QI & PDSA for Public Health

Debra Tews, MAMichigan Dept. of Community HealthPPHC Pre-Session

Bay City, MI10/26/2010

Plan

DoStudy

Act

A brief overview of QI including PH definitions for Quality and QI

An intro to PDSA from Michigan’s Quality Improvement Guidebook

An intro to QI tools

Today’s Focus

What is Quality in Public Health?

“Quality in public health is the degree to which policies, programs, services and research for the population increase desired health outcomes and conditions in which the population can be healthy.”

Public Health Quality Forum

So How Can One Define Quality Improvement for Public Health?

Use of a deliberate and defined improvement process, such as Plan-Do-Check [Study]-Act, which is focused on activities that are responsive to community needs and improving population health. It refers to a continuous and ongoing effort to achieve measurable improvements in the efficiency, effectiveness, performance, accountability, outcomes, and other indicators of quality in services or processes which achieve equity and improve the health of the community.

Accreditation Coalition 2009

Why QI in Public Health?

QI Can:Reduce costs and

redundancyEliminate wasteStreamline

processesEnhance ability to

meet service demand Increase customer

satisfaction Improve outcomes

Tough Economic Times Require a

Different Approach!

Is it QI or is it QA?

Quality Improvement

GOES BEYONDQuality

Assurance!

Doing Both? QUALITYASSURANCE relates to Monitoring & Compliance.

It GUARANTEES quality.

Standards met? Deficiencies corrected?QA is . . . . . reactive!

QUALITY IMPROVEMENT relates to Learning & Improving.It RAISES quality.

Quality can’t always be assured. Ongoing efforts to identify opportunities for improvement are needed. QI relies on measurement & data-driven decisions to improve outcomes. QI is . . . . . proactive!

Principles of QIFrom the Public Health Memory Jogger

Pocket Guide of QI Tools:

Develop a strong customer focus

Continually improve all processes

Involve employees

Mobilize both data and team knowledge to improve decision making

Three Key Questions !!!1. What are we

trying to accomplish?

2. How will we know that a change is an improvement?

3. What changes can we make that will result in improvement?

Change Vs. ImprovementEdwards Deming: Of all changes observed, about 5% were improvements, the rest at best were illusions of progress!

To move beyond illusions of progress, a QI method (PDSA) and QI tools are needed.

Embracing Quality in Local Public Heath: Michigan’s QI Guidebook explains the PDSA method and suggests tools.

Snapshot: Plan-Do-Study-Act (PDSA)

Plan

DoStudy

Act

Some Common Tools of QI Process Mapping

Cause and Effect/Fishbone Diagrams

Five Whys

Run Charts

Pareto Charts

Check Sheets

Understand Your Process & Make Sense of Your Data!

QI: Assembling the Pieces Listen to LHD customers

Use data to make data-driven decisions

Continually improve processes in your LHD

Use recognized QI methods and tools

Work together; a team approach is best.

Ask the 3 Key Questions!

What Do Users Say?

“We now have staff eager to use the same tools/methods to evaluate performance and make improvements in other areas of our work” MLC-3 LHD

“The PH focus of the Guidebook helps with the application of QI methods; it becomes ‘real’ for participants . . . we can ‘look through our public health windows’” Allegan LHD

“For any PH agency interested in learning QI and how PH can apply these principles/methods, I would recommend they start with this Guidebook” Saginaw LHD

“The Guidebook has been a road map for our team as we navigate our way down this new path of improving our processes” MMDHD

“I refer to the Guidebook often

even though I know the steps”

MI Mentor

There’s More . . . “The Guidebook has been

incredibly useful for QI work, serving as the primary textbook for teaching QI throughout the department” MI Mentor

“The Guidebook helps with capacity building . . . it would not be possible to spread QI methodologies easily without it” Muskegon LHD

“The Guidebook is used in our QI meetings as an effective discussion and clarification tool; it generates comfort levels” Allegan LHD

“The Guidebook is the glue that holds

the whole effort together”

MI Consultant

QI Resources for Public Health

www.accreditation.localhealth.net and www.phf.org

Another Resource for QI Tools http://www.langfordlearning.com