
Classic Process for Improvement
How will we know that a
modification is an improvement?
What alterations can
we make that will
result in improvement?
What are we trying
to achieve?
PDSA Cycle
What are we trying to achieve?
Increased Staff Motivation
Benefits of the achievement:
1. Increased Job Satisfaction
2. Lower Staff Turnover
3. Increased Enrollment Volume
4. Establishment of Best Practices
5. Continuation of Program
How will we know that a
modification is an improvement?
Data Analysis:
1. What is our baseline?
2. What was the trend this time last year?
3. What was the trend last month?
4. Are we collecting the data necessary to measure this
modification?
5. What results will we be satisfied with?
What alterations can we make that
will result in improvement?
Brainstorming
1. What alterations have we made already?
2. How much can we invest?
3. What would be the impact on our other
processes?
4. Will this alteration streamline our workflow?
5. What ideas have been presented during regular
feedback sessions?
PLAN
Form the Team
Set the Goals
Establish Measures
Select Changes
Case Study: Increasing Motivation Amongst Community Health Workers
Form the Team:
Care Transitions Management at TSA
Set the Goals:
950 Enrollees in Care Transitions Program
Establish the Measures:
Comparative Enrollment Chart
Select the Changes:
Offering a Monetary Incentive
Do
Test Changes
Implement Changes
Spreading Changes
Case Study: Increasing Motivation Amongst Community Health Workers
Test Changes:
Roll-out Monetary Incentive to a Small Group
Implement Changes:
Roll-out Monetary Incentive to a Entire Group
Spreading Changes:
Remind Group Continually of Monetary Incentive
STUDY
Data Analysis
Assess Process Gaps
Identify Unforeseen Barriers
Case Study: Increasing Motivation Amongst Community Health Workers
Data Analysis:
500
550
600
650
700
750
800
850
900
950
May June July August
Target Enrollment
Actual Enrollment
Incentivized
Goal: 950
Case Study: Increasing Motivation Amongst Community Health Workers
Assess Process Gaps:
Staff Survey on Motivation
Disclosure of Incentive Amount
Identify Unforeseen Barriers:
Staff Not Satisfied with Selected Amount
Staff Motivated by Other Avenues
ACT
Assess Goal Achievement
Identify Redundancy
Report Findings
Case Study: Increasing Motivation Amongst Community Health Workers
Assess Goal Achievement:
Goal Not Achieved: Decrease in Percentage Change
0
2
4
6
8
10
12
14
June July August
Enrollment Percentage Change
Percentage Change
Incentive Offered
Case Study: Increasing Motivation Amongst Community Health Workers
Identify Redundancy: Ask Community Health Workers “What Motivates You?”
Report Findings:
• “Leaving work every day knowing I have made a significant impact in someone’s life”
• “Helping others in need”
• “Whether it’s a short conversation, being able to provide transportation and meals, or helping a patient recognize the importance of following their medication administration schedule, it’s a truly fulfilling position to be able to put a smile on the face of someone who may not even get the opportunity to speak with another human being who genuinely cares and listens for five minutes, let alone forty.”
Case Study: Increasing Motivation Amongst Community Health Workers
NEW PDSA What are we trying to achieve?
Increased Staff Motivation
How will we know that a modification is an improvement?
Increased Program Enrollment
What alterations can we make that will result in
improvement?
Increasing Recognition of Staff Accomplishments
2014 vs. 2015
2014 2015
12,927 eligible participants
8217 enrolled participants
7649 successfully paid cases
3 of 6 hospitals exceeding
CMS target
16,368 eligible participants
12,276 enrolled
participants
11,662 successfully paid
cases
All hospitals exceeding
CMS target
Case Study: Increasing Motivation Amongst Community Health Workers
Reference Langley GL, Moen R, Nolan KM, Nolan TW, Norman CL, Provost LP. The Improvement Guide: A
Practical Approach to Enhancing Organizational Performance (2nd edition). San Francisco: Jossey-
Bass Publishers; 2009.
Source: 2015 IHI National Forum presentation by Robert Lloyd (Vice President, IHI) and Dave Williams (Executive Director, IHI)
Model for Improvement
Question #1: What are we trying to accomplish?
Source: www.ihi.org/resources/Pages/HowToImprove/default.aspx
Model for Improvement
Question #2: How will we know that a change is an improvement?
Source: www.ihi.org/resources/Pages/HowToImprove/default.aspx
Model for Improvement
Question #3: What changes can we make that will result in improvement?
Source: www.ihi.org/resources/Pages/HowToImprove/default.aspx
Plan, Do, Study, Act Cycle
Source: http://www.ihi.org/resources/PublishingImages/PDSA.jpg
For More Information and Additional PDSA Examples:
• The Improvement Guide: A Practical Approach to Enhancing
Organizational Performance (2nd Edition) Langley GL, Moen R, Nolan KM, Nolan TW, Norman CL, Provost LP San Francisco, California, USA: Jossey-Bass Publishers; 2009.
• Institute for Healthcare Improvement: Science for Improvement on
a Whiteboard Series http://www.ihi.org/education/IHIOpenSchool/resources/Pages/BobLloydWhiteboard.aspx
• Video: The Domestic Lean Goddess – Getting the Kids to School on
Time PDSA https://www.youtube.com/watch?v=jsp-19o_5vU
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