Lostinnocenceyoucouldexploreachildsoldierwhohasbeen.docx

Lost innocence: you could explore a childsoldier
who has been recruited by
Boko Haram and is being forced to kill
for the first time.You could then subtly
allude to Gothicismand Romanticism through
descriptions of location/setting
(I.e. The fog is rolling into the village at dusk in
a remote Nigerian village,
violent screams can be heard in the background,
nature is protesting through
the groans of the forest).
Responsibility and abandonment: you could explore a
mother who is struggling
with the decision to abandon her baby. This could
be set in eerie 1800s London
(I.e. Like Oliver Twist) or it could be in
modern China (in a society where only 1
childwas allowed, infanticide was quitecommon. Female
babies would be
killed as only male children were desired)
Fascination with the sublime: The character is a
grave robber in Ancient Egypt
who is fixated on collecting the sublime gold
artefacts hidden awayin the
Pharaoh’s tombs…but thereare risks with doing this
sort of stuff…
Pursuit of dangerous knowledge: You could create
a dystopian narrative where

the character’s town is destroyed by an atomic
bomb. Maybe an air-raid siren
has just gone off (to warn of an impending bomb)
and the character knows
they won’t make it out alive in time.They only
have just enough time to reflect
on the cruelty of atomic warfare and cuddle
their children goodbye.
Society’s preconcieved notions of beauty: you could
explore an outcast ‘ugly'
character (like the Hunchback of Notre Dam)
and how this spawns hatred
within them.
Copyright © 2018 Foundation of the American
College of Healthcare Executives. Not for sale.
Introduction to Healthcare
Quality Management
Continuous Improvement

• Analyzing performance of various processes and
improving them repeatedly to achieve quality
objectives
– Some performance problems can be resolved quickly,
but in other situations an in-depth evaluation may be
required.
The Improvement Step
• Find and fix the cause of
unfavorable performance.
• Two factors influence the
decision to initiate improvement:
– Results of performance assessment
– Improvement priorities
Measurement
How are we
doing?

Assessment
Are we meeting
expectations?
Improvement
How can we improve
performance?
Yes
No
Common Steps of Performance
Improvement
1. Define the improvement goal
2. Analyze current practices
3. Design and implement improvements
4. Measure success

Improvement Models
• Walter A. Shewhart
• W. Edwards Deming
Act Plan
Check Do
See Exhibit 5.4 PDSA Improvement Project on page 119
Improvement Models
Rapid Cycle Improvement
Improvement Models
FOCUS-PDCA FADE

Improvement Models: Lean
• Lean: Eliminate inefficiencies adversely
affecting performance.
• Lean’s project goal is to minimize waste.
Five Lean Principles
1. Specify
Value
2. Identify
value
stream
3. Flow4. Pull
5.
Perfection
& eliminating
waste

Define and
understand the
process that
creates value for
the customer
Create smooth and
continuous development
of value though out the
process
Produce only what
the customer is
demanding, when
they demand it
Relentlessly
eliminate waste
from the value
stream
Define value from the customers

perspective
House of Lean
Process management
Stable & capable processes
Standardised methods
Eliminate Waste
Just In
Time
Jidoka
Quality Cost Delivery & Agility
Deliver
exactly what
the customer
wants, when
they want it

with minimal
waste
Detect &
resolve
abnormalities
that threaten
quality and
delivery
Types of Waste (Muda)
• Movement
• Waiting
• Overprocessing
• Defects
• Inventories
• Transportation

• Design
• Overproduction
Exercise Process Thinking and Waste
Purpose This exercise focuses on process thinking and the types
of
waste in a process
Silent reflect on
your own
(4 minutes)
Individually, respond to the following question:
What are the most prevalent types of waste (Muda) in a
process (or activity) that you are very familiar with?
Group
discussion
In group, select one of these processes, list the steps of this
process and identify1-3 types of waste for every step in the

process (20-25).
1. Performance problem identified
2. Evaluate current work processes
3. Identify areas of opportunity
4. Find root causes of problems
5. Design better way of working
6. Create implementation plan
7. Identify expected improvements
8. Make process changes and measure results
Lean Project Steps
Lean Improvement Techniques
• 5S Methodology

• Kanban
• Mistake-proofing
• Value stream map
• Visual control
The 5S Methodology
Reduce waste
Maintain and
continually
improve the
workplace
1
2
3
4
5

Sort
Straighten
Sanitize
Standardize
Sustain
Separate unnecessary from
necessary items
Designate a place for all
necessary items
Create written and visual
standards to help
maintain 5S
Implement systems to monitor
standards
Make 5S part of the company culture
Clean the work area

Improvement Models: Six Sigma
• Six Sigma: Reduce performance variability
– Goal: Create processes that operate within Six
Sigma quality.
– The higher the sigma level, the lower the defect
rate.
• 1 sigma = 32% defect rate
• 2 sigma = 5% defect rate
• 6 sigma = 99.999% defect free (near perfect)
What is Sigma?
deviation from mean value, an indicator of the degree of
variation in a set of a process.
a given process deviates from
perfection. For example, the following 2 sets of data have
same mean but different sigma:

Which set of data is more spread out?
What is Six Sigma?
• A highly disciplined (or structured) improvement methodology
that enables organizations to deliver better or nearly perfect
products and services.
• It is a Quality Philosophy and the way of improving
performance
by knowing where you are and where you could be.
• A methodology to measure and improve company’s
performance,
practices and systems
DMAIC – Six Sigma Project

Methodology
1. Define
2. Measure
3. Analyze
4. Improve
5. Control
Define
• Describe the problem in operational terms
• Drill down to a specific problem statement
(project scoping)
• Identify customers and CTQs, performance
metrics, and cost/revenue implications

Measure
• Understand causal relationships between
process performance and customer value.
Y = f(X)
where Y = customer CTQs and X represents critical
input variables that influence Y
Data Collection Issues
• What questions are we trying to answer?
• What type of data will we need to answer
the question?
• Where can we find the data?
• Who can provide the data?
• How can we collect the data with minimum
effort and with minimum chance of error?

Analyze
• Focus on why defects, errors, or excessive
variation occur
– Experimentation and verification to verify
Y = f(X) relationships
Improve
• Improve the X variables so as to improve Y
– Idea generation
– Brainstorming
– Evaluation and selection
– Implementation planning

Control
• Maintain improvements
–Standard operating procedures
–Training
–Checklist or reviews
–Statistical process control charts
Improvement Models:
Lean Six Sigma
Lean Six Sigma: Eliminate waste and reduce
process variation
Performance Improvement
Models

• Organizations don’t choose one approach
to the exclusion of the others.
• The approach most likely to achieve
improvement goals for a particular project
is used.
• Various improvement models
are used to improve healthcare
quality.
• The different models share a
common thread of analysis,
implementation, and review.
Measurement
How are we
doing?

Assessment
Are we meeting
expectations?
Improvement
How can we improve
performance?
Yes
No
Practicum: Applying Process Improvement Models
Choose a process improvement model from Chapter 5 in the
Spath textbook, and apply this model to your practice problem.
By Day 4
Post a Discussion entry describing the model that you selected
and how each step of the model will be used to develop the plan
for the Practicum Project. Continue to collaborate with the
selected individuals in your practice environment as needed in
the development of the Practicum Project, and share this
information with your group.
By Day 7
Read and respond to two or more of your colleagues’ postings
from the Discussion question. Provide feedback on the selected
model, and offer other models if appropriate for their project.
As a member of a community of practice, help each other refine
and clarify the patient-centered Practicum Project.
The process improvement model chosen is the plan-do-study-act
(PDSA) cycle. The PDSA cycle is the most widely recognized

process improvement model (Spath, 2013). The design of the
model is to ensure continuous improvement, as the steps cycle
and repeat (Spath, 2013). I feel that this model is best for fall
prevention in long-term care because there are always constant
changes and using a model like the PDSA will help to
incorporate and address the changes as they come.
Plan- Patient falls will be reduced as a result of implementing a
fall prevention plan in the facility. A fall prevention committee
will be formed consisting of stakeholders who represent the
broad range of organizational members. Providing the weekly
fall information discussed in the risk meetings to all facility
employees and families to keep them informed. Ensuring that
fall risk assessments scores are provided to frontline staff and
that they are educated on patient-centered fall prevention
measures. Lastly, implementing interdisciplinary hourly
rounding throughout the facility.
Do- Form the fall prevention committee that will consist of staff
nurses, certified nursing assistants (CNA), physical therapists,
occupational therapist, physicians, nurse practitioners,
dieticians, environmental services managers, pharmacist, and
risk managers. Weekly risk meetings will continue in the
facility, but members of the fall prevention committee will also
be present.
A fall report will be provided to all facility staff weekly,
families of affected residents will be provided the outcome that
week as well, and monthly reports provided to department heads
to disperse to their staff. Fall risk scores will be made available
to frontline nursing staff by placing it in the resident’s
medication administration record and the care tracker for
certified nursing assistants.
Lastly, create and enforce hourly rounding protocols that are
facility-wide and conducted by all staff to help address
resident’s needs to help prevent falls.
Study- Analyze the fall rates from the facility incident reports
to determine if the changes made have been effective in
reducing falls. Collect information from the fall prevention

committee, facility staff, including frontline nurses and CNAs,
families, and residents to determine if the changes have been
effective in preventing falls. Also get feedback on the hourly
rounding to help determine what was found as resident’s needs
that could have led to falls. Summarize the lessons learned after
implementing the fall prevention plan in the facility.
Act- Evaluate if the fall prevention plan in the facility was
successful, if not make changes where appropriate. If the
changes were successful, fine-tune them to make the changes
even better.
Reference
Spath, P. (2013). Continuous improvement. In Introduction to
healthcare quality
management (2nd ed.). (pp. 117-119). Chicago, IL: Health
Administration Press.
Bottom of Form
Unit:
The Power of Gothic
Instrument:
8
Item and assessment technique:
Written Task: Narrative – Short Story
Dimensions:
1. Understanding and responding to contexts
2. Understanding and controlling textual features
3. Creating meaning
Areas of study:
Past Worlds
Other information:
Summative Assessment Task
Context:

In this unit you have extended your understanding of how fear
and suspense is constructed in texts by reading, viewing and
responding to literary and non-literary Romantic Gothic texts.
You have interpreted, analysed and evaluated Mary Shelley’s
Frankenstein or the Modern Prometheus, paying particular
attention Shelley’s use of language and textual features when
constructing Frankenstein’s creature.
Task:
You are to create an engaging narrative using a theme from
Mary Shelley’s Frankenstein or the Modern Prometheus as
stimulus. You will need to draw on the thematic and intertextual
connections within the text to influence your audience whilst
using the relevant narrative structure and aesthetic features such
as figurative language.
Possible themes include:
- The pursuit of dangerous knowledge - Society’s
preconceived notions of beauty
- Fascination with the sublime - Responsibility
and abandonment
- Lost innocence
Genre and purpose:
Narrative/Short story (to create mood and atmosphere; to
entertain; to make a social comment)
Field (Subject matter):
Your narrative must include:
· 3rd person, past tense narration
· Few characters
· Appropriate short story structure
· Allusions to texts such as Milton’s Paradise Lost, Prometheus,
and Dante’s Inferno
· Vocabulary, grammar, sentence structure, paragraphing and
punctuation for purpose
· Use aesthetic features for purpose such as:

Tenor (Roles and relationships):
Student writer to teacher
CCEs
Creating/composing/devising; Using vocabulary appropriate to a
context; Structuring/organising extended written text;
Interrelating ideas/themes/issues.
Mode and medium:
Word processed and emailed to your teacher or printed and
submitted – at your teacher’s discretion
Conditions:
Length: 800 – 1200 words
Preparation Time: You will have 4 weeks notice of task. You
will have 4 lessons of class time in which to write a plan and a
draft. You will need to use home time as well.
Access to Resources: unlimited access to resources; access to
one draft due during Week 5.

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