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