Continuous Improvement: What Will it Take?

1
Continuous Improvement What Will it Take?

• Leadership commitment
• A new management
• model
• New skills
• Strategy

2
Core Principles ofManaging Quality

• Intention to improve
• Focus on customers
• Focus on process and system
• Proper use of measurement and statistics
• Involvement of everyone
• Continuous testing of changes
• On-going training
• Collaboration, valuing interdependency
• Key role of leaders

3
Pursuing ImprovementFive Guiding Question

• Who depends on you?
• What do they need?
• How do you know?
• How well are you meeting their needs?
• How do you know?

4
Alphabet Soup ofQ programs

• QA TQM QI
• 1970 1966 1970s
• QM PI
• 1990s 2000
• IOM (2002)
• Organizational clinical
• __________________________
• ISO 9000, Baldrige

5
Web sites

• IOM report To Err is Human
• (2002)
• Crossing the Chasm
• www.iom.edu
• www.brownspath.com
• www.ihi.org (success stories)
• www.qualityindicators.ahrg.gov
• www.fmeainfocentre.com/download_area.htm
• www.healthgrades.com
• www.ahima.org/convention
• __________________________
• Data Sets Comparative Data
• HEDIS, ORYX, OASIS Healthgrades.com
• (NCQA (JCAHO) LTC
• CMS)
• QUIC.gov (2002)

6
Definition of Quality

• Meeting the needs and exceeding the expectations
  of those we serve.
• Delivering all and only the care that the patient
  and family needs.

7
Quality A Strategic Necessity

• Cost escalation
• Variation in practice
• Standardize
• Purchaser dominance
• Issues of public trust
• Integrated systems and managed care
• New information systems

8
TAXONOMY OF QUALITY
Outcome
Process
Structure
Traditional Triad
-Avedis Donabedian
9
TAXONOMY OF QUALITY
Cost Efficiency
Clinical Quality
Service Quality
Community Needs
Newer Triad for Organizational
Performance
-Brent James
10

• Performance improvement is the integration of a
  customer-focused, continuous-improvement
  philosophy, analytical skills, people skills, and
  a structure and organization, within an internal
  and external culture affected by leadership

11
Categories and Point Value for the Malcolm
Baldrige National Quality Award Examination

• Leadership 120
• The way senior executives create and sustain
  corporate citizenship, customer focus, clear
  value, and expectations and promote quality and
  performance excellence
• Information Analysis 75
• Management and effectiveness of the use of data
  and information to support customer-driven
  performance and market excellence
• Strategic Planning 55
• The way the company sets strategic direction,
  how it determine plan requirements, and how plan
  requirements relate to performance management

12
Categories and Point Value for the Malcolm
Baldrige National Quality Award Examination

• Human Resource Development and Management 140
• Companys effort to develop and utilize the work
  and to maintain an environment conductive to full
  participation, continuous improvement, and
  personal and organizational growth
• Process Management 140
• Process design and control, including
  customer-focused design, product and service
  delivery, support services, and supply management
• Business Results 220
• Companys performance and improvement in key
  business areas (product, service, and supply
  quality, productivity, and operational
  effectiveness and related financial indicators)

13
Categories and Point Value for the Malcolm
Baldrige National Quality Award Examination

• Customer Focus and Satisfaction 250
• Companys knowledge of the customer, customer
  service systems, responsiveness to customer,
  customer satisfaction
• TOTAL POINTS 1000

14
Complaints Analysis Satisfaction Surveys Focus
Groups Request for Proposal
Understand customer need
Identify processes and Outcomes that
meet Customer need
Treating Disease Managing Health Service Quality
Appropriateness Review Peer Review Benchmarking Ou
tcomes Assessment
Assess performance compared with Professional
or best-of- Class standards
Structure, Process and Outcome Criteria Case Mix
Adjustment
Define indicators to measure performance
Establish performance expectations
Monitor performance and compare with expectations
Profiling, Report Cards
Provide feedback to Providers and customers
Practice Guidline Case Management QI Teams
Implement improvements