Steps for a successful service improvement exercise in health establishments.

1. AL TABABA
TRAINING
SERIES
Steps for Successful Ser vice Improvement

2. Service Improvement
THE STEPS (IN THEIR CORRECT ORDER!)

4. Steps for Successful Service Improvement
1
• Leadership declaration that the organization is adopting a new code of
practice and all employees are the change agents
2
• Create a sense of urgency “emotionally” with a clear vision of the end
results or goals by the Leaders: Engagement Strategies
3
• Create Change managers/Change teams with expert and respected leaders:
The Knowledge Translation or Quality Improvement Team
4
• Identify and prioritize the areas were change is needed based on a needs
assessment survey.

5. Steps for Successful Service Improvement
5
• Assess the barriers for improvement e.g. organizational such as poor
training programs or individual e.g. unmotivated staff using a readiness
assessment tool.
6
• Create competent trainers to train staff on the new interventions.
7
• Create Monitoring Teams with a “Reward System in place”.

6. The Steps: Step 1
The first and TOP RATED step is:
Leadership declaration that the organization is adopting a
new code of practice and all employees are the change
agents.
http://journal-dl.com/downloadpdf/591088333fbb6e13743edfa9

7. The Steps: Step 2
The second step is:
Create a sense of urgency “emotionally”: “a mother of 5
just died because of poor service! with a clear vision of the
end results or goals by the Leaders: Engagement Strategies
Be the Catalyst!

8. Set direction from the top and engage people below!

11. Engagement Strategies
 Discover common purpose
improve patient outcomes, reduce hassle and wasted time
 Create partnerships
Physician not contractor; hospital not supplier/controller
Share responsibility with individual and system of patients
 Involve physicians early
 Work with medical leadership
Division director, Chair MAC, Physician in chief
 Identify/ be a champion
find/ be a vocal believer, consider making/ being project lead

12. Engagement Strategies
 Standardize/ protocolize evidence
Start with aspects that are agreed upon with evidence
 Use (local) data to drive change
use aggregate data to show change is needed
use meaningful/ agreed upon quality indicators
 Make the right thing easy to try
involve MDs in PDSA/ reliability tests
 Make the right thing easy to do
avoid plans that add more work for MDs or others
 Make physician involvement visible

13. Doeshigherphysicianinvolvementimproveservicequality?

16. The Steps: Step 3
The third step is: Improvement TEAM
Create Change managers/Change teams with expert and
respected leaders: Enroll Charismatic Figures
The Knowledge Translation or Quality Improvement Team

17. The Steps: Step 4
The Fourth step is:
Identify and prioritize the areas were change is needed
based on a needs assessment survey.

18. The Steps: Step 5
The Fifth Step
Assess the barriers for improvement e.g. organizational such
as poor training programs or individual e.g. unmotivated
staff using a readiness assessment tool.
Assessment Tools:
AHRQ survey tool to assess leaders' perspectives on organizational readiness:
https://www.ahrq.gov/professionals/systems/hospital/qitoolkit/index.html
Organizational Readiness to Change Assessment (ORCA):
http://ibr.tcu.edu/wp-content/uploads/2013/10/ORC-SA-sg.pdf

19. The Steps: Step 6
The Sixth Step:
Create competent trainers to train staff on the new
interventions.

20. The Steps: Step 7
The Seventh Step:
Create Monitoring Teams- NO Monitoring: Guaranteed
Failure! with
a “Reward System in place”-Make it a Pleasurable Change!

21. The Steps: Step 7-Incentives to improve staff
compliance
◦ Spot-checks
◦ Recognize Success/Make it Visible: Financial or Material incentives.
◦ Conference/Travel reimbursements
◦ Recognition/Accreditation Certificates: Champions/Employee-of-the
Month/Pathway Implementer Certificates etc.
◦ Unit League-tables-best &worst!
◦ Protection against Litigation.
Incentify your Workforce: Happiness at work!

23. What is NEXT?
•Try it out!

24. Please visit and subscribe to
altababa.org