introduction to qa, qi and performance management
DESCRIPTION
Introduction to QA, QI and Performance Management . A Mark Durand PIHOA Quality and Health Information Coordinator December, 2011. Are you satisfied?. QA/QI- Program Development by Site. Key : 0 = No activity yet = Preliminary plan = Some progress = Program components installed - PowerPoint PPT PresentationTRANSCRIPT
Introduction to QA QI and Performance Management
A Mark Durand
PIHOA Quality and Health Information Coordinator
December 2011
Are you satisfied
QAQI- Program Development by Site
Am Samoa CHCAm Samoa Hosp
Guam GMHCNMI Hosp
Pohnpei DHS amp CHCYap DHSYap CHC
Palau MOHGuam CHCRMI- EbeyeKosrae DHS
FSM NatlGuam DPHSS
Am Samoa DHSCNMI PH
Chuuk DHS
0 05 1 15 2 25 3 35 4
Key0 = No activity yet1 = Preliminary plan 2 = Some progress3 = Program
components installed4 = Program running
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
QA amp QI amp PM
Church of God
Seventh Day Adventist
Congregational
Catholic
Orthodox
Presbyterian
Lutheran
Baptist
Church of Christ
Church of God
Seventh Day Adventist
Congregational
Catholic
Presbyterian
Lutheran
Baptist
Church of Christ
Quality Assurance
Quality Improvement
Continuous Quality Improvement
Total Quality Management
Performance Management
Lean
Six Sigma
Baldridge Criteria
Define Standards or Goals
Measure
Monitor amp
Report
Change what
you do until you
reach goals
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
QA amp QI amp PM
QA
Plan
Do
Study
Act
Define Quality
Standards
Monitor amp Report Quality
Correct Deficiencie
s
QI
QI Tools
Plan bull Objectivebull Questions and predictionsbull Plan to carry out the cycle (who what where when)bull Plan for data collection
Do bull Carry out the planbull Document problems and
unexpected observationsbull Begin analysis of the dataTrack progress on work plan or Gantt
Studybull Complete the data
analysisbull Compare data to predictionsbull Summarize lessonsData analysis report
Actbull What changes are to be
madebull Next cycle
Documentation of recommendations report or minutes
Learning and Improvement Cycle
Logic model
Problem (Effect)
5 Whyrsquos Technique
Why
Why
Why
Why
Why
Fishbone Diagram
Lack of knowledge amp skill in QI
People
Culture
Methods
Materials
Resources
Cause and Effect Diagram for Low Use of HIV Screening
PoorHIV Testing
ClientTest Location
Donrsquot see benefit
Counseling
Not Client Centered
Not convenient
Staff
Not Respectful
Fearful
Not Offered Poor Experience
Not Private
Donrsquot Want Test
QA
Plan
Do
Study
Act
Define Quality
Standards
Measure Monitor amp Report
Correct Deficiencie
s
QI
QI Tools
Agency (Director) ----------------------
UnitsPrograms ----- (Supervisors)
Staff -------------
Key Point
bull What is the job of a health worker - Perform your duties to help your team to deliver services
bull What is the job of your health units and programs
- Perform specific tasks or deliver specific services
bull What is the job of your agency - Support the work of its units and staff - Meet the needs of the population
Benchmark
Health Worker Unit Program AgencyQuestion to answer
How well does a health worker do hisher duties
How well does a unit or program do its tasks or services
How well does agency meet- community needs- needs of unitsstaff
Benchmark
Job Description(Yearly Individual Performance Plan)
Unit Standard Operating Procedures (QA)Goalsamp Objectives(QI)
Strategic Plan (Goals amp Objectives)
Improvement Planning
Yearly IndividualPerformance Plan
- Corrective action plan (QA)
- ldquoPrdquo in PDSA (QI)
Performance Management Plan (using PDSA as needed)
How to monitor Individual performance evaluation
- QA Survey (scores)- PDSA(Set indicators- ldquoPrdquo Measure results- ldquoSrdquo)
Perf Management Plan Reports
Incentives Recognize Merit $ Promote ldquoPerksrdquo
- Recognize team celebrate $$ (to team or individuals)
- Budget grants Promotiondemotion
PMStrategic
Goals
Measure Monitor amp Report
Correct Deficiencies
QI
Tools
Agency or jurisdiction level
Examples 1
bull Nursing shortagebull Low $ collections
2bull Access to carebull NCD epidemic
Key Point
bull What is the job of a health worker - Perform your duties to help your team to deliver services
bull What is the job of your health units and programs
- Perform specific tasks or deliver specific services
bull What is the job of your agency - Support the work of its units and staff - Meet the needs of the population
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Level 1 ldquoreactiverdquo response
Level 2 partial response
Level 3 performance management
Example Situation Nursing shortage
3 Levels of response
Situation Nursing shortage
Needs assessment Not done
Goal Not clear
Objective Not clear
Strategy 1 Train practical nurses whenever shortage becomes acute
2 Hire nurses off-island
Level 1 ldquoreactiverdquo response
Situation Nursing shortage
Needs assessment Done
Goal A supply of high-quality local nurses
Objective Not clear
Strategy 1 Recruit nurses to study off-island 2 Establish community college nursing pgm 2 Hire expat nurses
Level 2 Partial response
Situation Nursing shortage
Needs assessment Done
Goal An adequate supply of high-quality local nurses
Objective 100 of ward nurses should have formal college nursing certificates or degrees by 2015
Strategy bull Partnership between hospital and comm college
- define target group of nurses - financing - employment policies - work-study scheduling transport classroom site
Level 3 Proactive response
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Community Health Assessment
Community Health Improvement Plan
Agency Strategic Plan
Performance Improvement System (for 10 essential public health services)
Assessment1048713 Monitor health status1048713 Investigate health problems 1048713 Evaluate personal and population-based health servicesPolicy Development1048713 To support individual and community health efforts1048713 Enforce laws and regulations that protect health1048713 Research for solutions to health problemsAssurance1048713 Link people to needed personal health services 1048713 Assure a competent health care workforce1048713 Inform people about health issues1048713 Mobilize partnerships to solve health problems
BureausSections reponsibleDOMAIN 1 Conduct and disseminate assessments focused on population health status and public health issues facing the communityStandard 11 Participate in or conduct a collaborative process resulting in a comprehensive community health assessment
111 S Participate in or conduct a state partnership that develops a comprehensive state community health assessment of the population of the state
112 S Complete a state level community health assessment
113 A Ensure that the community health assessment is accessible to agencies organizations and the general public
Standard 12 Collect and maintain reliable comparable and valid data that provide information on conditions of public health importance and on the health status of the population121 A Maintain a surveillance system for receiving reports 247 in order to identify health problems public health threats and environmental public health hazards
122 A Communicate with surveillance sites at least annually
123 A Collect additional primary and secondary data on population health status
Public Health Accreditation Board Standards and Measures
httpwwwcecentralcomphab
PH Accreditation Orientation (web-based)
bull Type of measure (ie output or outcome measure)
bull Format of measure (eg YesNo count proportion time-based other)
bull Measurement specifications (eg startstop time numeratordenominator what is being counted)
bull Baseline value and associated date(s)
bull Target value and associated date(s)
CDC Performance Management Reporting Tool
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you reach
goals
Quiz Is it QA-QI-PM(or is it a ldquoblind improvement attemptrdquo)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Behavioral health unit offers substance abuse counseling training to DHS staff
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Staff in OPD put labels on supply shelves in clinic as part of corrective action plan from last survey
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Chief nurse arranges transportation to help night shift nurses get to work
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing team develops plan to help decrease absenteeism rate on medical ward
QA-QI-PM (if impact is measured)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
Are you satisfied
QAQI- Program Development by Site
Am Samoa CHCAm Samoa Hosp
Guam GMHCNMI Hosp
Pohnpei DHS amp CHCYap DHSYap CHC
Palau MOHGuam CHCRMI- EbeyeKosrae DHS
FSM NatlGuam DPHSS
Am Samoa DHSCNMI PH
Chuuk DHS
0 05 1 15 2 25 3 35 4
Key0 = No activity yet1 = Preliminary plan 2 = Some progress3 = Program
components installed4 = Program running
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
QA amp QI amp PM
Church of God
Seventh Day Adventist
Congregational
Catholic
Orthodox
Presbyterian
Lutheran
Baptist
Church of Christ
Church of God
Seventh Day Adventist
Congregational
Catholic
Presbyterian
Lutheran
Baptist
Church of Christ
Quality Assurance
Quality Improvement
Continuous Quality Improvement
Total Quality Management
Performance Management
Lean
Six Sigma
Baldridge Criteria
Define Standards or Goals
Measure
Monitor amp
Report
Change what
you do until you
reach goals
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
QA amp QI amp PM
QA
Plan
Do
Study
Act
Define Quality
Standards
Monitor amp Report Quality
Correct Deficiencie
s
QI
QI Tools
Plan bull Objectivebull Questions and predictionsbull Plan to carry out the cycle (who what where when)bull Plan for data collection
Do bull Carry out the planbull Document problems and
unexpected observationsbull Begin analysis of the dataTrack progress on work plan or Gantt
Studybull Complete the data
analysisbull Compare data to predictionsbull Summarize lessonsData analysis report
Actbull What changes are to be
madebull Next cycle
Documentation of recommendations report or minutes
Learning and Improvement Cycle
Logic model
Problem (Effect)
5 Whyrsquos Technique
Why
Why
Why
Why
Why
Fishbone Diagram
Lack of knowledge amp skill in QI
People
Culture
Methods
Materials
Resources
Cause and Effect Diagram for Low Use of HIV Screening
PoorHIV Testing
ClientTest Location
Donrsquot see benefit
Counseling
Not Client Centered
Not convenient
Staff
Not Respectful
Fearful
Not Offered Poor Experience
Not Private
Donrsquot Want Test
QA
Plan
Do
Study
Act
Define Quality
Standards
Measure Monitor amp Report
Correct Deficiencie
s
QI
QI Tools
Agency (Director) ----------------------
UnitsPrograms ----- (Supervisors)
Staff -------------
Key Point
bull What is the job of a health worker - Perform your duties to help your team to deliver services
bull What is the job of your health units and programs
- Perform specific tasks or deliver specific services
bull What is the job of your agency - Support the work of its units and staff - Meet the needs of the population
Benchmark
Health Worker Unit Program AgencyQuestion to answer
How well does a health worker do hisher duties
How well does a unit or program do its tasks or services
How well does agency meet- community needs- needs of unitsstaff
Benchmark
Job Description(Yearly Individual Performance Plan)
Unit Standard Operating Procedures (QA)Goalsamp Objectives(QI)
Strategic Plan (Goals amp Objectives)
Improvement Planning
Yearly IndividualPerformance Plan
- Corrective action plan (QA)
- ldquoPrdquo in PDSA (QI)
Performance Management Plan (using PDSA as needed)
How to monitor Individual performance evaluation
- QA Survey (scores)- PDSA(Set indicators- ldquoPrdquo Measure results- ldquoSrdquo)
Perf Management Plan Reports
Incentives Recognize Merit $ Promote ldquoPerksrdquo
- Recognize team celebrate $$ (to team or individuals)
- Budget grants Promotiondemotion
PMStrategic
Goals
Measure Monitor amp Report
Correct Deficiencies
QI
Tools
Agency or jurisdiction level
Examples 1
bull Nursing shortagebull Low $ collections
2bull Access to carebull NCD epidemic
Key Point
bull What is the job of a health worker - Perform your duties to help your team to deliver services
bull What is the job of your health units and programs
- Perform specific tasks or deliver specific services
bull What is the job of your agency - Support the work of its units and staff - Meet the needs of the population
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Level 1 ldquoreactiverdquo response
Level 2 partial response
Level 3 performance management
Example Situation Nursing shortage
3 Levels of response
Situation Nursing shortage
Needs assessment Not done
Goal Not clear
Objective Not clear
Strategy 1 Train practical nurses whenever shortage becomes acute
2 Hire nurses off-island
Level 1 ldquoreactiverdquo response
Situation Nursing shortage
Needs assessment Done
Goal A supply of high-quality local nurses
Objective Not clear
Strategy 1 Recruit nurses to study off-island 2 Establish community college nursing pgm 2 Hire expat nurses
Level 2 Partial response
Situation Nursing shortage
Needs assessment Done
Goal An adequate supply of high-quality local nurses
Objective 100 of ward nurses should have formal college nursing certificates or degrees by 2015
Strategy bull Partnership between hospital and comm college
- define target group of nurses - financing - employment policies - work-study scheduling transport classroom site
Level 3 Proactive response
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Community Health Assessment
Community Health Improvement Plan
Agency Strategic Plan
Performance Improvement System (for 10 essential public health services)
Assessment1048713 Monitor health status1048713 Investigate health problems 1048713 Evaluate personal and population-based health servicesPolicy Development1048713 To support individual and community health efforts1048713 Enforce laws and regulations that protect health1048713 Research for solutions to health problemsAssurance1048713 Link people to needed personal health services 1048713 Assure a competent health care workforce1048713 Inform people about health issues1048713 Mobilize partnerships to solve health problems
BureausSections reponsibleDOMAIN 1 Conduct and disseminate assessments focused on population health status and public health issues facing the communityStandard 11 Participate in or conduct a collaborative process resulting in a comprehensive community health assessment
111 S Participate in or conduct a state partnership that develops a comprehensive state community health assessment of the population of the state
112 S Complete a state level community health assessment
113 A Ensure that the community health assessment is accessible to agencies organizations and the general public
Standard 12 Collect and maintain reliable comparable and valid data that provide information on conditions of public health importance and on the health status of the population121 A Maintain a surveillance system for receiving reports 247 in order to identify health problems public health threats and environmental public health hazards
122 A Communicate with surveillance sites at least annually
123 A Collect additional primary and secondary data on population health status
Public Health Accreditation Board Standards and Measures
httpwwwcecentralcomphab
PH Accreditation Orientation (web-based)
bull Type of measure (ie output or outcome measure)
bull Format of measure (eg YesNo count proportion time-based other)
bull Measurement specifications (eg startstop time numeratordenominator what is being counted)
bull Baseline value and associated date(s)
bull Target value and associated date(s)
CDC Performance Management Reporting Tool
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you reach
goals
Quiz Is it QA-QI-PM(or is it a ldquoblind improvement attemptrdquo)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Behavioral health unit offers substance abuse counseling training to DHS staff
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Staff in OPD put labels on supply shelves in clinic as part of corrective action plan from last survey
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Chief nurse arranges transportation to help night shift nurses get to work
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing team develops plan to help decrease absenteeism rate on medical ward
QA-QI-PM (if impact is measured)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
QAQI- Program Development by Site
Am Samoa CHCAm Samoa Hosp
Guam GMHCNMI Hosp
Pohnpei DHS amp CHCYap DHSYap CHC
Palau MOHGuam CHCRMI- EbeyeKosrae DHS
FSM NatlGuam DPHSS
Am Samoa DHSCNMI PH
Chuuk DHS
0 05 1 15 2 25 3 35 4
Key0 = No activity yet1 = Preliminary plan 2 = Some progress3 = Program
components installed4 = Program running
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
QA amp QI amp PM
Church of God
Seventh Day Adventist
Congregational
Catholic
Orthodox
Presbyterian
Lutheran
Baptist
Church of Christ
Church of God
Seventh Day Adventist
Congregational
Catholic
Presbyterian
Lutheran
Baptist
Church of Christ
Quality Assurance
Quality Improvement
Continuous Quality Improvement
Total Quality Management
Performance Management
Lean
Six Sigma
Baldridge Criteria
Define Standards or Goals
Measure
Monitor amp
Report
Change what
you do until you
reach goals
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
QA amp QI amp PM
QA
Plan
Do
Study
Act
Define Quality
Standards
Monitor amp Report Quality
Correct Deficiencie
s
QI
QI Tools
Plan bull Objectivebull Questions and predictionsbull Plan to carry out the cycle (who what where when)bull Plan for data collection
Do bull Carry out the planbull Document problems and
unexpected observationsbull Begin analysis of the dataTrack progress on work plan or Gantt
Studybull Complete the data
analysisbull Compare data to predictionsbull Summarize lessonsData analysis report
Actbull What changes are to be
madebull Next cycle
Documentation of recommendations report or minutes
Learning and Improvement Cycle
Logic model
Problem (Effect)
5 Whyrsquos Technique
Why
Why
Why
Why
Why
Fishbone Diagram
Lack of knowledge amp skill in QI
People
Culture
Methods
Materials
Resources
Cause and Effect Diagram for Low Use of HIV Screening
PoorHIV Testing
ClientTest Location
Donrsquot see benefit
Counseling
Not Client Centered
Not convenient
Staff
Not Respectful
Fearful
Not Offered Poor Experience
Not Private
Donrsquot Want Test
QA
Plan
Do
Study
Act
Define Quality
Standards
Measure Monitor amp Report
Correct Deficiencie
s
QI
QI Tools
Agency (Director) ----------------------
UnitsPrograms ----- (Supervisors)
Staff -------------
Key Point
bull What is the job of a health worker - Perform your duties to help your team to deliver services
bull What is the job of your health units and programs
- Perform specific tasks or deliver specific services
bull What is the job of your agency - Support the work of its units and staff - Meet the needs of the population
Benchmark
Health Worker Unit Program AgencyQuestion to answer
How well does a health worker do hisher duties
How well does a unit or program do its tasks or services
How well does agency meet- community needs- needs of unitsstaff
Benchmark
Job Description(Yearly Individual Performance Plan)
Unit Standard Operating Procedures (QA)Goalsamp Objectives(QI)
Strategic Plan (Goals amp Objectives)
Improvement Planning
Yearly IndividualPerformance Plan
- Corrective action plan (QA)
- ldquoPrdquo in PDSA (QI)
Performance Management Plan (using PDSA as needed)
How to monitor Individual performance evaluation
- QA Survey (scores)- PDSA(Set indicators- ldquoPrdquo Measure results- ldquoSrdquo)
Perf Management Plan Reports
Incentives Recognize Merit $ Promote ldquoPerksrdquo
- Recognize team celebrate $$ (to team or individuals)
- Budget grants Promotiondemotion
PMStrategic
Goals
Measure Monitor amp Report
Correct Deficiencies
QI
Tools
Agency or jurisdiction level
Examples 1
bull Nursing shortagebull Low $ collections
2bull Access to carebull NCD epidemic
Key Point
bull What is the job of a health worker - Perform your duties to help your team to deliver services
bull What is the job of your health units and programs
- Perform specific tasks or deliver specific services
bull What is the job of your agency - Support the work of its units and staff - Meet the needs of the population
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Level 1 ldquoreactiverdquo response
Level 2 partial response
Level 3 performance management
Example Situation Nursing shortage
3 Levels of response
Situation Nursing shortage
Needs assessment Not done
Goal Not clear
Objective Not clear
Strategy 1 Train practical nurses whenever shortage becomes acute
2 Hire nurses off-island
Level 1 ldquoreactiverdquo response
Situation Nursing shortage
Needs assessment Done
Goal A supply of high-quality local nurses
Objective Not clear
Strategy 1 Recruit nurses to study off-island 2 Establish community college nursing pgm 2 Hire expat nurses
Level 2 Partial response
Situation Nursing shortage
Needs assessment Done
Goal An adequate supply of high-quality local nurses
Objective 100 of ward nurses should have formal college nursing certificates or degrees by 2015
Strategy bull Partnership between hospital and comm college
- define target group of nurses - financing - employment policies - work-study scheduling transport classroom site
Level 3 Proactive response
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Community Health Assessment
Community Health Improvement Plan
Agency Strategic Plan
Performance Improvement System (for 10 essential public health services)
Assessment1048713 Monitor health status1048713 Investigate health problems 1048713 Evaluate personal and population-based health servicesPolicy Development1048713 To support individual and community health efforts1048713 Enforce laws and regulations that protect health1048713 Research for solutions to health problemsAssurance1048713 Link people to needed personal health services 1048713 Assure a competent health care workforce1048713 Inform people about health issues1048713 Mobilize partnerships to solve health problems
BureausSections reponsibleDOMAIN 1 Conduct and disseminate assessments focused on population health status and public health issues facing the communityStandard 11 Participate in or conduct a collaborative process resulting in a comprehensive community health assessment
111 S Participate in or conduct a state partnership that develops a comprehensive state community health assessment of the population of the state
112 S Complete a state level community health assessment
113 A Ensure that the community health assessment is accessible to agencies organizations and the general public
Standard 12 Collect and maintain reliable comparable and valid data that provide information on conditions of public health importance and on the health status of the population121 A Maintain a surveillance system for receiving reports 247 in order to identify health problems public health threats and environmental public health hazards
122 A Communicate with surveillance sites at least annually
123 A Collect additional primary and secondary data on population health status
Public Health Accreditation Board Standards and Measures
httpwwwcecentralcomphab
PH Accreditation Orientation (web-based)
bull Type of measure (ie output or outcome measure)
bull Format of measure (eg YesNo count proportion time-based other)
bull Measurement specifications (eg startstop time numeratordenominator what is being counted)
bull Baseline value and associated date(s)
bull Target value and associated date(s)
CDC Performance Management Reporting Tool
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you reach
goals
Quiz Is it QA-QI-PM(or is it a ldquoblind improvement attemptrdquo)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Behavioral health unit offers substance abuse counseling training to DHS staff
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Staff in OPD put labels on supply shelves in clinic as part of corrective action plan from last survey
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Chief nurse arranges transportation to help night shift nurses get to work
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing team develops plan to help decrease absenteeism rate on medical ward
QA-QI-PM (if impact is measured)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
QA amp QI amp PM
Church of God
Seventh Day Adventist
Congregational
Catholic
Orthodox
Presbyterian
Lutheran
Baptist
Church of Christ
Church of God
Seventh Day Adventist
Congregational
Catholic
Presbyterian
Lutheran
Baptist
Church of Christ
Quality Assurance
Quality Improvement
Continuous Quality Improvement
Total Quality Management
Performance Management
Lean
Six Sigma
Baldridge Criteria
Define Standards or Goals
Measure
Monitor amp
Report
Change what
you do until you
reach goals
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
QA amp QI amp PM
QA
Plan
Do
Study
Act
Define Quality
Standards
Monitor amp Report Quality
Correct Deficiencie
s
QI
QI Tools
Plan bull Objectivebull Questions and predictionsbull Plan to carry out the cycle (who what where when)bull Plan for data collection
Do bull Carry out the planbull Document problems and
unexpected observationsbull Begin analysis of the dataTrack progress on work plan or Gantt
Studybull Complete the data
analysisbull Compare data to predictionsbull Summarize lessonsData analysis report
Actbull What changes are to be
madebull Next cycle
Documentation of recommendations report or minutes
Learning and Improvement Cycle
Logic model
Problem (Effect)
5 Whyrsquos Technique
Why
Why
Why
Why
Why
Fishbone Diagram
Lack of knowledge amp skill in QI
People
Culture
Methods
Materials
Resources
Cause and Effect Diagram for Low Use of HIV Screening
PoorHIV Testing
ClientTest Location
Donrsquot see benefit
Counseling
Not Client Centered
Not convenient
Staff
Not Respectful
Fearful
Not Offered Poor Experience
Not Private
Donrsquot Want Test
QA
Plan
Do
Study
Act
Define Quality
Standards
Measure Monitor amp Report
Correct Deficiencie
s
QI
QI Tools
Agency (Director) ----------------------
UnitsPrograms ----- (Supervisors)
Staff -------------
Key Point
bull What is the job of a health worker - Perform your duties to help your team to deliver services
bull What is the job of your health units and programs
- Perform specific tasks or deliver specific services
bull What is the job of your agency - Support the work of its units and staff - Meet the needs of the population
Benchmark
Health Worker Unit Program AgencyQuestion to answer
How well does a health worker do hisher duties
How well does a unit or program do its tasks or services
How well does agency meet- community needs- needs of unitsstaff
Benchmark
Job Description(Yearly Individual Performance Plan)
Unit Standard Operating Procedures (QA)Goalsamp Objectives(QI)
Strategic Plan (Goals amp Objectives)
Improvement Planning
Yearly IndividualPerformance Plan
- Corrective action plan (QA)
- ldquoPrdquo in PDSA (QI)
Performance Management Plan (using PDSA as needed)
How to monitor Individual performance evaluation
- QA Survey (scores)- PDSA(Set indicators- ldquoPrdquo Measure results- ldquoSrdquo)
Perf Management Plan Reports
Incentives Recognize Merit $ Promote ldquoPerksrdquo
- Recognize team celebrate $$ (to team or individuals)
- Budget grants Promotiondemotion
PMStrategic
Goals
Measure Monitor amp Report
Correct Deficiencies
QI
Tools
Agency or jurisdiction level
Examples 1
bull Nursing shortagebull Low $ collections
2bull Access to carebull NCD epidemic
Key Point
bull What is the job of a health worker - Perform your duties to help your team to deliver services
bull What is the job of your health units and programs
- Perform specific tasks or deliver specific services
bull What is the job of your agency - Support the work of its units and staff - Meet the needs of the population
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Level 1 ldquoreactiverdquo response
Level 2 partial response
Level 3 performance management
Example Situation Nursing shortage
3 Levels of response
Situation Nursing shortage
Needs assessment Not done
Goal Not clear
Objective Not clear
Strategy 1 Train practical nurses whenever shortage becomes acute
2 Hire nurses off-island
Level 1 ldquoreactiverdquo response
Situation Nursing shortage
Needs assessment Done
Goal A supply of high-quality local nurses
Objective Not clear
Strategy 1 Recruit nurses to study off-island 2 Establish community college nursing pgm 2 Hire expat nurses
Level 2 Partial response
Situation Nursing shortage
Needs assessment Done
Goal An adequate supply of high-quality local nurses
Objective 100 of ward nurses should have formal college nursing certificates or degrees by 2015
Strategy bull Partnership between hospital and comm college
- define target group of nurses - financing - employment policies - work-study scheduling transport classroom site
Level 3 Proactive response
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Community Health Assessment
Community Health Improvement Plan
Agency Strategic Plan
Performance Improvement System (for 10 essential public health services)
Assessment1048713 Monitor health status1048713 Investigate health problems 1048713 Evaluate personal and population-based health servicesPolicy Development1048713 To support individual and community health efforts1048713 Enforce laws and regulations that protect health1048713 Research for solutions to health problemsAssurance1048713 Link people to needed personal health services 1048713 Assure a competent health care workforce1048713 Inform people about health issues1048713 Mobilize partnerships to solve health problems
BureausSections reponsibleDOMAIN 1 Conduct and disseminate assessments focused on population health status and public health issues facing the communityStandard 11 Participate in or conduct a collaborative process resulting in a comprehensive community health assessment
111 S Participate in or conduct a state partnership that develops a comprehensive state community health assessment of the population of the state
112 S Complete a state level community health assessment
113 A Ensure that the community health assessment is accessible to agencies organizations and the general public
Standard 12 Collect and maintain reliable comparable and valid data that provide information on conditions of public health importance and on the health status of the population121 A Maintain a surveillance system for receiving reports 247 in order to identify health problems public health threats and environmental public health hazards
122 A Communicate with surveillance sites at least annually
123 A Collect additional primary and secondary data on population health status
Public Health Accreditation Board Standards and Measures
httpwwwcecentralcomphab
PH Accreditation Orientation (web-based)
bull Type of measure (ie output or outcome measure)
bull Format of measure (eg YesNo count proportion time-based other)
bull Measurement specifications (eg startstop time numeratordenominator what is being counted)
bull Baseline value and associated date(s)
bull Target value and associated date(s)
CDC Performance Management Reporting Tool
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you reach
goals
Quiz Is it QA-QI-PM(or is it a ldquoblind improvement attemptrdquo)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Behavioral health unit offers substance abuse counseling training to DHS staff
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Staff in OPD put labels on supply shelves in clinic as part of corrective action plan from last survey
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Chief nurse arranges transportation to help night shift nurses get to work
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing team develops plan to help decrease absenteeism rate on medical ward
QA-QI-PM (if impact is measured)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
Church of God
Seventh Day Adventist
Congregational
Catholic
Orthodox
Presbyterian
Lutheran
Baptist
Church of Christ
Church of God
Seventh Day Adventist
Congregational
Catholic
Presbyterian
Lutheran
Baptist
Church of Christ
Quality Assurance
Quality Improvement
Continuous Quality Improvement
Total Quality Management
Performance Management
Lean
Six Sigma
Baldridge Criteria
Define Standards or Goals
Measure
Monitor amp
Report
Change what
you do until you
reach goals
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
QA amp QI amp PM
QA
Plan
Do
Study
Act
Define Quality
Standards
Monitor amp Report Quality
Correct Deficiencie
s
QI
QI Tools
Plan bull Objectivebull Questions and predictionsbull Plan to carry out the cycle (who what where when)bull Plan for data collection
Do bull Carry out the planbull Document problems and
unexpected observationsbull Begin analysis of the dataTrack progress on work plan or Gantt
Studybull Complete the data
analysisbull Compare data to predictionsbull Summarize lessonsData analysis report
Actbull What changes are to be
madebull Next cycle
Documentation of recommendations report or minutes
Learning and Improvement Cycle
Logic model
Problem (Effect)
5 Whyrsquos Technique
Why
Why
Why
Why
Why
Fishbone Diagram
Lack of knowledge amp skill in QI
People
Culture
Methods
Materials
Resources
Cause and Effect Diagram for Low Use of HIV Screening
PoorHIV Testing
ClientTest Location
Donrsquot see benefit
Counseling
Not Client Centered
Not convenient
Staff
Not Respectful
Fearful
Not Offered Poor Experience
Not Private
Donrsquot Want Test
QA
Plan
Do
Study
Act
Define Quality
Standards
Measure Monitor amp Report
Correct Deficiencie
s
QI
QI Tools
Agency (Director) ----------------------
UnitsPrograms ----- (Supervisors)
Staff -------------
Key Point
bull What is the job of a health worker - Perform your duties to help your team to deliver services
bull What is the job of your health units and programs
- Perform specific tasks or deliver specific services
bull What is the job of your agency - Support the work of its units and staff - Meet the needs of the population
Benchmark
Health Worker Unit Program AgencyQuestion to answer
How well does a health worker do hisher duties
How well does a unit or program do its tasks or services
How well does agency meet- community needs- needs of unitsstaff
Benchmark
Job Description(Yearly Individual Performance Plan)
Unit Standard Operating Procedures (QA)Goalsamp Objectives(QI)
Strategic Plan (Goals amp Objectives)
Improvement Planning
Yearly IndividualPerformance Plan
- Corrective action plan (QA)
- ldquoPrdquo in PDSA (QI)
Performance Management Plan (using PDSA as needed)
How to monitor Individual performance evaluation
- QA Survey (scores)- PDSA(Set indicators- ldquoPrdquo Measure results- ldquoSrdquo)
Perf Management Plan Reports
Incentives Recognize Merit $ Promote ldquoPerksrdquo
- Recognize team celebrate $$ (to team or individuals)
- Budget grants Promotiondemotion
PMStrategic
Goals
Measure Monitor amp Report
Correct Deficiencies
QI
Tools
Agency or jurisdiction level
Examples 1
bull Nursing shortagebull Low $ collections
2bull Access to carebull NCD epidemic
Key Point
bull What is the job of a health worker - Perform your duties to help your team to deliver services
bull What is the job of your health units and programs
- Perform specific tasks or deliver specific services
bull What is the job of your agency - Support the work of its units and staff - Meet the needs of the population
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Level 1 ldquoreactiverdquo response
Level 2 partial response
Level 3 performance management
Example Situation Nursing shortage
3 Levels of response
Situation Nursing shortage
Needs assessment Not done
Goal Not clear
Objective Not clear
Strategy 1 Train practical nurses whenever shortage becomes acute
2 Hire nurses off-island
Level 1 ldquoreactiverdquo response
Situation Nursing shortage
Needs assessment Done
Goal A supply of high-quality local nurses
Objective Not clear
Strategy 1 Recruit nurses to study off-island 2 Establish community college nursing pgm 2 Hire expat nurses
Level 2 Partial response
Situation Nursing shortage
Needs assessment Done
Goal An adequate supply of high-quality local nurses
Objective 100 of ward nurses should have formal college nursing certificates or degrees by 2015
Strategy bull Partnership between hospital and comm college
- define target group of nurses - financing - employment policies - work-study scheduling transport classroom site
Level 3 Proactive response
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Community Health Assessment
Community Health Improvement Plan
Agency Strategic Plan
Performance Improvement System (for 10 essential public health services)
Assessment1048713 Monitor health status1048713 Investigate health problems 1048713 Evaluate personal and population-based health servicesPolicy Development1048713 To support individual and community health efforts1048713 Enforce laws and regulations that protect health1048713 Research for solutions to health problemsAssurance1048713 Link people to needed personal health services 1048713 Assure a competent health care workforce1048713 Inform people about health issues1048713 Mobilize partnerships to solve health problems
BureausSections reponsibleDOMAIN 1 Conduct and disseminate assessments focused on population health status and public health issues facing the communityStandard 11 Participate in or conduct a collaborative process resulting in a comprehensive community health assessment
111 S Participate in or conduct a state partnership that develops a comprehensive state community health assessment of the population of the state
112 S Complete a state level community health assessment
113 A Ensure that the community health assessment is accessible to agencies organizations and the general public
Standard 12 Collect and maintain reliable comparable and valid data that provide information on conditions of public health importance and on the health status of the population121 A Maintain a surveillance system for receiving reports 247 in order to identify health problems public health threats and environmental public health hazards
122 A Communicate with surveillance sites at least annually
123 A Collect additional primary and secondary data on population health status
Public Health Accreditation Board Standards and Measures
httpwwwcecentralcomphab
PH Accreditation Orientation (web-based)
bull Type of measure (ie output or outcome measure)
bull Format of measure (eg YesNo count proportion time-based other)
bull Measurement specifications (eg startstop time numeratordenominator what is being counted)
bull Baseline value and associated date(s)
bull Target value and associated date(s)
CDC Performance Management Reporting Tool
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you reach
goals
Quiz Is it QA-QI-PM(or is it a ldquoblind improvement attemptrdquo)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Behavioral health unit offers substance abuse counseling training to DHS staff
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Staff in OPD put labels on supply shelves in clinic as part of corrective action plan from last survey
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Chief nurse arranges transportation to help night shift nurses get to work
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing team develops plan to help decrease absenteeism rate on medical ward
QA-QI-PM (if impact is measured)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
Church of God
Seventh Day Adventist
Congregational
Catholic
Presbyterian
Lutheran
Baptist
Church of Christ
Quality Assurance
Quality Improvement
Continuous Quality Improvement
Total Quality Management
Performance Management
Lean
Six Sigma
Baldridge Criteria
Define Standards or Goals
Measure
Monitor amp
Report
Change what
you do until you
reach goals
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
QA amp QI amp PM
QA
Plan
Do
Study
Act
Define Quality
Standards
Monitor amp Report Quality
Correct Deficiencie
s
QI
QI Tools
Plan bull Objectivebull Questions and predictionsbull Plan to carry out the cycle (who what where when)bull Plan for data collection
Do bull Carry out the planbull Document problems and
unexpected observationsbull Begin analysis of the dataTrack progress on work plan or Gantt
Studybull Complete the data
analysisbull Compare data to predictionsbull Summarize lessonsData analysis report
Actbull What changes are to be
madebull Next cycle
Documentation of recommendations report or minutes
Learning and Improvement Cycle
Logic model
Problem (Effect)
5 Whyrsquos Technique
Why
Why
Why
Why
Why
Fishbone Diagram
Lack of knowledge amp skill in QI
People
Culture
Methods
Materials
Resources
Cause and Effect Diagram for Low Use of HIV Screening
PoorHIV Testing
ClientTest Location
Donrsquot see benefit
Counseling
Not Client Centered
Not convenient
Staff
Not Respectful
Fearful
Not Offered Poor Experience
Not Private
Donrsquot Want Test
QA
Plan
Do
Study
Act
Define Quality
Standards
Measure Monitor amp Report
Correct Deficiencie
s
QI
QI Tools
Agency (Director) ----------------------
UnitsPrograms ----- (Supervisors)
Staff -------------
Key Point
bull What is the job of a health worker - Perform your duties to help your team to deliver services
bull What is the job of your health units and programs
- Perform specific tasks or deliver specific services
bull What is the job of your agency - Support the work of its units and staff - Meet the needs of the population
Benchmark
Health Worker Unit Program AgencyQuestion to answer
How well does a health worker do hisher duties
How well does a unit or program do its tasks or services
How well does agency meet- community needs- needs of unitsstaff
Benchmark
Job Description(Yearly Individual Performance Plan)
Unit Standard Operating Procedures (QA)Goalsamp Objectives(QI)
Strategic Plan (Goals amp Objectives)
Improvement Planning
Yearly IndividualPerformance Plan
- Corrective action plan (QA)
- ldquoPrdquo in PDSA (QI)
Performance Management Plan (using PDSA as needed)
How to monitor Individual performance evaluation
- QA Survey (scores)- PDSA(Set indicators- ldquoPrdquo Measure results- ldquoSrdquo)
Perf Management Plan Reports
Incentives Recognize Merit $ Promote ldquoPerksrdquo
- Recognize team celebrate $$ (to team or individuals)
- Budget grants Promotiondemotion
PMStrategic
Goals
Measure Monitor amp Report
Correct Deficiencies
QI
Tools
Agency or jurisdiction level
Examples 1
bull Nursing shortagebull Low $ collections
2bull Access to carebull NCD epidemic
Key Point
bull What is the job of a health worker - Perform your duties to help your team to deliver services
bull What is the job of your health units and programs
- Perform specific tasks or deliver specific services
bull What is the job of your agency - Support the work of its units and staff - Meet the needs of the population
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Level 1 ldquoreactiverdquo response
Level 2 partial response
Level 3 performance management
Example Situation Nursing shortage
3 Levels of response
Situation Nursing shortage
Needs assessment Not done
Goal Not clear
Objective Not clear
Strategy 1 Train practical nurses whenever shortage becomes acute
2 Hire nurses off-island
Level 1 ldquoreactiverdquo response
Situation Nursing shortage
Needs assessment Done
Goal A supply of high-quality local nurses
Objective Not clear
Strategy 1 Recruit nurses to study off-island 2 Establish community college nursing pgm 2 Hire expat nurses
Level 2 Partial response
Situation Nursing shortage
Needs assessment Done
Goal An adequate supply of high-quality local nurses
Objective 100 of ward nurses should have formal college nursing certificates or degrees by 2015
Strategy bull Partnership between hospital and comm college
- define target group of nurses - financing - employment policies - work-study scheduling transport classroom site
Level 3 Proactive response
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Community Health Assessment
Community Health Improvement Plan
Agency Strategic Plan
Performance Improvement System (for 10 essential public health services)
Assessment1048713 Monitor health status1048713 Investigate health problems 1048713 Evaluate personal and population-based health servicesPolicy Development1048713 To support individual and community health efforts1048713 Enforce laws and regulations that protect health1048713 Research for solutions to health problemsAssurance1048713 Link people to needed personal health services 1048713 Assure a competent health care workforce1048713 Inform people about health issues1048713 Mobilize partnerships to solve health problems
BureausSections reponsibleDOMAIN 1 Conduct and disseminate assessments focused on population health status and public health issues facing the communityStandard 11 Participate in or conduct a collaborative process resulting in a comprehensive community health assessment
111 S Participate in or conduct a state partnership that develops a comprehensive state community health assessment of the population of the state
112 S Complete a state level community health assessment
113 A Ensure that the community health assessment is accessible to agencies organizations and the general public
Standard 12 Collect and maintain reliable comparable and valid data that provide information on conditions of public health importance and on the health status of the population121 A Maintain a surveillance system for receiving reports 247 in order to identify health problems public health threats and environmental public health hazards
122 A Communicate with surveillance sites at least annually
123 A Collect additional primary and secondary data on population health status
Public Health Accreditation Board Standards and Measures
httpwwwcecentralcomphab
PH Accreditation Orientation (web-based)
bull Type of measure (ie output or outcome measure)
bull Format of measure (eg YesNo count proportion time-based other)
bull Measurement specifications (eg startstop time numeratordenominator what is being counted)
bull Baseline value and associated date(s)
bull Target value and associated date(s)
CDC Performance Management Reporting Tool
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you reach
goals
Quiz Is it QA-QI-PM(or is it a ldquoblind improvement attemptrdquo)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Behavioral health unit offers substance abuse counseling training to DHS staff
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Staff in OPD put labels on supply shelves in clinic as part of corrective action plan from last survey
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Chief nurse arranges transportation to help night shift nurses get to work
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing team develops plan to help decrease absenteeism rate on medical ward
QA-QI-PM (if impact is measured)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
QA amp QI amp PM
QA
Plan
Do
Study
Act
Define Quality
Standards
Monitor amp Report Quality
Correct Deficiencie
s
QI
QI Tools
Plan bull Objectivebull Questions and predictionsbull Plan to carry out the cycle (who what where when)bull Plan for data collection
Do bull Carry out the planbull Document problems and
unexpected observationsbull Begin analysis of the dataTrack progress on work plan or Gantt
Studybull Complete the data
analysisbull Compare data to predictionsbull Summarize lessonsData analysis report
Actbull What changes are to be
madebull Next cycle
Documentation of recommendations report or minutes
Learning and Improvement Cycle
Logic model
Problem (Effect)
5 Whyrsquos Technique
Why
Why
Why
Why
Why
Fishbone Diagram
Lack of knowledge amp skill in QI
People
Culture
Methods
Materials
Resources
Cause and Effect Diagram for Low Use of HIV Screening
PoorHIV Testing
ClientTest Location
Donrsquot see benefit
Counseling
Not Client Centered
Not convenient
Staff
Not Respectful
Fearful
Not Offered Poor Experience
Not Private
Donrsquot Want Test
QA
Plan
Do
Study
Act
Define Quality
Standards
Measure Monitor amp Report
Correct Deficiencie
s
QI
QI Tools
Agency (Director) ----------------------
UnitsPrograms ----- (Supervisors)
Staff -------------
Key Point
bull What is the job of a health worker - Perform your duties to help your team to deliver services
bull What is the job of your health units and programs
- Perform specific tasks or deliver specific services
bull What is the job of your agency - Support the work of its units and staff - Meet the needs of the population
Benchmark
Health Worker Unit Program AgencyQuestion to answer
How well does a health worker do hisher duties
How well does a unit or program do its tasks or services
How well does agency meet- community needs- needs of unitsstaff
Benchmark
Job Description(Yearly Individual Performance Plan)
Unit Standard Operating Procedures (QA)Goalsamp Objectives(QI)
Strategic Plan (Goals amp Objectives)
Improvement Planning
Yearly IndividualPerformance Plan
- Corrective action plan (QA)
- ldquoPrdquo in PDSA (QI)
Performance Management Plan (using PDSA as needed)
How to monitor Individual performance evaluation
- QA Survey (scores)- PDSA(Set indicators- ldquoPrdquo Measure results- ldquoSrdquo)
Perf Management Plan Reports
Incentives Recognize Merit $ Promote ldquoPerksrdquo
- Recognize team celebrate $$ (to team or individuals)
- Budget grants Promotiondemotion
PMStrategic
Goals
Measure Monitor amp Report
Correct Deficiencies
QI
Tools
Agency or jurisdiction level
Examples 1
bull Nursing shortagebull Low $ collections
2bull Access to carebull NCD epidemic
Key Point
bull What is the job of a health worker - Perform your duties to help your team to deliver services
bull What is the job of your health units and programs
- Perform specific tasks or deliver specific services
bull What is the job of your agency - Support the work of its units and staff - Meet the needs of the population
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Level 1 ldquoreactiverdquo response
Level 2 partial response
Level 3 performance management
Example Situation Nursing shortage
3 Levels of response
Situation Nursing shortage
Needs assessment Not done
Goal Not clear
Objective Not clear
Strategy 1 Train practical nurses whenever shortage becomes acute
2 Hire nurses off-island
Level 1 ldquoreactiverdquo response
Situation Nursing shortage
Needs assessment Done
Goal A supply of high-quality local nurses
Objective Not clear
Strategy 1 Recruit nurses to study off-island 2 Establish community college nursing pgm 2 Hire expat nurses
Level 2 Partial response
Situation Nursing shortage
Needs assessment Done
Goal An adequate supply of high-quality local nurses
Objective 100 of ward nurses should have formal college nursing certificates or degrees by 2015
Strategy bull Partnership between hospital and comm college
- define target group of nurses - financing - employment policies - work-study scheduling transport classroom site
Level 3 Proactive response
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Community Health Assessment
Community Health Improvement Plan
Agency Strategic Plan
Performance Improvement System (for 10 essential public health services)
Assessment1048713 Monitor health status1048713 Investigate health problems 1048713 Evaluate personal and population-based health servicesPolicy Development1048713 To support individual and community health efforts1048713 Enforce laws and regulations that protect health1048713 Research for solutions to health problemsAssurance1048713 Link people to needed personal health services 1048713 Assure a competent health care workforce1048713 Inform people about health issues1048713 Mobilize partnerships to solve health problems
BureausSections reponsibleDOMAIN 1 Conduct and disseminate assessments focused on population health status and public health issues facing the communityStandard 11 Participate in or conduct a collaborative process resulting in a comprehensive community health assessment
111 S Participate in or conduct a state partnership that develops a comprehensive state community health assessment of the population of the state
112 S Complete a state level community health assessment
113 A Ensure that the community health assessment is accessible to agencies organizations and the general public
Standard 12 Collect and maintain reliable comparable and valid data that provide information on conditions of public health importance and on the health status of the population121 A Maintain a surveillance system for receiving reports 247 in order to identify health problems public health threats and environmental public health hazards
122 A Communicate with surveillance sites at least annually
123 A Collect additional primary and secondary data on population health status
Public Health Accreditation Board Standards and Measures
httpwwwcecentralcomphab
PH Accreditation Orientation (web-based)
bull Type of measure (ie output or outcome measure)
bull Format of measure (eg YesNo count proportion time-based other)
bull Measurement specifications (eg startstop time numeratordenominator what is being counted)
bull Baseline value and associated date(s)
bull Target value and associated date(s)
CDC Performance Management Reporting Tool
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you reach
goals
Quiz Is it QA-QI-PM(or is it a ldquoblind improvement attemptrdquo)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Behavioral health unit offers substance abuse counseling training to DHS staff
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Staff in OPD put labels on supply shelves in clinic as part of corrective action plan from last survey
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Chief nurse arranges transportation to help night shift nurses get to work
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing team develops plan to help decrease absenteeism rate on medical ward
QA-QI-PM (if impact is measured)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
QA
Plan
Do
Study
Act
Define Quality
Standards
Monitor amp Report Quality
Correct Deficiencie
s
QI
QI Tools
Plan bull Objectivebull Questions and predictionsbull Plan to carry out the cycle (who what where when)bull Plan for data collection
Do bull Carry out the planbull Document problems and
unexpected observationsbull Begin analysis of the dataTrack progress on work plan or Gantt
Studybull Complete the data
analysisbull Compare data to predictionsbull Summarize lessonsData analysis report
Actbull What changes are to be
madebull Next cycle
Documentation of recommendations report or minutes
Learning and Improvement Cycle
Logic model
Problem (Effect)
5 Whyrsquos Technique
Why
Why
Why
Why
Why
Fishbone Diagram
Lack of knowledge amp skill in QI
People
Culture
Methods
Materials
Resources
Cause and Effect Diagram for Low Use of HIV Screening
PoorHIV Testing
ClientTest Location
Donrsquot see benefit
Counseling
Not Client Centered
Not convenient
Staff
Not Respectful
Fearful
Not Offered Poor Experience
Not Private
Donrsquot Want Test
QA
Plan
Do
Study
Act
Define Quality
Standards
Measure Monitor amp Report
Correct Deficiencie
s
QI
QI Tools
Agency (Director) ----------------------
UnitsPrograms ----- (Supervisors)
Staff -------------
Key Point
bull What is the job of a health worker - Perform your duties to help your team to deliver services
bull What is the job of your health units and programs
- Perform specific tasks or deliver specific services
bull What is the job of your agency - Support the work of its units and staff - Meet the needs of the population
Benchmark
Health Worker Unit Program AgencyQuestion to answer
How well does a health worker do hisher duties
How well does a unit or program do its tasks or services
How well does agency meet- community needs- needs of unitsstaff
Benchmark
Job Description(Yearly Individual Performance Plan)
Unit Standard Operating Procedures (QA)Goalsamp Objectives(QI)
Strategic Plan (Goals amp Objectives)
Improvement Planning
Yearly IndividualPerformance Plan
- Corrective action plan (QA)
- ldquoPrdquo in PDSA (QI)
Performance Management Plan (using PDSA as needed)
How to monitor Individual performance evaluation
- QA Survey (scores)- PDSA(Set indicators- ldquoPrdquo Measure results- ldquoSrdquo)
Perf Management Plan Reports
Incentives Recognize Merit $ Promote ldquoPerksrdquo
- Recognize team celebrate $$ (to team or individuals)
- Budget grants Promotiondemotion
PMStrategic
Goals
Measure Monitor amp Report
Correct Deficiencies
QI
Tools
Agency or jurisdiction level
Examples 1
bull Nursing shortagebull Low $ collections
2bull Access to carebull NCD epidemic
Key Point
bull What is the job of a health worker - Perform your duties to help your team to deliver services
bull What is the job of your health units and programs
- Perform specific tasks or deliver specific services
bull What is the job of your agency - Support the work of its units and staff - Meet the needs of the population
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Level 1 ldquoreactiverdquo response
Level 2 partial response
Level 3 performance management
Example Situation Nursing shortage
3 Levels of response
Situation Nursing shortage
Needs assessment Not done
Goal Not clear
Objective Not clear
Strategy 1 Train practical nurses whenever shortage becomes acute
2 Hire nurses off-island
Level 1 ldquoreactiverdquo response
Situation Nursing shortage
Needs assessment Done
Goal A supply of high-quality local nurses
Objective Not clear
Strategy 1 Recruit nurses to study off-island 2 Establish community college nursing pgm 2 Hire expat nurses
Level 2 Partial response
Situation Nursing shortage
Needs assessment Done
Goal An adequate supply of high-quality local nurses
Objective 100 of ward nurses should have formal college nursing certificates or degrees by 2015
Strategy bull Partnership between hospital and comm college
- define target group of nurses - financing - employment policies - work-study scheduling transport classroom site
Level 3 Proactive response
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Community Health Assessment
Community Health Improvement Plan
Agency Strategic Plan
Performance Improvement System (for 10 essential public health services)
Assessment1048713 Monitor health status1048713 Investigate health problems 1048713 Evaluate personal and population-based health servicesPolicy Development1048713 To support individual and community health efforts1048713 Enforce laws and regulations that protect health1048713 Research for solutions to health problemsAssurance1048713 Link people to needed personal health services 1048713 Assure a competent health care workforce1048713 Inform people about health issues1048713 Mobilize partnerships to solve health problems
BureausSections reponsibleDOMAIN 1 Conduct and disseminate assessments focused on population health status and public health issues facing the communityStandard 11 Participate in or conduct a collaborative process resulting in a comprehensive community health assessment
111 S Participate in or conduct a state partnership that develops a comprehensive state community health assessment of the population of the state
112 S Complete a state level community health assessment
113 A Ensure that the community health assessment is accessible to agencies organizations and the general public
Standard 12 Collect and maintain reliable comparable and valid data that provide information on conditions of public health importance and on the health status of the population121 A Maintain a surveillance system for receiving reports 247 in order to identify health problems public health threats and environmental public health hazards
122 A Communicate with surveillance sites at least annually
123 A Collect additional primary and secondary data on population health status
Public Health Accreditation Board Standards and Measures
httpwwwcecentralcomphab
PH Accreditation Orientation (web-based)
bull Type of measure (ie output or outcome measure)
bull Format of measure (eg YesNo count proportion time-based other)
bull Measurement specifications (eg startstop time numeratordenominator what is being counted)
bull Baseline value and associated date(s)
bull Target value and associated date(s)
CDC Performance Management Reporting Tool
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you reach
goals
Quiz Is it QA-QI-PM(or is it a ldquoblind improvement attemptrdquo)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Behavioral health unit offers substance abuse counseling training to DHS staff
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Staff in OPD put labels on supply shelves in clinic as part of corrective action plan from last survey
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Chief nurse arranges transportation to help night shift nurses get to work
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing team develops plan to help decrease absenteeism rate on medical ward
QA-QI-PM (if impact is measured)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
Plan bull Objectivebull Questions and predictionsbull Plan to carry out the cycle (who what where when)bull Plan for data collection
Do bull Carry out the planbull Document problems and
unexpected observationsbull Begin analysis of the dataTrack progress on work plan or Gantt
Studybull Complete the data
analysisbull Compare data to predictionsbull Summarize lessonsData analysis report
Actbull What changes are to be
madebull Next cycle
Documentation of recommendations report or minutes
Learning and Improvement Cycle
Logic model
Problem (Effect)
5 Whyrsquos Technique
Why
Why
Why
Why
Why
Fishbone Diagram
Lack of knowledge amp skill in QI
People
Culture
Methods
Materials
Resources
Cause and Effect Diagram for Low Use of HIV Screening
PoorHIV Testing
ClientTest Location
Donrsquot see benefit
Counseling
Not Client Centered
Not convenient
Staff
Not Respectful
Fearful
Not Offered Poor Experience
Not Private
Donrsquot Want Test
QA
Plan
Do
Study
Act
Define Quality
Standards
Measure Monitor amp Report
Correct Deficiencie
s
QI
QI Tools
Agency (Director) ----------------------
UnitsPrograms ----- (Supervisors)
Staff -------------
Key Point
bull What is the job of a health worker - Perform your duties to help your team to deliver services
bull What is the job of your health units and programs
- Perform specific tasks or deliver specific services
bull What is the job of your agency - Support the work of its units and staff - Meet the needs of the population
Benchmark
Health Worker Unit Program AgencyQuestion to answer
How well does a health worker do hisher duties
How well does a unit or program do its tasks or services
How well does agency meet- community needs- needs of unitsstaff
Benchmark
Job Description(Yearly Individual Performance Plan)
Unit Standard Operating Procedures (QA)Goalsamp Objectives(QI)
Strategic Plan (Goals amp Objectives)
Improvement Planning
Yearly IndividualPerformance Plan
- Corrective action plan (QA)
- ldquoPrdquo in PDSA (QI)
Performance Management Plan (using PDSA as needed)
How to monitor Individual performance evaluation
- QA Survey (scores)- PDSA(Set indicators- ldquoPrdquo Measure results- ldquoSrdquo)
Perf Management Plan Reports
Incentives Recognize Merit $ Promote ldquoPerksrdquo
- Recognize team celebrate $$ (to team or individuals)
- Budget grants Promotiondemotion
PMStrategic
Goals
Measure Monitor amp Report
Correct Deficiencies
QI
Tools
Agency or jurisdiction level
Examples 1
bull Nursing shortagebull Low $ collections
2bull Access to carebull NCD epidemic
Key Point
bull What is the job of a health worker - Perform your duties to help your team to deliver services
bull What is the job of your health units and programs
- Perform specific tasks or deliver specific services
bull What is the job of your agency - Support the work of its units and staff - Meet the needs of the population
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Level 1 ldquoreactiverdquo response
Level 2 partial response
Level 3 performance management
Example Situation Nursing shortage
3 Levels of response
Situation Nursing shortage
Needs assessment Not done
Goal Not clear
Objective Not clear
Strategy 1 Train practical nurses whenever shortage becomes acute
2 Hire nurses off-island
Level 1 ldquoreactiverdquo response
Situation Nursing shortage
Needs assessment Done
Goal A supply of high-quality local nurses
Objective Not clear
Strategy 1 Recruit nurses to study off-island 2 Establish community college nursing pgm 2 Hire expat nurses
Level 2 Partial response
Situation Nursing shortage
Needs assessment Done
Goal An adequate supply of high-quality local nurses
Objective 100 of ward nurses should have formal college nursing certificates or degrees by 2015
Strategy bull Partnership between hospital and comm college
- define target group of nurses - financing - employment policies - work-study scheduling transport classroom site
Level 3 Proactive response
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Community Health Assessment
Community Health Improvement Plan
Agency Strategic Plan
Performance Improvement System (for 10 essential public health services)
Assessment1048713 Monitor health status1048713 Investigate health problems 1048713 Evaluate personal and population-based health servicesPolicy Development1048713 To support individual and community health efforts1048713 Enforce laws and regulations that protect health1048713 Research for solutions to health problemsAssurance1048713 Link people to needed personal health services 1048713 Assure a competent health care workforce1048713 Inform people about health issues1048713 Mobilize partnerships to solve health problems
BureausSections reponsibleDOMAIN 1 Conduct and disseminate assessments focused on population health status and public health issues facing the communityStandard 11 Participate in or conduct a collaborative process resulting in a comprehensive community health assessment
111 S Participate in or conduct a state partnership that develops a comprehensive state community health assessment of the population of the state
112 S Complete a state level community health assessment
113 A Ensure that the community health assessment is accessible to agencies organizations and the general public
Standard 12 Collect and maintain reliable comparable and valid data that provide information on conditions of public health importance and on the health status of the population121 A Maintain a surveillance system for receiving reports 247 in order to identify health problems public health threats and environmental public health hazards
122 A Communicate with surveillance sites at least annually
123 A Collect additional primary and secondary data on population health status
Public Health Accreditation Board Standards and Measures
httpwwwcecentralcomphab
PH Accreditation Orientation (web-based)
bull Type of measure (ie output or outcome measure)
bull Format of measure (eg YesNo count proportion time-based other)
bull Measurement specifications (eg startstop time numeratordenominator what is being counted)
bull Baseline value and associated date(s)
bull Target value and associated date(s)
CDC Performance Management Reporting Tool
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you reach
goals
Quiz Is it QA-QI-PM(or is it a ldquoblind improvement attemptrdquo)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Behavioral health unit offers substance abuse counseling training to DHS staff
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Staff in OPD put labels on supply shelves in clinic as part of corrective action plan from last survey
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Chief nurse arranges transportation to help night shift nurses get to work
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing team develops plan to help decrease absenteeism rate on medical ward
QA-QI-PM (if impact is measured)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
Problem (Effect)
5 Whyrsquos Technique
Why
Why
Why
Why
Why
Fishbone Diagram
Lack of knowledge amp skill in QI
People
Culture
Methods
Materials
Resources
Cause and Effect Diagram for Low Use of HIV Screening
PoorHIV Testing
ClientTest Location
Donrsquot see benefit
Counseling
Not Client Centered
Not convenient
Staff
Not Respectful
Fearful
Not Offered Poor Experience
Not Private
Donrsquot Want Test
QA
Plan
Do
Study
Act
Define Quality
Standards
Measure Monitor amp Report
Correct Deficiencie
s
QI
QI Tools
Agency (Director) ----------------------
UnitsPrograms ----- (Supervisors)
Staff -------------
Key Point
bull What is the job of a health worker - Perform your duties to help your team to deliver services
bull What is the job of your health units and programs
- Perform specific tasks or deliver specific services
bull What is the job of your agency - Support the work of its units and staff - Meet the needs of the population
Benchmark
Health Worker Unit Program AgencyQuestion to answer
How well does a health worker do hisher duties
How well does a unit or program do its tasks or services
How well does agency meet- community needs- needs of unitsstaff
Benchmark
Job Description(Yearly Individual Performance Plan)
Unit Standard Operating Procedures (QA)Goalsamp Objectives(QI)
Strategic Plan (Goals amp Objectives)
Improvement Planning
Yearly IndividualPerformance Plan
- Corrective action plan (QA)
- ldquoPrdquo in PDSA (QI)
Performance Management Plan (using PDSA as needed)
How to monitor Individual performance evaluation
- QA Survey (scores)- PDSA(Set indicators- ldquoPrdquo Measure results- ldquoSrdquo)
Perf Management Plan Reports
Incentives Recognize Merit $ Promote ldquoPerksrdquo
- Recognize team celebrate $$ (to team or individuals)
- Budget grants Promotiondemotion
PMStrategic
Goals
Measure Monitor amp Report
Correct Deficiencies
QI
Tools
Agency or jurisdiction level
Examples 1
bull Nursing shortagebull Low $ collections
2bull Access to carebull NCD epidemic
Key Point
bull What is the job of a health worker - Perform your duties to help your team to deliver services
bull What is the job of your health units and programs
- Perform specific tasks or deliver specific services
bull What is the job of your agency - Support the work of its units and staff - Meet the needs of the population
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Level 1 ldquoreactiverdquo response
Level 2 partial response
Level 3 performance management
Example Situation Nursing shortage
3 Levels of response
Situation Nursing shortage
Needs assessment Not done
Goal Not clear
Objective Not clear
Strategy 1 Train practical nurses whenever shortage becomes acute
2 Hire nurses off-island
Level 1 ldquoreactiverdquo response
Situation Nursing shortage
Needs assessment Done
Goal A supply of high-quality local nurses
Objective Not clear
Strategy 1 Recruit nurses to study off-island 2 Establish community college nursing pgm 2 Hire expat nurses
Level 2 Partial response
Situation Nursing shortage
Needs assessment Done
Goal An adequate supply of high-quality local nurses
Objective 100 of ward nurses should have formal college nursing certificates or degrees by 2015
Strategy bull Partnership between hospital and comm college
- define target group of nurses - financing - employment policies - work-study scheduling transport classroom site
Level 3 Proactive response
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Community Health Assessment
Community Health Improvement Plan
Agency Strategic Plan
Performance Improvement System (for 10 essential public health services)
Assessment1048713 Monitor health status1048713 Investigate health problems 1048713 Evaluate personal and population-based health servicesPolicy Development1048713 To support individual and community health efforts1048713 Enforce laws and regulations that protect health1048713 Research for solutions to health problemsAssurance1048713 Link people to needed personal health services 1048713 Assure a competent health care workforce1048713 Inform people about health issues1048713 Mobilize partnerships to solve health problems
BureausSections reponsibleDOMAIN 1 Conduct and disseminate assessments focused on population health status and public health issues facing the communityStandard 11 Participate in or conduct a collaborative process resulting in a comprehensive community health assessment
111 S Participate in or conduct a state partnership that develops a comprehensive state community health assessment of the population of the state
112 S Complete a state level community health assessment
113 A Ensure that the community health assessment is accessible to agencies organizations and the general public
Standard 12 Collect and maintain reliable comparable and valid data that provide information on conditions of public health importance and on the health status of the population121 A Maintain a surveillance system for receiving reports 247 in order to identify health problems public health threats and environmental public health hazards
122 A Communicate with surveillance sites at least annually
123 A Collect additional primary and secondary data on population health status
Public Health Accreditation Board Standards and Measures
httpwwwcecentralcomphab
PH Accreditation Orientation (web-based)
bull Type of measure (ie output or outcome measure)
bull Format of measure (eg YesNo count proportion time-based other)
bull Measurement specifications (eg startstop time numeratordenominator what is being counted)
bull Baseline value and associated date(s)
bull Target value and associated date(s)
CDC Performance Management Reporting Tool
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you reach
goals
Quiz Is it QA-QI-PM(or is it a ldquoblind improvement attemptrdquo)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Behavioral health unit offers substance abuse counseling training to DHS staff
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Staff in OPD put labels on supply shelves in clinic as part of corrective action plan from last survey
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Chief nurse arranges transportation to help night shift nurses get to work
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing team develops plan to help decrease absenteeism rate on medical ward
QA-QI-PM (if impact is measured)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
Fishbone Diagram
Lack of knowledge amp skill in QI
People
Culture
Methods
Materials
Resources
Cause and Effect Diagram for Low Use of HIV Screening
PoorHIV Testing
ClientTest Location
Donrsquot see benefit
Counseling
Not Client Centered
Not convenient
Staff
Not Respectful
Fearful
Not Offered Poor Experience
Not Private
Donrsquot Want Test
QA
Plan
Do
Study
Act
Define Quality
Standards
Measure Monitor amp Report
Correct Deficiencie
s
QI
QI Tools
Agency (Director) ----------------------
UnitsPrograms ----- (Supervisors)
Staff -------------
Key Point
bull What is the job of a health worker - Perform your duties to help your team to deliver services
bull What is the job of your health units and programs
- Perform specific tasks or deliver specific services
bull What is the job of your agency - Support the work of its units and staff - Meet the needs of the population
Benchmark
Health Worker Unit Program AgencyQuestion to answer
How well does a health worker do hisher duties
How well does a unit or program do its tasks or services
How well does agency meet- community needs- needs of unitsstaff
Benchmark
Job Description(Yearly Individual Performance Plan)
Unit Standard Operating Procedures (QA)Goalsamp Objectives(QI)
Strategic Plan (Goals amp Objectives)
Improvement Planning
Yearly IndividualPerformance Plan
- Corrective action plan (QA)
- ldquoPrdquo in PDSA (QI)
Performance Management Plan (using PDSA as needed)
How to monitor Individual performance evaluation
- QA Survey (scores)- PDSA(Set indicators- ldquoPrdquo Measure results- ldquoSrdquo)
Perf Management Plan Reports
Incentives Recognize Merit $ Promote ldquoPerksrdquo
- Recognize team celebrate $$ (to team or individuals)
- Budget grants Promotiondemotion
PMStrategic
Goals
Measure Monitor amp Report
Correct Deficiencies
QI
Tools
Agency or jurisdiction level
Examples 1
bull Nursing shortagebull Low $ collections
2bull Access to carebull NCD epidemic
Key Point
bull What is the job of a health worker - Perform your duties to help your team to deliver services
bull What is the job of your health units and programs
- Perform specific tasks or deliver specific services
bull What is the job of your agency - Support the work of its units and staff - Meet the needs of the population
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Level 1 ldquoreactiverdquo response
Level 2 partial response
Level 3 performance management
Example Situation Nursing shortage
3 Levels of response
Situation Nursing shortage
Needs assessment Not done
Goal Not clear
Objective Not clear
Strategy 1 Train practical nurses whenever shortage becomes acute
2 Hire nurses off-island
Level 1 ldquoreactiverdquo response
Situation Nursing shortage
Needs assessment Done
Goal A supply of high-quality local nurses
Objective Not clear
Strategy 1 Recruit nurses to study off-island 2 Establish community college nursing pgm 2 Hire expat nurses
Level 2 Partial response
Situation Nursing shortage
Needs assessment Done
Goal An adequate supply of high-quality local nurses
Objective 100 of ward nurses should have formal college nursing certificates or degrees by 2015
Strategy bull Partnership between hospital and comm college
- define target group of nurses - financing - employment policies - work-study scheduling transport classroom site
Level 3 Proactive response
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Community Health Assessment
Community Health Improvement Plan
Agency Strategic Plan
Performance Improvement System (for 10 essential public health services)
Assessment1048713 Monitor health status1048713 Investigate health problems 1048713 Evaluate personal and population-based health servicesPolicy Development1048713 To support individual and community health efforts1048713 Enforce laws and regulations that protect health1048713 Research for solutions to health problemsAssurance1048713 Link people to needed personal health services 1048713 Assure a competent health care workforce1048713 Inform people about health issues1048713 Mobilize partnerships to solve health problems
BureausSections reponsibleDOMAIN 1 Conduct and disseminate assessments focused on population health status and public health issues facing the communityStandard 11 Participate in or conduct a collaborative process resulting in a comprehensive community health assessment
111 S Participate in or conduct a state partnership that develops a comprehensive state community health assessment of the population of the state
112 S Complete a state level community health assessment
113 A Ensure that the community health assessment is accessible to agencies organizations and the general public
Standard 12 Collect and maintain reliable comparable and valid data that provide information on conditions of public health importance and on the health status of the population121 A Maintain a surveillance system for receiving reports 247 in order to identify health problems public health threats and environmental public health hazards
122 A Communicate with surveillance sites at least annually
123 A Collect additional primary and secondary data on population health status
Public Health Accreditation Board Standards and Measures
httpwwwcecentralcomphab
PH Accreditation Orientation (web-based)
bull Type of measure (ie output or outcome measure)
bull Format of measure (eg YesNo count proportion time-based other)
bull Measurement specifications (eg startstop time numeratordenominator what is being counted)
bull Baseline value and associated date(s)
bull Target value and associated date(s)
CDC Performance Management Reporting Tool
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you reach
goals
Quiz Is it QA-QI-PM(or is it a ldquoblind improvement attemptrdquo)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Behavioral health unit offers substance abuse counseling training to DHS staff
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Staff in OPD put labels on supply shelves in clinic as part of corrective action plan from last survey
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Chief nurse arranges transportation to help night shift nurses get to work
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing team develops plan to help decrease absenteeism rate on medical ward
QA-QI-PM (if impact is measured)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
Cause and Effect Diagram for Low Use of HIV Screening
PoorHIV Testing
ClientTest Location
Donrsquot see benefit
Counseling
Not Client Centered
Not convenient
Staff
Not Respectful
Fearful
Not Offered Poor Experience
Not Private
Donrsquot Want Test
QA
Plan
Do
Study
Act
Define Quality
Standards
Measure Monitor amp Report
Correct Deficiencie
s
QI
QI Tools
Agency (Director) ----------------------
UnitsPrograms ----- (Supervisors)
Staff -------------
Key Point
bull What is the job of a health worker - Perform your duties to help your team to deliver services
bull What is the job of your health units and programs
- Perform specific tasks or deliver specific services
bull What is the job of your agency - Support the work of its units and staff - Meet the needs of the population
Benchmark
Health Worker Unit Program AgencyQuestion to answer
How well does a health worker do hisher duties
How well does a unit or program do its tasks or services
How well does agency meet- community needs- needs of unitsstaff
Benchmark
Job Description(Yearly Individual Performance Plan)
Unit Standard Operating Procedures (QA)Goalsamp Objectives(QI)
Strategic Plan (Goals amp Objectives)
Improvement Planning
Yearly IndividualPerformance Plan
- Corrective action plan (QA)
- ldquoPrdquo in PDSA (QI)
Performance Management Plan (using PDSA as needed)
How to monitor Individual performance evaluation
- QA Survey (scores)- PDSA(Set indicators- ldquoPrdquo Measure results- ldquoSrdquo)
Perf Management Plan Reports
Incentives Recognize Merit $ Promote ldquoPerksrdquo
- Recognize team celebrate $$ (to team or individuals)
- Budget grants Promotiondemotion
PMStrategic
Goals
Measure Monitor amp Report
Correct Deficiencies
QI
Tools
Agency or jurisdiction level
Examples 1
bull Nursing shortagebull Low $ collections
2bull Access to carebull NCD epidemic
Key Point
bull What is the job of a health worker - Perform your duties to help your team to deliver services
bull What is the job of your health units and programs
- Perform specific tasks or deliver specific services
bull What is the job of your agency - Support the work of its units and staff - Meet the needs of the population
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Level 1 ldquoreactiverdquo response
Level 2 partial response
Level 3 performance management
Example Situation Nursing shortage
3 Levels of response
Situation Nursing shortage
Needs assessment Not done
Goal Not clear
Objective Not clear
Strategy 1 Train practical nurses whenever shortage becomes acute
2 Hire nurses off-island
Level 1 ldquoreactiverdquo response
Situation Nursing shortage
Needs assessment Done
Goal A supply of high-quality local nurses
Objective Not clear
Strategy 1 Recruit nurses to study off-island 2 Establish community college nursing pgm 2 Hire expat nurses
Level 2 Partial response
Situation Nursing shortage
Needs assessment Done
Goal An adequate supply of high-quality local nurses
Objective 100 of ward nurses should have formal college nursing certificates or degrees by 2015
Strategy bull Partnership between hospital and comm college
- define target group of nurses - financing - employment policies - work-study scheduling transport classroom site
Level 3 Proactive response
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Community Health Assessment
Community Health Improvement Plan
Agency Strategic Plan
Performance Improvement System (for 10 essential public health services)
Assessment1048713 Monitor health status1048713 Investigate health problems 1048713 Evaluate personal and population-based health servicesPolicy Development1048713 To support individual and community health efforts1048713 Enforce laws and regulations that protect health1048713 Research for solutions to health problemsAssurance1048713 Link people to needed personal health services 1048713 Assure a competent health care workforce1048713 Inform people about health issues1048713 Mobilize partnerships to solve health problems
BureausSections reponsibleDOMAIN 1 Conduct and disseminate assessments focused on population health status and public health issues facing the communityStandard 11 Participate in or conduct a collaborative process resulting in a comprehensive community health assessment
111 S Participate in or conduct a state partnership that develops a comprehensive state community health assessment of the population of the state
112 S Complete a state level community health assessment
113 A Ensure that the community health assessment is accessible to agencies organizations and the general public
Standard 12 Collect and maintain reliable comparable and valid data that provide information on conditions of public health importance and on the health status of the population121 A Maintain a surveillance system for receiving reports 247 in order to identify health problems public health threats and environmental public health hazards
122 A Communicate with surveillance sites at least annually
123 A Collect additional primary and secondary data on population health status
Public Health Accreditation Board Standards and Measures
httpwwwcecentralcomphab
PH Accreditation Orientation (web-based)
bull Type of measure (ie output or outcome measure)
bull Format of measure (eg YesNo count proportion time-based other)
bull Measurement specifications (eg startstop time numeratordenominator what is being counted)
bull Baseline value and associated date(s)
bull Target value and associated date(s)
CDC Performance Management Reporting Tool
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you reach
goals
Quiz Is it QA-QI-PM(or is it a ldquoblind improvement attemptrdquo)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Behavioral health unit offers substance abuse counseling training to DHS staff
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Staff in OPD put labels on supply shelves in clinic as part of corrective action plan from last survey
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Chief nurse arranges transportation to help night shift nurses get to work
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing team develops plan to help decrease absenteeism rate on medical ward
QA-QI-PM (if impact is measured)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
QA
Plan
Do
Study
Act
Define Quality
Standards
Measure Monitor amp Report
Correct Deficiencie
s
QI
QI Tools
Agency (Director) ----------------------
UnitsPrograms ----- (Supervisors)
Staff -------------
Key Point
bull What is the job of a health worker - Perform your duties to help your team to deliver services
bull What is the job of your health units and programs
- Perform specific tasks or deliver specific services
bull What is the job of your agency - Support the work of its units and staff - Meet the needs of the population
Benchmark
Health Worker Unit Program AgencyQuestion to answer
How well does a health worker do hisher duties
How well does a unit or program do its tasks or services
How well does agency meet- community needs- needs of unitsstaff
Benchmark
Job Description(Yearly Individual Performance Plan)
Unit Standard Operating Procedures (QA)Goalsamp Objectives(QI)
Strategic Plan (Goals amp Objectives)
Improvement Planning
Yearly IndividualPerformance Plan
- Corrective action plan (QA)
- ldquoPrdquo in PDSA (QI)
Performance Management Plan (using PDSA as needed)
How to monitor Individual performance evaluation
- QA Survey (scores)- PDSA(Set indicators- ldquoPrdquo Measure results- ldquoSrdquo)
Perf Management Plan Reports
Incentives Recognize Merit $ Promote ldquoPerksrdquo
- Recognize team celebrate $$ (to team or individuals)
- Budget grants Promotiondemotion
PMStrategic
Goals
Measure Monitor amp Report
Correct Deficiencies
QI
Tools
Agency or jurisdiction level
Examples 1
bull Nursing shortagebull Low $ collections
2bull Access to carebull NCD epidemic
Key Point
bull What is the job of a health worker - Perform your duties to help your team to deliver services
bull What is the job of your health units and programs
- Perform specific tasks or deliver specific services
bull What is the job of your agency - Support the work of its units and staff - Meet the needs of the population
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Level 1 ldquoreactiverdquo response
Level 2 partial response
Level 3 performance management
Example Situation Nursing shortage
3 Levels of response
Situation Nursing shortage
Needs assessment Not done
Goal Not clear
Objective Not clear
Strategy 1 Train practical nurses whenever shortage becomes acute
2 Hire nurses off-island
Level 1 ldquoreactiverdquo response
Situation Nursing shortage
Needs assessment Done
Goal A supply of high-quality local nurses
Objective Not clear
Strategy 1 Recruit nurses to study off-island 2 Establish community college nursing pgm 2 Hire expat nurses
Level 2 Partial response
Situation Nursing shortage
Needs assessment Done
Goal An adequate supply of high-quality local nurses
Objective 100 of ward nurses should have formal college nursing certificates or degrees by 2015
Strategy bull Partnership between hospital and comm college
- define target group of nurses - financing - employment policies - work-study scheduling transport classroom site
Level 3 Proactive response
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Community Health Assessment
Community Health Improvement Plan
Agency Strategic Plan
Performance Improvement System (for 10 essential public health services)
Assessment1048713 Monitor health status1048713 Investigate health problems 1048713 Evaluate personal and population-based health servicesPolicy Development1048713 To support individual and community health efforts1048713 Enforce laws and regulations that protect health1048713 Research for solutions to health problemsAssurance1048713 Link people to needed personal health services 1048713 Assure a competent health care workforce1048713 Inform people about health issues1048713 Mobilize partnerships to solve health problems
BureausSections reponsibleDOMAIN 1 Conduct and disseminate assessments focused on population health status and public health issues facing the communityStandard 11 Participate in or conduct a collaborative process resulting in a comprehensive community health assessment
111 S Participate in or conduct a state partnership that develops a comprehensive state community health assessment of the population of the state
112 S Complete a state level community health assessment
113 A Ensure that the community health assessment is accessible to agencies organizations and the general public
Standard 12 Collect and maintain reliable comparable and valid data that provide information on conditions of public health importance and on the health status of the population121 A Maintain a surveillance system for receiving reports 247 in order to identify health problems public health threats and environmental public health hazards
122 A Communicate with surveillance sites at least annually
123 A Collect additional primary and secondary data on population health status
Public Health Accreditation Board Standards and Measures
httpwwwcecentralcomphab
PH Accreditation Orientation (web-based)
bull Type of measure (ie output or outcome measure)
bull Format of measure (eg YesNo count proportion time-based other)
bull Measurement specifications (eg startstop time numeratordenominator what is being counted)
bull Baseline value and associated date(s)
bull Target value and associated date(s)
CDC Performance Management Reporting Tool
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you reach
goals
Quiz Is it QA-QI-PM(or is it a ldquoblind improvement attemptrdquo)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Behavioral health unit offers substance abuse counseling training to DHS staff
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Staff in OPD put labels on supply shelves in clinic as part of corrective action plan from last survey
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Chief nurse arranges transportation to help night shift nurses get to work
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing team develops plan to help decrease absenteeism rate on medical ward
QA-QI-PM (if impact is measured)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
Agency (Director) ----------------------
UnitsPrograms ----- (Supervisors)
Staff -------------
Key Point
bull What is the job of a health worker - Perform your duties to help your team to deliver services
bull What is the job of your health units and programs
- Perform specific tasks or deliver specific services
bull What is the job of your agency - Support the work of its units and staff - Meet the needs of the population
Benchmark
Health Worker Unit Program AgencyQuestion to answer
How well does a health worker do hisher duties
How well does a unit or program do its tasks or services
How well does agency meet- community needs- needs of unitsstaff
Benchmark
Job Description(Yearly Individual Performance Plan)
Unit Standard Operating Procedures (QA)Goalsamp Objectives(QI)
Strategic Plan (Goals amp Objectives)
Improvement Planning
Yearly IndividualPerformance Plan
- Corrective action plan (QA)
- ldquoPrdquo in PDSA (QI)
Performance Management Plan (using PDSA as needed)
How to monitor Individual performance evaluation
- QA Survey (scores)- PDSA(Set indicators- ldquoPrdquo Measure results- ldquoSrdquo)
Perf Management Plan Reports
Incentives Recognize Merit $ Promote ldquoPerksrdquo
- Recognize team celebrate $$ (to team or individuals)
- Budget grants Promotiondemotion
PMStrategic
Goals
Measure Monitor amp Report
Correct Deficiencies
QI
Tools
Agency or jurisdiction level
Examples 1
bull Nursing shortagebull Low $ collections
2bull Access to carebull NCD epidemic
Key Point
bull What is the job of a health worker - Perform your duties to help your team to deliver services
bull What is the job of your health units and programs
- Perform specific tasks or deliver specific services
bull What is the job of your agency - Support the work of its units and staff - Meet the needs of the population
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Level 1 ldquoreactiverdquo response
Level 2 partial response
Level 3 performance management
Example Situation Nursing shortage
3 Levels of response
Situation Nursing shortage
Needs assessment Not done
Goal Not clear
Objective Not clear
Strategy 1 Train practical nurses whenever shortage becomes acute
2 Hire nurses off-island
Level 1 ldquoreactiverdquo response
Situation Nursing shortage
Needs assessment Done
Goal A supply of high-quality local nurses
Objective Not clear
Strategy 1 Recruit nurses to study off-island 2 Establish community college nursing pgm 2 Hire expat nurses
Level 2 Partial response
Situation Nursing shortage
Needs assessment Done
Goal An adequate supply of high-quality local nurses
Objective 100 of ward nurses should have formal college nursing certificates or degrees by 2015
Strategy bull Partnership between hospital and comm college
- define target group of nurses - financing - employment policies - work-study scheduling transport classroom site
Level 3 Proactive response
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Community Health Assessment
Community Health Improvement Plan
Agency Strategic Plan
Performance Improvement System (for 10 essential public health services)
Assessment1048713 Monitor health status1048713 Investigate health problems 1048713 Evaluate personal and population-based health servicesPolicy Development1048713 To support individual and community health efforts1048713 Enforce laws and regulations that protect health1048713 Research for solutions to health problemsAssurance1048713 Link people to needed personal health services 1048713 Assure a competent health care workforce1048713 Inform people about health issues1048713 Mobilize partnerships to solve health problems
BureausSections reponsibleDOMAIN 1 Conduct and disseminate assessments focused on population health status and public health issues facing the communityStandard 11 Participate in or conduct a collaborative process resulting in a comprehensive community health assessment
111 S Participate in or conduct a state partnership that develops a comprehensive state community health assessment of the population of the state
112 S Complete a state level community health assessment
113 A Ensure that the community health assessment is accessible to agencies organizations and the general public
Standard 12 Collect and maintain reliable comparable and valid data that provide information on conditions of public health importance and on the health status of the population121 A Maintain a surveillance system for receiving reports 247 in order to identify health problems public health threats and environmental public health hazards
122 A Communicate with surveillance sites at least annually
123 A Collect additional primary and secondary data on population health status
Public Health Accreditation Board Standards and Measures
httpwwwcecentralcomphab
PH Accreditation Orientation (web-based)
bull Type of measure (ie output or outcome measure)
bull Format of measure (eg YesNo count proportion time-based other)
bull Measurement specifications (eg startstop time numeratordenominator what is being counted)
bull Baseline value and associated date(s)
bull Target value and associated date(s)
CDC Performance Management Reporting Tool
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you reach
goals
Quiz Is it QA-QI-PM(or is it a ldquoblind improvement attemptrdquo)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Behavioral health unit offers substance abuse counseling training to DHS staff
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Staff in OPD put labels on supply shelves in clinic as part of corrective action plan from last survey
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Chief nurse arranges transportation to help night shift nurses get to work
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing team develops plan to help decrease absenteeism rate on medical ward
QA-QI-PM (if impact is measured)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
Key Point
bull What is the job of a health worker - Perform your duties to help your team to deliver services
bull What is the job of your health units and programs
- Perform specific tasks or deliver specific services
bull What is the job of your agency - Support the work of its units and staff - Meet the needs of the population
Benchmark
Health Worker Unit Program AgencyQuestion to answer
How well does a health worker do hisher duties
How well does a unit or program do its tasks or services
How well does agency meet- community needs- needs of unitsstaff
Benchmark
Job Description(Yearly Individual Performance Plan)
Unit Standard Operating Procedures (QA)Goalsamp Objectives(QI)
Strategic Plan (Goals amp Objectives)
Improvement Planning
Yearly IndividualPerformance Plan
- Corrective action plan (QA)
- ldquoPrdquo in PDSA (QI)
Performance Management Plan (using PDSA as needed)
How to monitor Individual performance evaluation
- QA Survey (scores)- PDSA(Set indicators- ldquoPrdquo Measure results- ldquoSrdquo)
Perf Management Plan Reports
Incentives Recognize Merit $ Promote ldquoPerksrdquo
- Recognize team celebrate $$ (to team or individuals)
- Budget grants Promotiondemotion
PMStrategic
Goals
Measure Monitor amp Report
Correct Deficiencies
QI
Tools
Agency or jurisdiction level
Examples 1
bull Nursing shortagebull Low $ collections
2bull Access to carebull NCD epidemic
Key Point
bull What is the job of a health worker - Perform your duties to help your team to deliver services
bull What is the job of your health units and programs
- Perform specific tasks or deliver specific services
bull What is the job of your agency - Support the work of its units and staff - Meet the needs of the population
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Level 1 ldquoreactiverdquo response
Level 2 partial response
Level 3 performance management
Example Situation Nursing shortage
3 Levels of response
Situation Nursing shortage
Needs assessment Not done
Goal Not clear
Objective Not clear
Strategy 1 Train practical nurses whenever shortage becomes acute
2 Hire nurses off-island
Level 1 ldquoreactiverdquo response
Situation Nursing shortage
Needs assessment Done
Goal A supply of high-quality local nurses
Objective Not clear
Strategy 1 Recruit nurses to study off-island 2 Establish community college nursing pgm 2 Hire expat nurses
Level 2 Partial response
Situation Nursing shortage
Needs assessment Done
Goal An adequate supply of high-quality local nurses
Objective 100 of ward nurses should have formal college nursing certificates or degrees by 2015
Strategy bull Partnership between hospital and comm college
- define target group of nurses - financing - employment policies - work-study scheduling transport classroom site
Level 3 Proactive response
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Community Health Assessment
Community Health Improvement Plan
Agency Strategic Plan
Performance Improvement System (for 10 essential public health services)
Assessment1048713 Monitor health status1048713 Investigate health problems 1048713 Evaluate personal and population-based health servicesPolicy Development1048713 To support individual and community health efforts1048713 Enforce laws and regulations that protect health1048713 Research for solutions to health problemsAssurance1048713 Link people to needed personal health services 1048713 Assure a competent health care workforce1048713 Inform people about health issues1048713 Mobilize partnerships to solve health problems
BureausSections reponsibleDOMAIN 1 Conduct and disseminate assessments focused on population health status and public health issues facing the communityStandard 11 Participate in or conduct a collaborative process resulting in a comprehensive community health assessment
111 S Participate in or conduct a state partnership that develops a comprehensive state community health assessment of the population of the state
112 S Complete a state level community health assessment
113 A Ensure that the community health assessment is accessible to agencies organizations and the general public
Standard 12 Collect and maintain reliable comparable and valid data that provide information on conditions of public health importance and on the health status of the population121 A Maintain a surveillance system for receiving reports 247 in order to identify health problems public health threats and environmental public health hazards
122 A Communicate with surveillance sites at least annually
123 A Collect additional primary and secondary data on population health status
Public Health Accreditation Board Standards and Measures
httpwwwcecentralcomphab
PH Accreditation Orientation (web-based)
bull Type of measure (ie output or outcome measure)
bull Format of measure (eg YesNo count proportion time-based other)
bull Measurement specifications (eg startstop time numeratordenominator what is being counted)
bull Baseline value and associated date(s)
bull Target value and associated date(s)
CDC Performance Management Reporting Tool
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you reach
goals
Quiz Is it QA-QI-PM(or is it a ldquoblind improvement attemptrdquo)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Behavioral health unit offers substance abuse counseling training to DHS staff
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Staff in OPD put labels on supply shelves in clinic as part of corrective action plan from last survey
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Chief nurse arranges transportation to help night shift nurses get to work
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing team develops plan to help decrease absenteeism rate on medical ward
QA-QI-PM (if impact is measured)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
Benchmark
Health Worker Unit Program AgencyQuestion to answer
How well does a health worker do hisher duties
How well does a unit or program do its tasks or services
How well does agency meet- community needs- needs of unitsstaff
Benchmark
Job Description(Yearly Individual Performance Plan)
Unit Standard Operating Procedures (QA)Goalsamp Objectives(QI)
Strategic Plan (Goals amp Objectives)
Improvement Planning
Yearly IndividualPerformance Plan
- Corrective action plan (QA)
- ldquoPrdquo in PDSA (QI)
Performance Management Plan (using PDSA as needed)
How to monitor Individual performance evaluation
- QA Survey (scores)- PDSA(Set indicators- ldquoPrdquo Measure results- ldquoSrdquo)
Perf Management Plan Reports
Incentives Recognize Merit $ Promote ldquoPerksrdquo
- Recognize team celebrate $$ (to team or individuals)
- Budget grants Promotiondemotion
PMStrategic
Goals
Measure Monitor amp Report
Correct Deficiencies
QI
Tools
Agency or jurisdiction level
Examples 1
bull Nursing shortagebull Low $ collections
2bull Access to carebull NCD epidemic
Key Point
bull What is the job of a health worker - Perform your duties to help your team to deliver services
bull What is the job of your health units and programs
- Perform specific tasks or deliver specific services
bull What is the job of your agency - Support the work of its units and staff - Meet the needs of the population
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Level 1 ldquoreactiverdquo response
Level 2 partial response
Level 3 performance management
Example Situation Nursing shortage
3 Levels of response
Situation Nursing shortage
Needs assessment Not done
Goal Not clear
Objective Not clear
Strategy 1 Train practical nurses whenever shortage becomes acute
2 Hire nurses off-island
Level 1 ldquoreactiverdquo response
Situation Nursing shortage
Needs assessment Done
Goal A supply of high-quality local nurses
Objective Not clear
Strategy 1 Recruit nurses to study off-island 2 Establish community college nursing pgm 2 Hire expat nurses
Level 2 Partial response
Situation Nursing shortage
Needs assessment Done
Goal An adequate supply of high-quality local nurses
Objective 100 of ward nurses should have formal college nursing certificates or degrees by 2015
Strategy bull Partnership between hospital and comm college
- define target group of nurses - financing - employment policies - work-study scheduling transport classroom site
Level 3 Proactive response
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Community Health Assessment
Community Health Improvement Plan
Agency Strategic Plan
Performance Improvement System (for 10 essential public health services)
Assessment1048713 Monitor health status1048713 Investigate health problems 1048713 Evaluate personal and population-based health servicesPolicy Development1048713 To support individual and community health efforts1048713 Enforce laws and regulations that protect health1048713 Research for solutions to health problemsAssurance1048713 Link people to needed personal health services 1048713 Assure a competent health care workforce1048713 Inform people about health issues1048713 Mobilize partnerships to solve health problems
BureausSections reponsibleDOMAIN 1 Conduct and disseminate assessments focused on population health status and public health issues facing the communityStandard 11 Participate in or conduct a collaborative process resulting in a comprehensive community health assessment
111 S Participate in or conduct a state partnership that develops a comprehensive state community health assessment of the population of the state
112 S Complete a state level community health assessment
113 A Ensure that the community health assessment is accessible to agencies organizations and the general public
Standard 12 Collect and maintain reliable comparable and valid data that provide information on conditions of public health importance and on the health status of the population121 A Maintain a surveillance system for receiving reports 247 in order to identify health problems public health threats and environmental public health hazards
122 A Communicate with surveillance sites at least annually
123 A Collect additional primary and secondary data on population health status
Public Health Accreditation Board Standards and Measures
httpwwwcecentralcomphab
PH Accreditation Orientation (web-based)
bull Type of measure (ie output or outcome measure)
bull Format of measure (eg YesNo count proportion time-based other)
bull Measurement specifications (eg startstop time numeratordenominator what is being counted)
bull Baseline value and associated date(s)
bull Target value and associated date(s)
CDC Performance Management Reporting Tool
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you reach
goals
Quiz Is it QA-QI-PM(or is it a ldquoblind improvement attemptrdquo)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Behavioral health unit offers substance abuse counseling training to DHS staff
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Staff in OPD put labels on supply shelves in clinic as part of corrective action plan from last survey
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Chief nurse arranges transportation to help night shift nurses get to work
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing team develops plan to help decrease absenteeism rate on medical ward
QA-QI-PM (if impact is measured)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
Health Worker Unit Program AgencyQuestion to answer
How well does a health worker do hisher duties
How well does a unit or program do its tasks or services
How well does agency meet- community needs- needs of unitsstaff
Benchmark
Job Description(Yearly Individual Performance Plan)
Unit Standard Operating Procedures (QA)Goalsamp Objectives(QI)
Strategic Plan (Goals amp Objectives)
Improvement Planning
Yearly IndividualPerformance Plan
- Corrective action plan (QA)
- ldquoPrdquo in PDSA (QI)
Performance Management Plan (using PDSA as needed)
How to monitor Individual performance evaluation
- QA Survey (scores)- PDSA(Set indicators- ldquoPrdquo Measure results- ldquoSrdquo)
Perf Management Plan Reports
Incentives Recognize Merit $ Promote ldquoPerksrdquo
- Recognize team celebrate $$ (to team or individuals)
- Budget grants Promotiondemotion
PMStrategic
Goals
Measure Monitor amp Report
Correct Deficiencies
QI
Tools
Agency or jurisdiction level
Examples 1
bull Nursing shortagebull Low $ collections
2bull Access to carebull NCD epidemic
Key Point
bull What is the job of a health worker - Perform your duties to help your team to deliver services
bull What is the job of your health units and programs
- Perform specific tasks or deliver specific services
bull What is the job of your agency - Support the work of its units and staff - Meet the needs of the population
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Level 1 ldquoreactiverdquo response
Level 2 partial response
Level 3 performance management
Example Situation Nursing shortage
3 Levels of response
Situation Nursing shortage
Needs assessment Not done
Goal Not clear
Objective Not clear
Strategy 1 Train practical nurses whenever shortage becomes acute
2 Hire nurses off-island
Level 1 ldquoreactiverdquo response
Situation Nursing shortage
Needs assessment Done
Goal A supply of high-quality local nurses
Objective Not clear
Strategy 1 Recruit nurses to study off-island 2 Establish community college nursing pgm 2 Hire expat nurses
Level 2 Partial response
Situation Nursing shortage
Needs assessment Done
Goal An adequate supply of high-quality local nurses
Objective 100 of ward nurses should have formal college nursing certificates or degrees by 2015
Strategy bull Partnership between hospital and comm college
- define target group of nurses - financing - employment policies - work-study scheduling transport classroom site
Level 3 Proactive response
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Community Health Assessment
Community Health Improvement Plan
Agency Strategic Plan
Performance Improvement System (for 10 essential public health services)
Assessment1048713 Monitor health status1048713 Investigate health problems 1048713 Evaluate personal and population-based health servicesPolicy Development1048713 To support individual and community health efforts1048713 Enforce laws and regulations that protect health1048713 Research for solutions to health problemsAssurance1048713 Link people to needed personal health services 1048713 Assure a competent health care workforce1048713 Inform people about health issues1048713 Mobilize partnerships to solve health problems
BureausSections reponsibleDOMAIN 1 Conduct and disseminate assessments focused on population health status and public health issues facing the communityStandard 11 Participate in or conduct a collaborative process resulting in a comprehensive community health assessment
111 S Participate in or conduct a state partnership that develops a comprehensive state community health assessment of the population of the state
112 S Complete a state level community health assessment
113 A Ensure that the community health assessment is accessible to agencies organizations and the general public
Standard 12 Collect and maintain reliable comparable and valid data that provide information on conditions of public health importance and on the health status of the population121 A Maintain a surveillance system for receiving reports 247 in order to identify health problems public health threats and environmental public health hazards
122 A Communicate with surveillance sites at least annually
123 A Collect additional primary and secondary data on population health status
Public Health Accreditation Board Standards and Measures
httpwwwcecentralcomphab
PH Accreditation Orientation (web-based)
bull Type of measure (ie output or outcome measure)
bull Format of measure (eg YesNo count proportion time-based other)
bull Measurement specifications (eg startstop time numeratordenominator what is being counted)
bull Baseline value and associated date(s)
bull Target value and associated date(s)
CDC Performance Management Reporting Tool
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you reach
goals
Quiz Is it QA-QI-PM(or is it a ldquoblind improvement attemptrdquo)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Behavioral health unit offers substance abuse counseling training to DHS staff
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Staff in OPD put labels on supply shelves in clinic as part of corrective action plan from last survey
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Chief nurse arranges transportation to help night shift nurses get to work
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing team develops plan to help decrease absenteeism rate on medical ward
QA-QI-PM (if impact is measured)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
PMStrategic
Goals
Measure Monitor amp Report
Correct Deficiencies
QI
Tools
Agency or jurisdiction level
Examples 1
bull Nursing shortagebull Low $ collections
2bull Access to carebull NCD epidemic
Key Point
bull What is the job of a health worker - Perform your duties to help your team to deliver services
bull What is the job of your health units and programs
- Perform specific tasks or deliver specific services
bull What is the job of your agency - Support the work of its units and staff - Meet the needs of the population
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Level 1 ldquoreactiverdquo response
Level 2 partial response
Level 3 performance management
Example Situation Nursing shortage
3 Levels of response
Situation Nursing shortage
Needs assessment Not done
Goal Not clear
Objective Not clear
Strategy 1 Train practical nurses whenever shortage becomes acute
2 Hire nurses off-island
Level 1 ldquoreactiverdquo response
Situation Nursing shortage
Needs assessment Done
Goal A supply of high-quality local nurses
Objective Not clear
Strategy 1 Recruit nurses to study off-island 2 Establish community college nursing pgm 2 Hire expat nurses
Level 2 Partial response
Situation Nursing shortage
Needs assessment Done
Goal An adequate supply of high-quality local nurses
Objective 100 of ward nurses should have formal college nursing certificates or degrees by 2015
Strategy bull Partnership between hospital and comm college
- define target group of nurses - financing - employment policies - work-study scheduling transport classroom site
Level 3 Proactive response
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Community Health Assessment
Community Health Improvement Plan
Agency Strategic Plan
Performance Improvement System (for 10 essential public health services)
Assessment1048713 Monitor health status1048713 Investigate health problems 1048713 Evaluate personal and population-based health servicesPolicy Development1048713 To support individual and community health efforts1048713 Enforce laws and regulations that protect health1048713 Research for solutions to health problemsAssurance1048713 Link people to needed personal health services 1048713 Assure a competent health care workforce1048713 Inform people about health issues1048713 Mobilize partnerships to solve health problems
BureausSections reponsibleDOMAIN 1 Conduct and disseminate assessments focused on population health status and public health issues facing the communityStandard 11 Participate in or conduct a collaborative process resulting in a comprehensive community health assessment
111 S Participate in or conduct a state partnership that develops a comprehensive state community health assessment of the population of the state
112 S Complete a state level community health assessment
113 A Ensure that the community health assessment is accessible to agencies organizations and the general public
Standard 12 Collect and maintain reliable comparable and valid data that provide information on conditions of public health importance and on the health status of the population121 A Maintain a surveillance system for receiving reports 247 in order to identify health problems public health threats and environmental public health hazards
122 A Communicate with surveillance sites at least annually
123 A Collect additional primary and secondary data on population health status
Public Health Accreditation Board Standards and Measures
httpwwwcecentralcomphab
PH Accreditation Orientation (web-based)
bull Type of measure (ie output or outcome measure)
bull Format of measure (eg YesNo count proportion time-based other)
bull Measurement specifications (eg startstop time numeratordenominator what is being counted)
bull Baseline value and associated date(s)
bull Target value and associated date(s)
CDC Performance Management Reporting Tool
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you reach
goals
Quiz Is it QA-QI-PM(or is it a ldquoblind improvement attemptrdquo)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Behavioral health unit offers substance abuse counseling training to DHS staff
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Staff in OPD put labels on supply shelves in clinic as part of corrective action plan from last survey
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Chief nurse arranges transportation to help night shift nurses get to work
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing team develops plan to help decrease absenteeism rate on medical ward
QA-QI-PM (if impact is measured)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
Key Point
bull What is the job of a health worker - Perform your duties to help your team to deliver services
bull What is the job of your health units and programs
- Perform specific tasks or deliver specific services
bull What is the job of your agency - Support the work of its units and staff - Meet the needs of the population
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Level 1 ldquoreactiverdquo response
Level 2 partial response
Level 3 performance management
Example Situation Nursing shortage
3 Levels of response
Situation Nursing shortage
Needs assessment Not done
Goal Not clear
Objective Not clear
Strategy 1 Train practical nurses whenever shortage becomes acute
2 Hire nurses off-island
Level 1 ldquoreactiverdquo response
Situation Nursing shortage
Needs assessment Done
Goal A supply of high-quality local nurses
Objective Not clear
Strategy 1 Recruit nurses to study off-island 2 Establish community college nursing pgm 2 Hire expat nurses
Level 2 Partial response
Situation Nursing shortage
Needs assessment Done
Goal An adequate supply of high-quality local nurses
Objective 100 of ward nurses should have formal college nursing certificates or degrees by 2015
Strategy bull Partnership between hospital and comm college
- define target group of nurses - financing - employment policies - work-study scheduling transport classroom site
Level 3 Proactive response
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Community Health Assessment
Community Health Improvement Plan
Agency Strategic Plan
Performance Improvement System (for 10 essential public health services)
Assessment1048713 Monitor health status1048713 Investigate health problems 1048713 Evaluate personal and population-based health servicesPolicy Development1048713 To support individual and community health efforts1048713 Enforce laws and regulations that protect health1048713 Research for solutions to health problemsAssurance1048713 Link people to needed personal health services 1048713 Assure a competent health care workforce1048713 Inform people about health issues1048713 Mobilize partnerships to solve health problems
BureausSections reponsibleDOMAIN 1 Conduct and disseminate assessments focused on population health status and public health issues facing the communityStandard 11 Participate in or conduct a collaborative process resulting in a comprehensive community health assessment
111 S Participate in or conduct a state partnership that develops a comprehensive state community health assessment of the population of the state
112 S Complete a state level community health assessment
113 A Ensure that the community health assessment is accessible to agencies organizations and the general public
Standard 12 Collect and maintain reliable comparable and valid data that provide information on conditions of public health importance and on the health status of the population121 A Maintain a surveillance system for receiving reports 247 in order to identify health problems public health threats and environmental public health hazards
122 A Communicate with surveillance sites at least annually
123 A Collect additional primary and secondary data on population health status
Public Health Accreditation Board Standards and Measures
httpwwwcecentralcomphab
PH Accreditation Orientation (web-based)
bull Type of measure (ie output or outcome measure)
bull Format of measure (eg YesNo count proportion time-based other)
bull Measurement specifications (eg startstop time numeratordenominator what is being counted)
bull Baseline value and associated date(s)
bull Target value and associated date(s)
CDC Performance Management Reporting Tool
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you reach
goals
Quiz Is it QA-QI-PM(or is it a ldquoblind improvement attemptrdquo)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Behavioral health unit offers substance abuse counseling training to DHS staff
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Staff in OPD put labels on supply shelves in clinic as part of corrective action plan from last survey
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Chief nurse arranges transportation to help night shift nurses get to work
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing team develops plan to help decrease absenteeism rate on medical ward
QA-QI-PM (if impact is measured)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Level 1 ldquoreactiverdquo response
Level 2 partial response
Level 3 performance management
Example Situation Nursing shortage
3 Levels of response
Situation Nursing shortage
Needs assessment Not done
Goal Not clear
Objective Not clear
Strategy 1 Train practical nurses whenever shortage becomes acute
2 Hire nurses off-island
Level 1 ldquoreactiverdquo response
Situation Nursing shortage
Needs assessment Done
Goal A supply of high-quality local nurses
Objective Not clear
Strategy 1 Recruit nurses to study off-island 2 Establish community college nursing pgm 2 Hire expat nurses
Level 2 Partial response
Situation Nursing shortage
Needs assessment Done
Goal An adequate supply of high-quality local nurses
Objective 100 of ward nurses should have formal college nursing certificates or degrees by 2015
Strategy bull Partnership between hospital and comm college
- define target group of nurses - financing - employment policies - work-study scheduling transport classroom site
Level 3 Proactive response
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Community Health Assessment
Community Health Improvement Plan
Agency Strategic Plan
Performance Improvement System (for 10 essential public health services)
Assessment1048713 Monitor health status1048713 Investigate health problems 1048713 Evaluate personal and population-based health servicesPolicy Development1048713 To support individual and community health efforts1048713 Enforce laws and regulations that protect health1048713 Research for solutions to health problemsAssurance1048713 Link people to needed personal health services 1048713 Assure a competent health care workforce1048713 Inform people about health issues1048713 Mobilize partnerships to solve health problems
BureausSections reponsibleDOMAIN 1 Conduct and disseminate assessments focused on population health status and public health issues facing the communityStandard 11 Participate in or conduct a collaborative process resulting in a comprehensive community health assessment
111 S Participate in or conduct a state partnership that develops a comprehensive state community health assessment of the population of the state
112 S Complete a state level community health assessment
113 A Ensure that the community health assessment is accessible to agencies organizations and the general public
Standard 12 Collect and maintain reliable comparable and valid data that provide information on conditions of public health importance and on the health status of the population121 A Maintain a surveillance system for receiving reports 247 in order to identify health problems public health threats and environmental public health hazards
122 A Communicate with surveillance sites at least annually
123 A Collect additional primary and secondary data on population health status
Public Health Accreditation Board Standards and Measures
httpwwwcecentralcomphab
PH Accreditation Orientation (web-based)
bull Type of measure (ie output or outcome measure)
bull Format of measure (eg YesNo count proportion time-based other)
bull Measurement specifications (eg startstop time numeratordenominator what is being counted)
bull Baseline value and associated date(s)
bull Target value and associated date(s)
CDC Performance Management Reporting Tool
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you reach
goals
Quiz Is it QA-QI-PM(or is it a ldquoblind improvement attemptrdquo)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Behavioral health unit offers substance abuse counseling training to DHS staff
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Staff in OPD put labels on supply shelves in clinic as part of corrective action plan from last survey
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Chief nurse arranges transportation to help night shift nurses get to work
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing team develops plan to help decrease absenteeism rate on medical ward
QA-QI-PM (if impact is measured)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
Level 1 ldquoreactiverdquo response
Level 2 partial response
Level 3 performance management
Example Situation Nursing shortage
3 Levels of response
Situation Nursing shortage
Needs assessment Not done
Goal Not clear
Objective Not clear
Strategy 1 Train practical nurses whenever shortage becomes acute
2 Hire nurses off-island
Level 1 ldquoreactiverdquo response
Situation Nursing shortage
Needs assessment Done
Goal A supply of high-quality local nurses
Objective Not clear
Strategy 1 Recruit nurses to study off-island 2 Establish community college nursing pgm 2 Hire expat nurses
Level 2 Partial response
Situation Nursing shortage
Needs assessment Done
Goal An adequate supply of high-quality local nurses
Objective 100 of ward nurses should have formal college nursing certificates or degrees by 2015
Strategy bull Partnership between hospital and comm college
- define target group of nurses - financing - employment policies - work-study scheduling transport classroom site
Level 3 Proactive response
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Community Health Assessment
Community Health Improvement Plan
Agency Strategic Plan
Performance Improvement System (for 10 essential public health services)
Assessment1048713 Monitor health status1048713 Investigate health problems 1048713 Evaluate personal and population-based health servicesPolicy Development1048713 To support individual and community health efforts1048713 Enforce laws and regulations that protect health1048713 Research for solutions to health problemsAssurance1048713 Link people to needed personal health services 1048713 Assure a competent health care workforce1048713 Inform people about health issues1048713 Mobilize partnerships to solve health problems
BureausSections reponsibleDOMAIN 1 Conduct and disseminate assessments focused on population health status and public health issues facing the communityStandard 11 Participate in or conduct a collaborative process resulting in a comprehensive community health assessment
111 S Participate in or conduct a state partnership that develops a comprehensive state community health assessment of the population of the state
112 S Complete a state level community health assessment
113 A Ensure that the community health assessment is accessible to agencies organizations and the general public
Standard 12 Collect and maintain reliable comparable and valid data that provide information on conditions of public health importance and on the health status of the population121 A Maintain a surveillance system for receiving reports 247 in order to identify health problems public health threats and environmental public health hazards
122 A Communicate with surveillance sites at least annually
123 A Collect additional primary and secondary data on population health status
Public Health Accreditation Board Standards and Measures
httpwwwcecentralcomphab
PH Accreditation Orientation (web-based)
bull Type of measure (ie output or outcome measure)
bull Format of measure (eg YesNo count proportion time-based other)
bull Measurement specifications (eg startstop time numeratordenominator what is being counted)
bull Baseline value and associated date(s)
bull Target value and associated date(s)
CDC Performance Management Reporting Tool
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you reach
goals
Quiz Is it QA-QI-PM(or is it a ldquoblind improvement attemptrdquo)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Behavioral health unit offers substance abuse counseling training to DHS staff
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Staff in OPD put labels on supply shelves in clinic as part of corrective action plan from last survey
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Chief nurse arranges transportation to help night shift nurses get to work
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing team develops plan to help decrease absenteeism rate on medical ward
QA-QI-PM (if impact is measured)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
Situation Nursing shortage
Needs assessment Not done
Goal Not clear
Objective Not clear
Strategy 1 Train practical nurses whenever shortage becomes acute
2 Hire nurses off-island
Level 1 ldquoreactiverdquo response
Situation Nursing shortage
Needs assessment Done
Goal A supply of high-quality local nurses
Objective Not clear
Strategy 1 Recruit nurses to study off-island 2 Establish community college nursing pgm 2 Hire expat nurses
Level 2 Partial response
Situation Nursing shortage
Needs assessment Done
Goal An adequate supply of high-quality local nurses
Objective 100 of ward nurses should have formal college nursing certificates or degrees by 2015
Strategy bull Partnership between hospital and comm college
- define target group of nurses - financing - employment policies - work-study scheduling transport classroom site
Level 3 Proactive response
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Community Health Assessment
Community Health Improvement Plan
Agency Strategic Plan
Performance Improvement System (for 10 essential public health services)
Assessment1048713 Monitor health status1048713 Investigate health problems 1048713 Evaluate personal and population-based health servicesPolicy Development1048713 To support individual and community health efforts1048713 Enforce laws and regulations that protect health1048713 Research for solutions to health problemsAssurance1048713 Link people to needed personal health services 1048713 Assure a competent health care workforce1048713 Inform people about health issues1048713 Mobilize partnerships to solve health problems
BureausSections reponsibleDOMAIN 1 Conduct and disseminate assessments focused on population health status and public health issues facing the communityStandard 11 Participate in or conduct a collaborative process resulting in a comprehensive community health assessment
111 S Participate in or conduct a state partnership that develops a comprehensive state community health assessment of the population of the state
112 S Complete a state level community health assessment
113 A Ensure that the community health assessment is accessible to agencies organizations and the general public
Standard 12 Collect and maintain reliable comparable and valid data that provide information on conditions of public health importance and on the health status of the population121 A Maintain a surveillance system for receiving reports 247 in order to identify health problems public health threats and environmental public health hazards
122 A Communicate with surveillance sites at least annually
123 A Collect additional primary and secondary data on population health status
Public Health Accreditation Board Standards and Measures
httpwwwcecentralcomphab
PH Accreditation Orientation (web-based)
bull Type of measure (ie output or outcome measure)
bull Format of measure (eg YesNo count proportion time-based other)
bull Measurement specifications (eg startstop time numeratordenominator what is being counted)
bull Baseline value and associated date(s)
bull Target value and associated date(s)
CDC Performance Management Reporting Tool
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you reach
goals
Quiz Is it QA-QI-PM(or is it a ldquoblind improvement attemptrdquo)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Behavioral health unit offers substance abuse counseling training to DHS staff
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Staff in OPD put labels on supply shelves in clinic as part of corrective action plan from last survey
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Chief nurse arranges transportation to help night shift nurses get to work
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing team develops plan to help decrease absenteeism rate on medical ward
QA-QI-PM (if impact is measured)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
Situation Nursing shortage
Needs assessment Done
Goal A supply of high-quality local nurses
Objective Not clear
Strategy 1 Recruit nurses to study off-island 2 Establish community college nursing pgm 2 Hire expat nurses
Level 2 Partial response
Situation Nursing shortage
Needs assessment Done
Goal An adequate supply of high-quality local nurses
Objective 100 of ward nurses should have formal college nursing certificates or degrees by 2015
Strategy bull Partnership between hospital and comm college
- define target group of nurses - financing - employment policies - work-study scheduling transport classroom site
Level 3 Proactive response
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Community Health Assessment
Community Health Improvement Plan
Agency Strategic Plan
Performance Improvement System (for 10 essential public health services)
Assessment1048713 Monitor health status1048713 Investigate health problems 1048713 Evaluate personal and population-based health servicesPolicy Development1048713 To support individual and community health efforts1048713 Enforce laws and regulations that protect health1048713 Research for solutions to health problemsAssurance1048713 Link people to needed personal health services 1048713 Assure a competent health care workforce1048713 Inform people about health issues1048713 Mobilize partnerships to solve health problems
BureausSections reponsibleDOMAIN 1 Conduct and disseminate assessments focused on population health status and public health issues facing the communityStandard 11 Participate in or conduct a collaborative process resulting in a comprehensive community health assessment
111 S Participate in or conduct a state partnership that develops a comprehensive state community health assessment of the population of the state
112 S Complete a state level community health assessment
113 A Ensure that the community health assessment is accessible to agencies organizations and the general public
Standard 12 Collect and maintain reliable comparable and valid data that provide information on conditions of public health importance and on the health status of the population121 A Maintain a surveillance system for receiving reports 247 in order to identify health problems public health threats and environmental public health hazards
122 A Communicate with surveillance sites at least annually
123 A Collect additional primary and secondary data on population health status
Public Health Accreditation Board Standards and Measures
httpwwwcecentralcomphab
PH Accreditation Orientation (web-based)
bull Type of measure (ie output or outcome measure)
bull Format of measure (eg YesNo count proportion time-based other)
bull Measurement specifications (eg startstop time numeratordenominator what is being counted)
bull Baseline value and associated date(s)
bull Target value and associated date(s)
CDC Performance Management Reporting Tool
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you reach
goals
Quiz Is it QA-QI-PM(or is it a ldquoblind improvement attemptrdquo)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Behavioral health unit offers substance abuse counseling training to DHS staff
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Staff in OPD put labels on supply shelves in clinic as part of corrective action plan from last survey
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Chief nurse arranges transportation to help night shift nurses get to work
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing team develops plan to help decrease absenteeism rate on medical ward
QA-QI-PM (if impact is measured)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
Situation Nursing shortage
Needs assessment Done
Goal An adequate supply of high-quality local nurses
Objective 100 of ward nurses should have formal college nursing certificates or degrees by 2015
Strategy bull Partnership between hospital and comm college
- define target group of nurses - financing - employment policies - work-study scheduling transport classroom site
Level 3 Proactive response
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Community Health Assessment
Community Health Improvement Plan
Agency Strategic Plan
Performance Improvement System (for 10 essential public health services)
Assessment1048713 Monitor health status1048713 Investigate health problems 1048713 Evaluate personal and population-based health servicesPolicy Development1048713 To support individual and community health efforts1048713 Enforce laws and regulations that protect health1048713 Research for solutions to health problemsAssurance1048713 Link people to needed personal health services 1048713 Assure a competent health care workforce1048713 Inform people about health issues1048713 Mobilize partnerships to solve health problems
BureausSections reponsibleDOMAIN 1 Conduct and disseminate assessments focused on population health status and public health issues facing the communityStandard 11 Participate in or conduct a collaborative process resulting in a comprehensive community health assessment
111 S Participate in or conduct a state partnership that develops a comprehensive state community health assessment of the population of the state
112 S Complete a state level community health assessment
113 A Ensure that the community health assessment is accessible to agencies organizations and the general public
Standard 12 Collect and maintain reliable comparable and valid data that provide information on conditions of public health importance and on the health status of the population121 A Maintain a surveillance system for receiving reports 247 in order to identify health problems public health threats and environmental public health hazards
122 A Communicate with surveillance sites at least annually
123 A Collect additional primary and secondary data on population health status
Public Health Accreditation Board Standards and Measures
httpwwwcecentralcomphab
PH Accreditation Orientation (web-based)
bull Type of measure (ie output or outcome measure)
bull Format of measure (eg YesNo count proportion time-based other)
bull Measurement specifications (eg startstop time numeratordenominator what is being counted)
bull Baseline value and associated date(s)
bull Target value and associated date(s)
CDC Performance Management Reporting Tool
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you reach
goals
Quiz Is it QA-QI-PM(or is it a ldquoblind improvement attemptrdquo)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Behavioral health unit offers substance abuse counseling training to DHS staff
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Staff in OPD put labels on supply shelves in clinic as part of corrective action plan from last survey
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Chief nurse arranges transportation to help night shift nurses get to work
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing team develops plan to help decrease absenteeism rate on medical ward
QA-QI-PM (if impact is measured)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
Are we satisfied
Current situation Needs Assessment
What to do Goals strategiesamp objectives
Assure success Performance Improvement
System
Community Health Assessment
Community Health Improvement Plan
Agency Strategic Plan
Performance Improvement System (for 10 essential public health services)
Assessment1048713 Monitor health status1048713 Investigate health problems 1048713 Evaluate personal and population-based health servicesPolicy Development1048713 To support individual and community health efforts1048713 Enforce laws and regulations that protect health1048713 Research for solutions to health problemsAssurance1048713 Link people to needed personal health services 1048713 Assure a competent health care workforce1048713 Inform people about health issues1048713 Mobilize partnerships to solve health problems
BureausSections reponsibleDOMAIN 1 Conduct and disseminate assessments focused on population health status and public health issues facing the communityStandard 11 Participate in or conduct a collaborative process resulting in a comprehensive community health assessment
111 S Participate in or conduct a state partnership that develops a comprehensive state community health assessment of the population of the state
112 S Complete a state level community health assessment
113 A Ensure that the community health assessment is accessible to agencies organizations and the general public
Standard 12 Collect and maintain reliable comparable and valid data that provide information on conditions of public health importance and on the health status of the population121 A Maintain a surveillance system for receiving reports 247 in order to identify health problems public health threats and environmental public health hazards
122 A Communicate with surveillance sites at least annually
123 A Collect additional primary and secondary data on population health status
Public Health Accreditation Board Standards and Measures
httpwwwcecentralcomphab
PH Accreditation Orientation (web-based)
bull Type of measure (ie output or outcome measure)
bull Format of measure (eg YesNo count proportion time-based other)
bull Measurement specifications (eg startstop time numeratordenominator what is being counted)
bull Baseline value and associated date(s)
bull Target value and associated date(s)
CDC Performance Management Reporting Tool
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you reach
goals
Quiz Is it QA-QI-PM(or is it a ldquoblind improvement attemptrdquo)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Behavioral health unit offers substance abuse counseling training to DHS staff
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Staff in OPD put labels on supply shelves in clinic as part of corrective action plan from last survey
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Chief nurse arranges transportation to help night shift nurses get to work
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing team develops plan to help decrease absenteeism rate on medical ward
QA-QI-PM (if impact is measured)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
Community Health Assessment
Community Health Improvement Plan
Agency Strategic Plan
Performance Improvement System (for 10 essential public health services)
Assessment1048713 Monitor health status1048713 Investigate health problems 1048713 Evaluate personal and population-based health servicesPolicy Development1048713 To support individual and community health efforts1048713 Enforce laws and regulations that protect health1048713 Research for solutions to health problemsAssurance1048713 Link people to needed personal health services 1048713 Assure a competent health care workforce1048713 Inform people about health issues1048713 Mobilize partnerships to solve health problems
BureausSections reponsibleDOMAIN 1 Conduct and disseminate assessments focused on population health status and public health issues facing the communityStandard 11 Participate in or conduct a collaborative process resulting in a comprehensive community health assessment
111 S Participate in or conduct a state partnership that develops a comprehensive state community health assessment of the population of the state
112 S Complete a state level community health assessment
113 A Ensure that the community health assessment is accessible to agencies organizations and the general public
Standard 12 Collect and maintain reliable comparable and valid data that provide information on conditions of public health importance and on the health status of the population121 A Maintain a surveillance system for receiving reports 247 in order to identify health problems public health threats and environmental public health hazards
122 A Communicate with surveillance sites at least annually
123 A Collect additional primary and secondary data on population health status
Public Health Accreditation Board Standards and Measures
httpwwwcecentralcomphab
PH Accreditation Orientation (web-based)
bull Type of measure (ie output or outcome measure)
bull Format of measure (eg YesNo count proportion time-based other)
bull Measurement specifications (eg startstop time numeratordenominator what is being counted)
bull Baseline value and associated date(s)
bull Target value and associated date(s)
CDC Performance Management Reporting Tool
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you reach
goals
Quiz Is it QA-QI-PM(or is it a ldquoblind improvement attemptrdquo)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Behavioral health unit offers substance abuse counseling training to DHS staff
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Staff in OPD put labels on supply shelves in clinic as part of corrective action plan from last survey
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Chief nurse arranges transportation to help night shift nurses get to work
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing team develops plan to help decrease absenteeism rate on medical ward
QA-QI-PM (if impact is measured)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
BureausSections reponsibleDOMAIN 1 Conduct and disseminate assessments focused on population health status and public health issues facing the communityStandard 11 Participate in or conduct a collaborative process resulting in a comprehensive community health assessment
111 S Participate in or conduct a state partnership that develops a comprehensive state community health assessment of the population of the state
112 S Complete a state level community health assessment
113 A Ensure that the community health assessment is accessible to agencies organizations and the general public
Standard 12 Collect and maintain reliable comparable and valid data that provide information on conditions of public health importance and on the health status of the population121 A Maintain a surveillance system for receiving reports 247 in order to identify health problems public health threats and environmental public health hazards
122 A Communicate with surveillance sites at least annually
123 A Collect additional primary and secondary data on population health status
Public Health Accreditation Board Standards and Measures
httpwwwcecentralcomphab
PH Accreditation Orientation (web-based)
bull Type of measure (ie output or outcome measure)
bull Format of measure (eg YesNo count proportion time-based other)
bull Measurement specifications (eg startstop time numeratordenominator what is being counted)
bull Baseline value and associated date(s)
bull Target value and associated date(s)
CDC Performance Management Reporting Tool
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you reach
goals
Quiz Is it QA-QI-PM(or is it a ldquoblind improvement attemptrdquo)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Behavioral health unit offers substance abuse counseling training to DHS staff
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Staff in OPD put labels on supply shelves in clinic as part of corrective action plan from last survey
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Chief nurse arranges transportation to help night shift nurses get to work
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing team develops plan to help decrease absenteeism rate on medical ward
QA-QI-PM (if impact is measured)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
httpwwwcecentralcomphab
PH Accreditation Orientation (web-based)
bull Type of measure (ie output or outcome measure)
bull Format of measure (eg YesNo count proportion time-based other)
bull Measurement specifications (eg startstop time numeratordenominator what is being counted)
bull Baseline value and associated date(s)
bull Target value and associated date(s)
CDC Performance Management Reporting Tool
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you reach
goals
Quiz Is it QA-QI-PM(or is it a ldquoblind improvement attemptrdquo)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Behavioral health unit offers substance abuse counseling training to DHS staff
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Staff in OPD put labels on supply shelves in clinic as part of corrective action plan from last survey
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Chief nurse arranges transportation to help night shift nurses get to work
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing team develops plan to help decrease absenteeism rate on medical ward
QA-QI-PM (if impact is measured)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
bull Type of measure (ie output or outcome measure)
bull Format of measure (eg YesNo count proportion time-based other)
bull Measurement specifications (eg startstop time numeratordenominator what is being counted)
bull Baseline value and associated date(s)
bull Target value and associated date(s)
CDC Performance Management Reporting Tool
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you reach
goals
Quiz Is it QA-QI-PM(or is it a ldquoblind improvement attemptrdquo)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Behavioral health unit offers substance abuse counseling training to DHS staff
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Staff in OPD put labels on supply shelves in clinic as part of corrective action plan from last survey
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Chief nurse arranges transportation to help night shift nurses get to work
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing team develops plan to help decrease absenteeism rate on medical ward
QA-QI-PM (if impact is measured)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you reach
goals
Quiz Is it QA-QI-PM(or is it a ldquoblind improvement attemptrdquo)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Behavioral health unit offers substance abuse counseling training to DHS staff
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Staff in OPD put labels on supply shelves in clinic as part of corrective action plan from last survey
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Chief nurse arranges transportation to help night shift nurses get to work
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing team develops plan to help decrease absenteeism rate on medical ward
QA-QI-PM (if impact is measured)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Behavioral health unit offers substance abuse counseling training to DHS staff
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Staff in OPD put labels on supply shelves in clinic as part of corrective action plan from last survey
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Chief nurse arranges transportation to help night shift nurses get to work
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing team develops plan to help decrease absenteeism rate on medical ward
QA-QI-PM (if impact is measured)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Staff in OPD put labels on supply shelves in clinic as part of corrective action plan from last survey
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Chief nurse arranges transportation to help night shift nurses get to work
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing team develops plan to help decrease absenteeism rate on medical ward
QA-QI-PM (if impact is measured)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Chief nurse arranges transportation to help night shift nurses get to work
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing team develops plan to help decrease absenteeism rate on medical ward
QA-QI-PM (if impact is measured)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing team develops plan to help decrease absenteeism rate on medical ward
QA-QI-PM (if impact is measured)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Team from Public Health goes to Mortlocks to do screening and health promotion to address NCD epidemic
ldquoBlind improvement attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS works with legislature to pass increase in tobacco tax in hope of decreasing teen tobacco use 10 from current rate of 67
QA-QI-PM (if follow-up measurment is done)
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
Nursing Supervisor requires all nursing unit supervisors to take on-line QI course and follows-up until all supervisors on her list have completed
QA-QI-PM
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
DHS hosts training workshop to train doctors nurses and health assistants to apply new NCD treatment guidelines
ldquoBlind Improvement Attemptrdquo
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
Define Standards or Goals
Measure Monitor amp Report
Change what you do until you
reach goals
HRH Committee develops strategy for recruiting 60 new students into COM-FSM nursing program by 2013
QA-QI-PM
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-
durandpihoaorg
A Mark Durand
- Introduction to QA QI and Performance Management
- Slide 2
- Slide 3
- QAQI- Program Development by Site
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- QA
- Slide 11
- Learning and Improvement Cycle
- Slide 13
- Fishbone Diagram
- Slide 15
- Slide 16
- QA (2)
- Slide 18
- Key Point
- Benchmark
- Slide 21
- PM
- Key Point (2)
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Slide 32
- Slide 33
- Slide 34
- Slide 35
- Slide 36
- Slide 37
- Slide 38
- Slide 39
- Slide 40
- Slide 41
- Slide 42
- Slide 43
- Slide 44
- Slide 45
-