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Clinical Safety & EffectivenessSession # 6

Falls Prevention at the MARC

DATEEducating for Quality Improvement & Patient Safety

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Use of the Template

This template is a resource to help your team develop your project presentation for the CS&E program. It is aligned with the Improvement Model to help your team communicate your story of quality improvement.

The suggested topics in the template are provided to help facilitate the development of an effective presentation – they are not required content. Feel free to customize the template to fit your project and presentation style.

Please keep the presentation format in mind as you develop your slides. Your team will have 20 minutes to present their final presentation. Groups typically allow 15 minutes for slides and 5 minutes for Q&A. It is recommended that teams review or practice their presentation together to ensure a tight, focused and valuable delivery.

See Appendix A for guidance about the Improvement Model

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The Team

• Division – Deborah Cantu, RN, BSN Clinic Services Manager

– Denise R. Flinn, MD Clinical geriatrician

– Pam Glasscock, Director of Clinical Operations

– Helena Crosby, Clinical Services Coordinator

– Michelle Webb, Meeter/Greeter

– Michelle Sanchez, Medical Assistant

– Ric, Housekeeping Supervisor

– Dan Parker, Facilities

– Jenny Greenlee, PT

– Mike Charlton—Institutional Safety

• Sponsor Department– L. David Hillis, MD

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What We Are Trying to Accomplish?

OUR AIM STATEMENT

To reduce the number of falls among patients visiting the MARC for outpatient appointments by 50% by January 1, 2011.

See Appendix B for guidance about aim statements

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Project Milestones

• Team Created August 2010

• AIM statement created August 2010

• Weekly Team Meetings Sept—Dec 2010

• Background Data, Brainstorm Sessions, May 2010--

Workflow and Fishbone Analyses

• Interventions Implemented October 2010

• Data Analysis Oct—Dec 2010

• CS&E Presentation January 20, 2011

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Background

• Context

• Rationale

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How Will We Know That a Change is an Improvement?

• Types of measures

• How you will measure

• Specific targets for change

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What Changes Can We Make That Will Result in an Improvement?

Outline the changes that will be tried by your team. These are based on findings from your process analysis tools, decision-making tools and relevant organizational factors.

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Selected Process Analysis Tools

List of the tools you chose to use for your project and how they fit with your project’s aim and methodology

Examples:

• Brainstorming

• Affinity sort

• Flowchart

• Fishbone

• Check sheet

See “The Quality Toolbox,” Second Edition, Nancy R. Tague, Pages 4 – 12 for a complete list of qualityimprovement tools

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Selected Decision Making Tools

List of the tools you chose to use for your project and how they fit with your project’s aim and methodology.

Examples:

• Pareto Diagram• Nominal Group Technique• Rank ordering• Decision tree

See “The Quality Toolbox,” Second Edition, Nancy R. Tague, Pages 4 – 12 for a complete list of qualityimprovement tools

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Background Data

Examples: current state data that describe the process, previous project results related to the process.

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Intervention

Plan

Overview of Your PDCA Action Plan

See Appendix C for guidance about PDCA cycle

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Implementing the Change

Do

How you implemented the change, including date, documentation, implementation issues and lessons learned.

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Results/Impact

Check

The results you obtained, including measures on run/control charts.

If run charts used, please annotate to show when improvement was initiated.

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Expansion of Our Implementation

Act

Explain how your change will be implemented elsewhere (spread or expanded) or if will it be abandoned because it did not result in an improvement.

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Return on Investment

Determine the Return on Investment (ROI)

for your project.

If it is not possible to determine ROI, then discuss lessons learned and any value added to the organization or its constituencies from your project.

* See Appendix D for guidance about ROI

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Conclusion/What’s Next

Highlight your final conclusions, knowledge gained from the project, and any next steps that the team is considering.

You may also address future benefits that you anticipate for patients, clinicians or the organization and/or barriers that may affect your ability to sustain your project results.

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Thank you!

Educating for Quality Improvement & Patient Safety