Improving quality of Care for Older adults, by Vera Sverdlovsky (MD, PhD, MHA), as presented within the 2018 GWEP January Symposium.

1. Vera Sverdlovsky, MD, PhD, MHA
UCSDGWEP

2.  With people living longer lives and elderly
populations growing rapidly, health care for
seniors is of growing importance both in the
United States—where more than 40 percent
of health care spending goes toward
individuals 65 or older—and across the globe..

3.  Quality of care differs widely between different
types of care or conditions.
▪ Preventive care suffers the most. Providers give
diagnostic and treatment procedures most frequently.
▪ Care is worse for geriatric conditions (e.g., incontinence,
falls) than for conditions that affect all adults (e.g.,
hypertension).
▪ Physicians often fail to prescribe recommended
medications for elderly patients.

4.  Continuous improvement, sometimes called
continual improvement, is the ongoing
improvement of products, services or
processes through incremental and
breakthrough improvements.

5.  Among the most widely used tools for
continuous improvement is a four-step
quality model—the plan-do-check-act
(PDCA) cycle, also known as Deming Cycle or
ShewhartCycle
 Six Sigma, Lean, andTotal Quality
Management — emphasize employee
involvement and teamwork; measuring and
systematizing processes; and reducing
variation, defects and cycle times.

6.  Lean Six Sigma focuses on eliminating
defects. In healthcare, a defect can be the
difference between life and death.
 Use Lean Six Sigma to improve patient
safety by eliminating life-threatening errors.

7.  Lean and Lean Six Sigma applications in
healthcare require an understanding of how
the tools and methodologies translate to the
people-intensive processes of patient care.
Once applied, the possibilities are endless.

8.  Lean
Eliminate non-value-added activities and
waste. Save time and money.
 Lean Six Sigma
Increase patient satisfaction and reduce
errors by improving your processes.

9.  Using Lean Six Sigma, Morton Plant Hospital
in Clearwater, FL, improved patient
satisfaction over 50%, reduced emergency
department length of service by 21%, and
recovered over $4 million in cost of quality.

10.  Flow Chart
 Cause-and-Effect Diagram
 Check Sheet
 Histogram (Chart)
 Pareto Chart
 Control Chart
 Scatter Diagram

11.  Empower participants to excel in Quality
improvement and problem solving by
demonstrating the ability to tackle common
problems and show success
 Enable participants to utilize QI (Quality
Improvement) tools through practical
applications to facilitate improvements

12.  Symposia
 Clinical Geriatrics Interprofessional
Symposium
 Wound CareWorkshop
 Technology and Innovation in Medicine
 Publications
 RCQI (RapidQuality Cycle Improvement)
 Influenza Immunization
 Fall prevenion
 Interprofessional Geriatric
Education
 GWEP Scholars
 GWEP Fellows
 Healthcare Community
 Caregivers
 Falls Prevention
 Reduction of high risk medication use
in the Elderly
 Caregiver resource education
(Subaward)
 Text Book Series
 Technology in Aging
 Homeless Geriatrics
 Latino Geriatrics
 Augmented Reality for Geriatric
Education
 UCSD Engineering Collaboration -
Hololens
 http://gwep.cloud.ucsd.edu/
 http://slideshare.net/sdgwep
 #sdgwep

13.  Understand the basic concepts and value of
QI/CI methodologies.
 Apply specific concepts learned to real-world
project ideas from participants
 Characterize the importance of data analysis
and metrics definition for successfully
executing improvement initiatives

14.  Training and facilitation provided by Black
and Green Belt Lean Six Sigma Quality
Improvement Specialists

15.  Problem solving fundamentals training
 Project selection
 Problem definition and primary metric
selection
 Data collection and analysis
 Current state map/ Identifying opportunities
for improvement and create solutions to the
opportunities

16.  Action plan and a pilot plan.
 Project review
 Implementation pilot results
 Project review
 Standardize and sustain
 Project review
 Final presentation & certificate

17.  Reducing the number of ER visits and
readmission rates
 Improving Dialysis treatments availability
 Reducing hyperglycemia, complications
(dialysis, retinopathy, ..) from uncontrolled
diabetes
 Improve effectiveness of theWound care
rounds
 Falls prevention and reduction

18.  ASQ ,
http://asq.org/healthcaresixsigma/lean-six-
sigma.html
 RAND Health,
https://www.rand.org/capabilities/solutions/i
mproving-health-care-quality-for-vulnerable-
elders.html

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