Module 4: Research & LTC
108 4.2.4 Quality Improvement Steps
Step 1: Get Started
- Identify the problem
- Ask – who can help me with this?
- Decide how big the change will be – one area or whole home?
Step 2: Get People on Board
- Determine who will be project lead (clinical and/or administrative)
- Build your project team
- Talk to your stakeholders (staff, residents, family members)
- Build awareness of your project in the home
Step 3: Take a Deeper Dive
- Identify the root causes of the problem (Ask the 5 Whys)
- Ask – Are we ready to make a change?
- Ask – What can help us? What can block us?
Step 4: Prepare for the Change
- Aim: What are we trying to accomplish?
- Pick an issue that is important to those involved
- Make your aim specific, measurable, actionable, relevant, time-limited (SMART)
- Measures: How will we know a change is an improvement?
- Process Measures = Are we doing the right things to get there?
- Outcome Measures = Where are we ultimately trying to go?
- Balancing Measures = Has the change led to any unintended consequences (whether good or bad)?
- Changes: What changes can we make that will result in improvement?
- Improve patient/provider interaction
- Eliminate waste
- Improve workflow
- Change the work environment
- Manage time
- Reduce errors
Step 5: Plan, Do, Study, Act
- A Plan-Do-Study-Act (PDSA) Cycle is a useful tool for documenting & testing out change ideas.
- Plan: Start by planning how to test a change.
- Do: Implement your plan and pilot the change. Collect data — keep it simple, this is not research!
- Study: Analyze what happened when the change was implemented. Summarize what you learned.
- Act: Determine whether this is a change worth maintaining or if modifications are needed (adopt, adapt or abandon).
Step 6: Celebrate, Sustain, and Spread