Process ImprovementConcept OverviewRegional Breast Health Improvement Initiative

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Some Concepts Based in Improvement Knowledge

• Every system is perfectly suited to produce the results it produces (Everybody is already doing their best).

• All work is a process.

• Improvement of processes requires change.

• But all change is not improvement.

Breast Health MeasuresProvider Teams Current Breast Cancer Screening Rates

All Work is a Process:

Group ActivityKnow Your Processes

Questionnaire

Scheduling Referral AppointmentsExample: Block Scheduling

• GBMS provider sees PT and records referral into EMR as WAH.• GBMS staff schedules patient for one of the blocked appt slots.• One week prior to blocked slots, GBMS will fax the completed appt

list along with the referrals and required documents WAH.• WAH will provide reminder calls 48 hours prior to the appointment.• Following the appointment, WAH will fax the results to GBMS

referral site.• No shows will be closely monitored and communicated to GBMS.

GBMS will reschedule the appt as appropriate. • GBMS will be responsible for filling out the state application

paperwork for diagnostic procedures.

Improvement of processes requires changeExample of a Decision Aid

Reliable Screening: Identified Best PracticesProcess to: Examples

Identify women for screening • Flag Charts• EMR Visit Planner Tool• CMA documents during triage

Schedule referral appointment • Same day walk-in appointments• Block Appointments with partner facility• Centralized appointment system, PT calls from clinic

Getting screening accomplished

• Quick turnaround between referral and screening• PT reminder via phone• Obtaining previous records prior to screening visit• PT education about procedure

Receiving and Acting on results • Establishing relationships/Improving communication and handoffs• Standardized protocol for follow-up for abnormal results

But all change is not improvement:

Planning a Small TestPDSA Worksheet

The Improvement Guide, 2nd Edition, Langley, Nolan, et.al., Jossey-Bass 2009

Sequential Building of Knowledge:Include a Wide Range of Conditions in the Sequence of Tests

BreakthroughResults

Theories, hunches,& best practices

Learning and improvement

A P

S D

Evidence & Data

A P

S D

A P

S D

A P

S D

The Improvement Guide, 2nd Edition, Langley, Nolan, et.al., Jossey-Bass 2009

Thank you!