This document provides an overview of knowledge acquisition for health care process analysis and redesign. It discusses the goals of knowledge acquisition as eliciting and documenting workflow information about clinical practices to improve patient care through leveraging technology. It also covers different categories of knowledge, including internal/external and coded/tacit knowledge, and how knowledge impacts organizations according to the Capability Maturity Model levels. The importance of knowledge acquisition is that clinicians and IT professionals have different types of knowledge, so acquiring knowledge about clinical workflows is necessary for computers to work effectively in healthcare settings.
This document provides an overview of quality improvement methods for healthcare settings. It describes strategies for quality improvement, including the role of leadership in creating a culture that supports quality improvement. The document discusses concepts like the PDSA cycle and foundations of quality improvement developed by thinkers like Shewhart, Deming, and Juran. The goal is to introduce methods that can be used to identify and redesign processes, collect and analyze data, and make improvements to eliminate problems and strategically change healthcare systems over time.
Case management: What it is and how can it be implemented?The King's Fund
Nick Goodwin introduces our new paper on case management, evaluating practical examples and considering how it can help establish integrated health and social care.
Escalating healthcare costs, heightened awareness of medical errors, and a higher-than-ever number of insured Americans have drawn attention to the need for quality improvement in US healthcare. Today, many efforts around patient outcomes and safety, care coordination, efficiency, and cost-cutting are underway and care redesign initiatives are being evaluated to guide future healthcare quality improvements. The following tips may aid you in your healthcare improvement efforts.
Knowledge translation model, tools and strategies for successImad Hassan
The document discusses knowledge translation (KT), which refers to closing the gap between what is known from research and what is practiced. It notes several barriers to KT, including organizational, professional, and social barriers. The document then provides a framework for KT, outlining five essential components: using evidence-based knowledge, implementing change tools scientifically, employing process change skills, redesigning systems, and developing KT competency training for healthcare staff. It emphasizes that both individual and organizational factors must be addressed for successful KT.
Quality improvement projects and research aim to systematically improve healthcare quality and outcomes. They both focus on: patients, using a team approach, and applying data to processes. While projects target local improvements, research develops generalizable knowledge. Together they advance evidence-based practice and disseminate solutions through peer-reviewed resources.
Team health presentation to advisory commmittee 9 february 2012HealthXn
This document summarizes the proceedings of a Team Health Advisory Committee meeting on improving teamwork, communication, and collaboration in healthcare. It discusses three key initiatives:
1) Transition to Work in Health program for final year students to build core skills. Pilots show promise and evaluation is ongoing.
2) Foundational Skills modules for new graduates, covering topics like handovers, escalating care, and roles. Ten topics were identified and modules are in development.
3) Building High Performing Teams program to facilitate improvement initiatives within clinical teams using a network of facilitators. A phased implementation was proposed targeting several health districts. Feedback on the plan was requested.
Journal Club Presentation on The Importance of Leadership in Preventing Healt...Sonali Shah
Leadership plays a key role in preventing healthcare-associated infections. Through interviews at multiple hospitals, the study found that effective leaders in infection prevention displayed behaviors like vision, knowledge, and strong communication skills. While senior executives can be leaders, the study observed that roles like epidemiologists, nurses, and quality managers also demonstrated transformational leadership through inspiring staff and cultivating a culture of clinical excellence. The findings suggest leadership broadly defined and at different levels contributes significantly to hospitals' ability to implement infection control practices.
This document provides an overview of quality improvement methods for healthcare settings. It describes strategies for quality improvement, including the role of leadership in creating a culture that supports quality improvement. The document discusses concepts like the PDSA cycle and foundations of quality improvement developed by thinkers like Shewhart, Deming, and Juran. The goal is to introduce methods that can be used to identify and redesign processes, collect and analyze data, and make improvements to eliminate problems and strategically change healthcare systems over time.
Case management: What it is and how can it be implemented?The King's Fund
Nick Goodwin introduces our new paper on case management, evaluating practical examples and considering how it can help establish integrated health and social care.
Escalating healthcare costs, heightened awareness of medical errors, and a higher-than-ever number of insured Americans have drawn attention to the need for quality improvement in US healthcare. Today, many efforts around patient outcomes and safety, care coordination, efficiency, and cost-cutting are underway and care redesign initiatives are being evaluated to guide future healthcare quality improvements. The following tips may aid you in your healthcare improvement efforts.
Knowledge translation model, tools and strategies for successImad Hassan
The document discusses knowledge translation (KT), which refers to closing the gap between what is known from research and what is practiced. It notes several barriers to KT, including organizational, professional, and social barriers. The document then provides a framework for KT, outlining five essential components: using evidence-based knowledge, implementing change tools scientifically, employing process change skills, redesigning systems, and developing KT competency training for healthcare staff. It emphasizes that both individual and organizational factors must be addressed for successful KT.
Quality improvement projects and research aim to systematically improve healthcare quality and outcomes. They both focus on: patients, using a team approach, and applying data to processes. While projects target local improvements, research develops generalizable knowledge. Together they advance evidence-based practice and disseminate solutions through peer-reviewed resources.
Team health presentation to advisory commmittee 9 february 2012HealthXn
This document summarizes the proceedings of a Team Health Advisory Committee meeting on improving teamwork, communication, and collaboration in healthcare. It discusses three key initiatives:
1) Transition to Work in Health program for final year students to build core skills. Pilots show promise and evaluation is ongoing.
2) Foundational Skills modules for new graduates, covering topics like handovers, escalating care, and roles. Ten topics were identified and modules are in development.
3) Building High Performing Teams program to facilitate improvement initiatives within clinical teams using a network of facilitators. A phased implementation was proposed targeting several health districts. Feedback on the plan was requested.
Journal Club Presentation on The Importance of Leadership in Preventing Healt...Sonali Shah
Leadership plays a key role in preventing healthcare-associated infections. Through interviews at multiple hospitals, the study found that effective leaders in infection prevention displayed behaviors like vision, knowledge, and strong communication skills. While senior executives can be leaders, the study observed that roles like epidemiologists, nurses, and quality managers also demonstrated transformational leadership through inspiring staff and cultivating a culture of clinical excellence. The findings suggest leadership broadly defined and at different levels contributes significantly to hospitals' ability to implement infection control practices.
Sills MR. Overview of the SAFTINet Program. Presented to the Emergency Department Research Committee, Department of Pediatrics, University of Colorado School of Medicine. 6 January 2015.
Team Health Right Start presentation 27 February 2012byersd
The document outlines plans for the Team Health 'Right Start' initiative which aims to improve teamwork, communication and collaboration in healthcare. It discusses:
- Past projects that provided training to final year students and new graduates to build core skills. Evaluation found these improved work self-efficacy and attitudes towards collaboration.
- Future plans to develop training modules for new graduates over 2 years and roll out training to existing clinical teams, with a focus on high-risk clinical/communication issues.
- The training will be evaluated and refined as it is implemented more broadly across healthcare networks and facilities.
The document discusses a forum aimed at showcasing educational resources and facilitating networking from Team Health's 'Right Start' initiative to improve collaboration. It provides an overview of the 'Right Start' program which includes transition support for final year students, training for new graduates, and building high-performing clinical teams. Initial evaluations found the program improved participants' work self-efficacy and comfort with interprofessional collaboration. The organizers outlined next steps such as developing online modules and mapping training to national standards to expand the program.
The power of tailored messaging: Preliminary results from Canada’s first tria...Health Evidence™
This study evaluated different knowledge transfer strategies to promote evidence-informed decision making in public health units across Canada. Preliminary results found that providing targeted summaries of systematic reviews was more effective than knowledge brokering or a control in promoting evidence use. Qualitative findings also suggested knowledge brokering had a positive impact. However, the study results were unclear and more research is needed to fully understand how to effectively support evidence-informed decision making in public health organizations over the long term.
MEDICal REsearch Support is a scientific, post graduate, international, life long learning, medical education and publication program for health care professionals aiming to support medical research by ‘Evidence Based Medicine and Medical Decision Making’ tools, especially Biostatistics.
Quality improvement is integral to the practice of medicine. Sometimes, QI strays over into clinical research. This presentation provides an overview of the intersection between QI and research
1. The document discusses leadership and administration in patient safety. It outlines national and international goals for patient safety including reducing medical errors and healthcare associated infections.
2. India's National Patient Safety Implementation Framework aims to improve structural systems and establish a culture of safety. It includes objectives like ensuring a competent workforce and preventing infections.
3. Successful leadership in patient safety involves creating a culture that prioritizes safe, high-quality care and supports improvement efforts through resources, training and removing obstacles for clinicians.
The document describes a curriculum at The Ohio State University College of Medicine called the Lead Serve Inspire Curriculum (LSI) which aims to develop competency in healthcare quality improvement and patient safety. It consists of three parts, with Part 1 focusing on clinical foundations, Part 2 on clinical applications, and Part 3 containing the Health Systems, Informatics, and Quality (HSIQ) project. The HSIQ project is a longitudinal experience where students work in groups on value-creation projects around cost-conscious care, patient experience, and identifying systems failures. They apply a process improvement methodology to propose, implement, and measure interventions. The document discusses lessons learned and challenges in engaging students and assessing competency in quality improvement and patient
This document outlines Manitoba's provincial patient-reported measurement strategy. It defines patient-reported measures and their role in patient-centered care. The strategy was developed with input from patients and the public. A provincial advisory committee with patient representatives was formed. Consultations ensured cultural and linguistic appropriateness. Valid and reliable tools will be selected and data collected electronically to integrate with health records. Results will be reported back clearly to enhance care and be understood by patients and clinicians.
Sally Redman | Early findings from SPIRITSax Institute
Professor Sally Redman AM, CEO of the Sax Institute, recently addressed a CIPHER forum to share how the SPIRIT trial is testing a program designed to increase the use of research in policy and programs.
CIPHER, the Centre for Informing Policy in Health with Evidence from Research, is an Australian collaborative research centre managed by the Sax Institute, that is investigating the tools, skills and systems that might contribute to an increased use of research evidence in policy.
For more information visit www.saxinstitute.org.au.
This document provides a step-by-step process for improving care delivery through collaborative learning. It outlines the Planned Care Model for redesigning care delivery and the Model for Improvement for testing changes. The 7 steps include: 1) familiarizing the care team with these models, 2) organizing roles, 3) adopting guidelines, 4) understanding patient needs, 5) choosing measures, 6) planning care, and 7) supporting patient self-management. Changes are tested with individual patients and successful changes are implemented for all patients.
The document describes the Association of Clinical Coordination and Research Management (ACCRM), which aims to enhance clinical research processes, establish a community for clinical research professionals, and recognize and develop the clinical research workforce. It provides resources like educational programs, tools, training, professional development opportunities, and a sense of community to help members advance their careers in clinical research.
his is the first in a series of interactive webinars designed to build capacity in the basic principles of knowledge translation and implementation science.
WATCH-ON DEMAND: https://goo.gl/hnp8gi
Integrated primary and behavioral healthcare aims to provide comprehensive treatment that addresses both physical and mental health needs. It can range from parallel care to fully integrated care within a single system. Fully integrated care is associated with improved health outcomes for patients with severe mental illness, who otherwise experience high rates of preventable medical conditions and die 25 years earlier on average than the general population. The Integrated Treatment Tool is a 30-item evaluation developed by the Center for Evidence Based Practices to assess the level of integration across organizational structure, treatment approaches, and care coordination across settings.
The document discusses various approaches to quality improvement in healthcare, including Six Sigma, Total Quality Management (TQM), and the FADE model. Six Sigma uses statistical methods and aims for near-zero defect rates. TQM takes a customer-focused approach to continuous process improvement through methods like scientific problem-solving and participation at all levels. The FADE model outlines five steps for quality improvement projects: focus, analyze, develop, execute, and evaluate. Microsystems thinking views individual care units as the building blocks for organizational outcomes.
The document discusses knowledge translation (KT), which involves closing the gaps between research knowledge and practice. KT includes disseminating research findings to relevant audiences and facilitating their implementation. Effective KT requires understanding user needs, tailoring knowledge tools and activities, addressing barriers, and evaluating impact on outcomes. Key aspects of KT include knowledge synthesis to integrate evidence, dissemination to communicate findings, and implementation efforts to promote adoption into practice or policy.
This document summarizes Bea Brown's scholarship objectives and learnings from a study tour related to implementation research. The objectives were to develop skills in implementation strategies, evaluation of quality programs, and strengthening relationships between the Sax Institute and international experts. Key lessons learned included the importance of organizational readiness, clinician involvement, and routine implementation. This directly informed the development of an implementation trial in cancer care.
The University of Michigan Medical School established the Patient Safety and Quality Leadership (PASQUAL) Scholars Program to create a community of clinical partners who can effectively collaborate with engineers and safety professionals to improve patient safety and quality of care. The program provides faculty and staff an 8-month curriculum covering quality improvement, patient safety, leadership, teaching and scholarship. Scholars identify an existing or new quality/safety project and work in interprofessional teams. Graduates are well positioned to lead quality/safety initiatives and collaborate with engineering professionals to positively impact healthcare outcomes.
Advancing the Methods of Evaluation of Quality and Safety Practice and Educa...Daniel McLinden
Improving healthcare in an organization requires individuals with the capability to design, test and implement improved processes in an organization with the capacity to support the scale and spread of improvement. If improvement capability is not widespread in the workforce then an intervention is needed to create the capability. In response to this challenge, Cincinnati Children’s designed and implemented a comprehensive Improvement Science curriculum to build capability. The program has achieved measurable improvements in both process and outcome measures of patient care and business processes. Incorporating unique design principles, this intervention served as a catalyst for quality transformation.
In this workshop we will share our perspective and provide examples with data that illustrates:
• Building support and buy-in through the design of participant selection.
• Creating an intervention to build capability that includes training but involves more than training.
• A comprehensive model based on competencies
• Expanding the four-level Kirkpatrick model evaluation with additional levels that encompass economic impact and network impact.
• Using self-assessment to evaluate learning outcomes.
Webinar on Quality Improvement Strategies in a Team-Based Care Environment CHC Connecticut
Building a quality improvement (QI) infrastructure within team-based care is an organizational strategy that will establish a culture of continuous improvement across departments and improve quality in all domains of performance. Many positions in primary care now require QI training as part of employees' professional development.
Our expert faculty discuss tools you can use to build and implement a QI infrastructure within your team-based setting to improve patient care.
Panelists:
• Deb Ward, RN, Senior Quality Improvement Manager, Community Health Center, Inc.
• Kathleen Thies, PhD, RN, Consultant, Researcher, Weitzman Institute
Sills MR. Overview of the SAFTINet Program. Presented to the Emergency Department Research Committee, Department of Pediatrics, University of Colorado School of Medicine. 6 January 2015.
Team Health Right Start presentation 27 February 2012byersd
The document outlines plans for the Team Health 'Right Start' initiative which aims to improve teamwork, communication and collaboration in healthcare. It discusses:
- Past projects that provided training to final year students and new graduates to build core skills. Evaluation found these improved work self-efficacy and attitudes towards collaboration.
- Future plans to develop training modules for new graduates over 2 years and roll out training to existing clinical teams, with a focus on high-risk clinical/communication issues.
- The training will be evaluated and refined as it is implemented more broadly across healthcare networks and facilities.
The document discusses a forum aimed at showcasing educational resources and facilitating networking from Team Health's 'Right Start' initiative to improve collaboration. It provides an overview of the 'Right Start' program which includes transition support for final year students, training for new graduates, and building high-performing clinical teams. Initial evaluations found the program improved participants' work self-efficacy and comfort with interprofessional collaboration. The organizers outlined next steps such as developing online modules and mapping training to national standards to expand the program.
The power of tailored messaging: Preliminary results from Canada’s first tria...Health Evidence™
This study evaluated different knowledge transfer strategies to promote evidence-informed decision making in public health units across Canada. Preliminary results found that providing targeted summaries of systematic reviews was more effective than knowledge brokering or a control in promoting evidence use. Qualitative findings also suggested knowledge brokering had a positive impact. However, the study results were unclear and more research is needed to fully understand how to effectively support evidence-informed decision making in public health organizations over the long term.
MEDICal REsearch Support is a scientific, post graduate, international, life long learning, medical education and publication program for health care professionals aiming to support medical research by ‘Evidence Based Medicine and Medical Decision Making’ tools, especially Biostatistics.
Quality improvement is integral to the practice of medicine. Sometimes, QI strays over into clinical research. This presentation provides an overview of the intersection between QI and research
1. The document discusses leadership and administration in patient safety. It outlines national and international goals for patient safety including reducing medical errors and healthcare associated infections.
2. India's National Patient Safety Implementation Framework aims to improve structural systems and establish a culture of safety. It includes objectives like ensuring a competent workforce and preventing infections.
3. Successful leadership in patient safety involves creating a culture that prioritizes safe, high-quality care and supports improvement efforts through resources, training and removing obstacles for clinicians.
The document describes a curriculum at The Ohio State University College of Medicine called the Lead Serve Inspire Curriculum (LSI) which aims to develop competency in healthcare quality improvement and patient safety. It consists of three parts, with Part 1 focusing on clinical foundations, Part 2 on clinical applications, and Part 3 containing the Health Systems, Informatics, and Quality (HSIQ) project. The HSIQ project is a longitudinal experience where students work in groups on value-creation projects around cost-conscious care, patient experience, and identifying systems failures. They apply a process improvement methodology to propose, implement, and measure interventions. The document discusses lessons learned and challenges in engaging students and assessing competency in quality improvement and patient
This document outlines Manitoba's provincial patient-reported measurement strategy. It defines patient-reported measures and their role in patient-centered care. The strategy was developed with input from patients and the public. A provincial advisory committee with patient representatives was formed. Consultations ensured cultural and linguistic appropriateness. Valid and reliable tools will be selected and data collected electronically to integrate with health records. Results will be reported back clearly to enhance care and be understood by patients and clinicians.
Sally Redman | Early findings from SPIRITSax Institute
Professor Sally Redman AM, CEO of the Sax Institute, recently addressed a CIPHER forum to share how the SPIRIT trial is testing a program designed to increase the use of research in policy and programs.
CIPHER, the Centre for Informing Policy in Health with Evidence from Research, is an Australian collaborative research centre managed by the Sax Institute, that is investigating the tools, skills and systems that might contribute to an increased use of research evidence in policy.
For more information visit www.saxinstitute.org.au.
This document provides a step-by-step process for improving care delivery through collaborative learning. It outlines the Planned Care Model for redesigning care delivery and the Model for Improvement for testing changes. The 7 steps include: 1) familiarizing the care team with these models, 2) organizing roles, 3) adopting guidelines, 4) understanding patient needs, 5) choosing measures, 6) planning care, and 7) supporting patient self-management. Changes are tested with individual patients and successful changes are implemented for all patients.
The document describes the Association of Clinical Coordination and Research Management (ACCRM), which aims to enhance clinical research processes, establish a community for clinical research professionals, and recognize and develop the clinical research workforce. It provides resources like educational programs, tools, training, professional development opportunities, and a sense of community to help members advance their careers in clinical research.
his is the first in a series of interactive webinars designed to build capacity in the basic principles of knowledge translation and implementation science.
WATCH-ON DEMAND: https://goo.gl/hnp8gi
Integrated primary and behavioral healthcare aims to provide comprehensive treatment that addresses both physical and mental health needs. It can range from parallel care to fully integrated care within a single system. Fully integrated care is associated with improved health outcomes for patients with severe mental illness, who otherwise experience high rates of preventable medical conditions and die 25 years earlier on average than the general population. The Integrated Treatment Tool is a 30-item evaluation developed by the Center for Evidence Based Practices to assess the level of integration across organizational structure, treatment approaches, and care coordination across settings.
The document discusses various approaches to quality improvement in healthcare, including Six Sigma, Total Quality Management (TQM), and the FADE model. Six Sigma uses statistical methods and aims for near-zero defect rates. TQM takes a customer-focused approach to continuous process improvement through methods like scientific problem-solving and participation at all levels. The FADE model outlines five steps for quality improvement projects: focus, analyze, develop, execute, and evaluate. Microsystems thinking views individual care units as the building blocks for organizational outcomes.
The document discusses knowledge translation (KT), which involves closing the gaps between research knowledge and practice. KT includes disseminating research findings to relevant audiences and facilitating their implementation. Effective KT requires understanding user needs, tailoring knowledge tools and activities, addressing barriers, and evaluating impact on outcomes. Key aspects of KT include knowledge synthesis to integrate evidence, dissemination to communicate findings, and implementation efforts to promote adoption into practice or policy.
This document summarizes Bea Brown's scholarship objectives and learnings from a study tour related to implementation research. The objectives were to develop skills in implementation strategies, evaluation of quality programs, and strengthening relationships between the Sax Institute and international experts. Key lessons learned included the importance of organizational readiness, clinician involvement, and routine implementation. This directly informed the development of an implementation trial in cancer care.
The University of Michigan Medical School established the Patient Safety and Quality Leadership (PASQUAL) Scholars Program to create a community of clinical partners who can effectively collaborate with engineers and safety professionals to improve patient safety and quality of care. The program provides faculty and staff an 8-month curriculum covering quality improvement, patient safety, leadership, teaching and scholarship. Scholars identify an existing or new quality/safety project and work in interprofessional teams. Graduates are well positioned to lead quality/safety initiatives and collaborate with engineering professionals to positively impact healthcare outcomes.
Advancing the Methods of Evaluation of Quality and Safety Practice and Educa...Daniel McLinden
Improving healthcare in an organization requires individuals with the capability to design, test and implement improved processes in an organization with the capacity to support the scale and spread of improvement. If improvement capability is not widespread in the workforce then an intervention is needed to create the capability. In response to this challenge, Cincinnati Children’s designed and implemented a comprehensive Improvement Science curriculum to build capability. The program has achieved measurable improvements in both process and outcome measures of patient care and business processes. Incorporating unique design principles, this intervention served as a catalyst for quality transformation.
In this workshop we will share our perspective and provide examples with data that illustrates:
• Building support and buy-in through the design of participant selection.
• Creating an intervention to build capability that includes training but involves more than training.
• A comprehensive model based on competencies
• Expanding the four-level Kirkpatrick model evaluation with additional levels that encompass economic impact and network impact.
• Using self-assessment to evaluate learning outcomes.
Webinar on Quality Improvement Strategies in a Team-Based Care Environment CHC Connecticut
Building a quality improvement (QI) infrastructure within team-based care is an organizational strategy that will establish a culture of continuous improvement across departments and improve quality in all domains of performance. Many positions in primary care now require QI training as part of employees' professional development.
Our expert faculty discuss tools you can use to build and implement a QI infrastructure within your team-based setting to improve patient care.
Panelists:
• Deb Ward, RN, Senior Quality Improvement Manager, Community Health Center, Inc.
• Kathleen Thies, PhD, RN, Consultant, Researcher, Weitzman Institute
This lecture discusses acquiring knowledge about clinical workflow processes in a healthcare facility. It identifies important stakeholders and common clinic processes to inventory, such as patient check-in, visits, prescriptions, labs, and billing. The analyst should observe these processes, identify activities, roles, information needs, and exceptions to understand the operations and determine how to streamline workflows, especially using health IT. Interviews with process participants and reviews of procedure manuals and information used are important ways to gain knowledge.
This document provides an overview of quality improvement methods for health care workflows. It describes strategies for quality improvement, including defining measurable goals, implementing process changes through the Plan-Do-Study-Act cycle, and establishing leadership accountability. The need for aggressive quality improvement in health care is discussed to address issues like medical errors. Examples show how projects have redesigned clinical offices and care processes to increase access and efficiency.
Transforming healthcare requires integrating new technologies with organizational changes and evolving care models. Clinical Decision Sciences uses clinical change management to facilitate quality improvement through reengineering workflows, implementing evidence-based practices, and ensuring clinicians adopt new technologies. Their 10-step process engages stakeholders, assesses needs, prioritizes goals, implements changes, and monitors outcomes to successfully transform clinical processes and care delivery.
This chapter discusses developing metrics to support projects, interventions, and programs. It covers the Institute for Healthcare Improvement's framework, including identifying areas for improvement, selecting measures, obtaining a baseline, and remeasuring. The chapter also discusses organizational readiness, levels of evidence, cost analyses, selecting appropriate variables, and developing a data management plan including defining needs, identifying sources and measures, designing studies, retrieving and analyzing data. The goal is to select meaningful metrics to quantify cost and quality to improve outcomes as the healthcare system reforms.
Judi Binderman, Vice President, Corporate CMIO, Community Medical Centers - Speaker at the marcus evans National Healthcare CIO Summit 2016 held in Las Vegaas, NV
This document outlines principles for improving patient safety through systems thinking and reliable design. It describes how human errors often stem from systemic issues rather than individual mistakes. Two case examples are presented where patients experienced harm due to miscommunications or lack of safeguards. The document discusses how reliability science focuses on anticipating and containing errors within complex systems. Checklists, standardized processes, and other tools can help reduce risks. Organizational culture and human factors also significantly impact safety. Continuous improvement models like PDCA and Lean are effective approaches to redesigning systems and workflows to prevent future harm.
The document outlines a clinical informatics strategy developed for a medical group practice that recently acquired another large physician practice. The strategy aims to standardize processes, roles, and the EMR across the combined practices. It involves developing a clinical informatics team to support workflows, education, and change management. The team will work with leadership and IT to merge the two EMR instances, standardize practices, and implement role-based training. The strategy consists of developing standardized processes, education plans, and expanding the informatics team with new roles. It was implemented but faced challenges with culture and priorities that resulted in lessons around clarifying roles and elevating clinical leadership involvement. Next steps include evaluating processes, engaging informaticists in more areas
This document discusses implementing clinical decision support (CDS) in electronic health records (EHRs). It defines CDS and describes common CDS tools like alerts, order checks, and reminders. It discusses the value of CDS in improving healthcare quality and addressing medical errors. The document then covers topics like the history and definitions of CDS, approaches to modern CDS, issues around alerts, and grand challenges in the field. Hands-on exercises are provided to demonstrate CDS tools in a simulated EHR environment.
Bringing knowledge to bear. NHS Milton Keynes 020210suelb
1) The document discusses bringing knowledge to bear on commissioning in the NHS Milton Keynes through a chief knowledge officer.
2) It outlines 5 main responsibilities: developing a knowledge management strategy, mainstreaming a self-improving system, enabling staff to access and use information/data, developing whole system approaches to care pathways, and achieving workforce and commissioning standards.
3) Applying knowledge involves aligning services with priorities through a focus on strategic goals, needs assessment, data review, and streamlining reporting to support commissioners and performance management. Building know-how involves tools for pathways, benchmarking, and a model for improvement.
NTTAP Webinar Series - April 13, 2023: Quality Improvement Strategies in a Te...CHC Connecticut
Join us for a webinar on quality improvement in team-based care!
Building a quality improvement (QI) infrastructure within team-based care is an organizational strategy that will establish a culture of continuous improvement across departments and improve quality in all domains of performance.
Participants will learn about:
• QI infrastructure
• Facilitating QI committees
• Coach training within health centers
Faculty will also provide an example of how trained coaches use QI tools to test and implement changes within an organization.
UCSF CER - What PCORI Wants (Symposium 2013)CTSI at UCSF
This document summarizes a presentation about the Patient-Centered Outcomes Research Institute (PCORI). PCORI is funding patient-centered comparative effectiveness research. The presentation highlights two award winning projects, discusses some projects that were not funded, and outlines PCORI's funding priorities and challenges. PCORI wants to advance research that engages stakeholders, reflects patient variability, and focuses on important health outcomes without using cost-effectiveness as a funding criterion. Opportunities for PCORI include supporting real-world evidence generation and incorporating diverse stakeholder perspectives, but challenges include stakeholder burnout and operating in the current fiscal environment.
The Healthcare industry has been embracing Lean and Six Sigma methodologies over the past few years. This presentation will decribe the role of a Green Belt within this industry and the challenges they face.
e-Zsigma is Canada’s leader in Six Sigma and Lean Enterprise coaching and deployment. Our completely integrated program of in-class and e-learning training, tools, methodology and technology enables you to rapidly customize and implement a quality improvement system and strategy that delivers the results that your Hospital and clients demand.
Our team of world class instructors and practitioners combined with our experience in Healthcare makes e-Zsigma your first choice for Six Sigma and Lean Enterprise strategies.
e-Zsigma is a Canadian based Management Consultancy, specializing in Lean Six Sigma, Project Management, and Supply Chain.http://www.e-zsigma.com
e-Zsigma is the Sponsor for the Canadian Society for Quality http://www.linkedin.com/groups/Canadian-Society-Quality-4233535
e-Zsigma is a partner of the International Standard for Lean Six Sigma (ISLSS) and Manager of the LinkedIn Lean Six Sigma Group http://www.linkedin.com/groups/Lean-Six-Sigma-37987
Follow e-Zsigma Company on LinkedIn http://www.linkedin.com/company/1017597 where you will find a list of our Lean Six Sigma Training and Certification Classes, both online and onsite.
The document outlines an agenda for a session on introducing the Q-PAC model for patient activation and involvement in quality management. The agenda includes introductions, an overview of patient activation, building patient capacity, patient-centered data reporting, and a panel discussion. The objectives are to introduce patient activation as a method for improving consumer involvement, provide a model for consumer involvement, and discuss a framework for patient data in quality management.
Presented by Nick Baker
General and Community Paediatrician
Executive Clinical Director for Community Based Services, Nelson Marlborough District Health Board.
The mission statement sets the direction and priority for developing and implementing the quality plan. It clearly states the nature of the organization’s commitment to quality and should then be tied to the organizational operations through programs, projects, actions and rewards/recognition.
Culture of healthcare_ week 1_ lecture_slidesCMDLMS
This lecture provides an overview of the culture of health care. It defines key terms like health, disease, illness, and health care. It explains that culture refers to integrated patterns of human behavior within groups, and defines the culture of health care. The lecture outlines several themes in the literature on the culture of health care, including patient and workforce diversity and various professional cultures. It emphasizes that health care involves a complex mix of cultures that are not always apparent from within.
Unhappy customers can significantly impact a company's bottom line through negative word-of-mouth advertising and lost sales. Studies show that 68% of unhappy customers felt disinterested or indifferent, and one dissatisfied luxury car owner can cost a dealership $100 million in annual revenue from lost sales. As social media has made it easier for customers to share negative opinions, companies place high value on resolving issues with challenging customers to maintain satisfaction and minimize financial losses.
This document discusses key principles for effective communication between support agents and customers. It emphasizes that listening is an active skill that takes effort. Both parties must be actively involved in the interaction to ensure understanding and progress towards resolution. Trust in the relationship allows for open communication, while mutual alignment of goals establishes shared expectations for resolving issues.
The document lists several challenges that were addressed and initiatives that were implemented including stopping upselling, establishing a quality control team, enforcing support tickets, creating organizational structures, identifying talent, delegating responsibilities, developing KPIs, creating autonomous customer service units, implementing various tools like WalkMe and Izenda, conducting HIPAA awareness sessions, creating a client retention unit, using Power BI for reporting, conducting in-house marketing, and creating CRs for CureX. It also shows the results of a survey on recognition, feedback, suggestions, happiness, satisfaction, wellness, ambassadorship, relationships with managers, relationships with colleagues, and company alignment for the Operations team at CureMD.
This lecture discusses how health information technology can help facilitate error reporting and analysis to improve patient safety. It presents three key HIT mechanisms: automated surveillance systems, online event reporting systems, and predictive analytics/data modeling. The lecture also emphasizes the importance of a culture of safety that encourages open discussion and learning from mistakes without blame. Error reports are analyzed using a risk assessment model to distinguish near misses from events that cause patient harm.
This document discusses quality improvement tools for analyzing health information technology (HIT) errors, including root cause analysis (RCA), failure mode and effects analysis (FMEA), and hazard analysis. RCA is a structured problem-solving process that considers all potential causal factors of an incident. FMEA prospectively predicts error modes by assessing the likelihood and impact of process failures. The document provides examples of using RCA and FMEA to analyze HIT-related errors and identifies key areas of focus for HIT safety measures.
This lecture discusses learning from mistakes and errors in health information technology (HIT). It covers types of errors like slips, mistakes, active failures and latent conditions. It also examines unintended consequences of HIT like new or more work, workflow issues, overdependence on technology, and copy-paste errors. The objectives are to assess HIT for negative consequences and examine common HIT design deficiencies. References from AHRQ and other sources on error reporting and analysis in HIT are also provided.
This document discusses electronic clinical quality measures (eCQMs) which are designed to leverage health information technology (HIT) to improve quality measurement. eCQMs use standardized data elements and terminology to measure care quality based on information in electronic health records. Effective eCQM reporting requires structured, coded data and use of standards for measure specification, calculation, and reporting. Widespread use of eCQMs could revolutionize quality measurement by facilitating automated reporting and improving data quality.
This lecture discusses key attributes of data quality including consistency, currency, timeliness, granularity, precision, and relevancy. It provides examples of each attribute and recommendations for maintaining data integrity such as establishing data governance and defining standards for data collection. The lecture also notes that data quality is important for research and quality improvement efforts and that poor data quality can lead to errors.
This lecture discusses assessing data quality and identifies 10 key attributes of data quality: definition, accuracy, accessibility, comprehensiveness, consistency, currency, timeliness, granularity, precision, and relevancy. Poor data quality can threaten patient safety and quality of care, reduce effectiveness of decision making, and increase costs. The lecture provides examples and recommendations for ensuring each of the 10 data quality attributes.
This lecture discusses assessing data quality and improving it through health information technology (HIT). It identifies common causes of insufficient data quality, such as unclear definitions, incomplete data, and programming errors. Both systematic and random issues can negatively impact data quality. The lecture outlines best practices for preventing, detecting, and improving data quality issues. Standardizing terminology, structuring data entry, and utilizing technologies like voice recognition can enhance data quality. Overall, high quality clinical data is important for healthcare decisions, and HIT professionals can implement strategies to enhance data quality.
This document discusses strategies for implementing health information technology (HIT) systems. It compares "big bang" implementations, where a system is launched system-wide at once, to "staggered" or phased implementations. While big bang implementations have faster rollout, they carry higher risk. Staggered implementations have lower risk but slower return on investment. The document also emphasizes the importance of user training and long-term support during and after implementation to ensure success. Contextual factors like organizational culture and individual user needs must also be considered in planning. Nested implementation teams and designated super-users or internal consultants can help provide support.
The document discusses effective health IT implementation planning. It outlines characteristics of effective implementation teams, including communication, understanding roles, and practical expertise. Three key strategies for health IT implementation are reviewed: single vendor, best of breed, and best of suite. Clinical workflows and the needs of different care settings like primary care and critical access hospitals are also addressed. The goal is to assist organizations in designing customized implementation plans that meet their unique quality and safety needs.
This document discusses a lecture on how health information technology (HIT) can impact patient safety culture. The lecture covers strategies for adaptive work that can be useful for HIT initiatives, including being unwavering in goals while inviting others to help achieve them, addressing real and perceived losses from changes, and assuming healthcare providers want to help patients. References are provided for images and content used in the lecture.
This document discusses health information technology (HIT) and its impact on patient safety culture. It provides learning objectives on adaptive leadership, frameworks for patient safety culture, and differentiating technical and adaptive change. It also summarizes a 2013 medical error case study where a patient received a 39-fold overdose due to a 50-step error-prone process. Root causes of use errors with HIT are identified, such as patient identification errors and data accuracy errors. Frameworks for risk assessment and classifying human interaction with HIT systems are presented. The document concludes that HIT has potential to reduce errors but also introduce new opportunities for errors and overreliance on technology.
This document is a lecture on how health information technology (HIT) can impact patient safety culture. It discusses applying quality improvement tools to analyze HIT errors. It highlights the success of efforts led by Dr. Peter Pronovost to reduce central line bloodstream infections through standardization, independent checks, and learning from defects. Checklists, data collection, and adopting practices from high-reliability industries like aviation and Toyota have helped significantly reduce infection rates.
This document provides an overview of quality improvement methods and tools. It describes several common quality improvement models including the API model, Baldrige criteria, FOCUS-PDCA, PDSA cycle, ISO 9000, Kaizen, Lean thinking, and Six Sigma DMAIC. A variety of basic quality improvement tools are also outlined, such as flowcharts, cause-and-effect diagrams, control charts, Pareto charts, and checklists. Finally, potential mistakes in quality improvement initiatives are reviewed, including choosing an inappropriate topic, lack of defined roles/expectations, and failure to sustain improvements.
- Alerts and reminders have the potential to improve patient safety but can also cause clinician frustration and "alert fatigue" if too many are nuisance alerts that provide little benefit.
- Successful alerts are specific, sensitive, clear, concise and support clinical workflow, allowing for safe, efficient responses. They include drug and lab alerts, practice and administrative reminders.
- Research found that drug interaction alerts, disease-drug contraindication alerts and dosing guidelines improved prescribing behaviors while unnecessary lab test repeats dropped with test result reminders.
- Clinical decision support (CDS) aims to improve healthcare decisions and outcomes by providing clinicians with relevant patient information and clinical knowledge. However, CDS has not been widely adopted by clinicians.
- Effective CDS provides the right information to the right person in the right format through the right channels at the right time. It can take many forms, including alerts, order sets, and guidelines.
- CDS helps with administrative tasks, managing clinical complexity, controlling costs, and supporting clinical decision-making. However, poor design can also lead to unintended consequences like alert fatigue.
This document discusses reliability, culture of safety, and health information technology. It explores the characteristics of high-reliability organizations and how they establish mindfulness, sensitivity to operations, reluctance to simplify problems, and other traits. The document also discusses creating a culture of safety by focusing on systems issues rather than blame, promoting a just culture, and distinguishing human error from reckless behavior. The overall goal is supporting quality improvement through reliability and safety.
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Comp10 unit4a lecture_slides
1. Health Care Workflow Process
Improvement
Acquiring Clinical Process Knowledge
Lecture a
This material (Comp 10 Unit 4) was developed by Duke University, funded by the Department of Health and
Human Services, Office of the National Coordinator for Health Information Technology under Award
Number IU24OC000024. This material was updated by Normandale Community College, funded under
Award Number 90WT0003.
This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International
License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/
2. Acquiring Clinical Process Knowledge
Learning Objectives
• Identify how the strategic goals and
stakeholders for a given health care facility
can influence workflow processes in that
facility
• Compare and contrast different types of
knowledge and their impact on
organizations
• Analyze a health care scenario according
to CMMI levels
2
3. See Things Right
• “Before you attempt to set things right,
make sure you see things right.”
– Blaine Lee
3
4. Topics - Lecture a
• Knowledge Acquisition (KA) goals
• Importance of KA
• Categories of knowledge
• Knowledge and the Capability Maturity
Model (CMM)
4
5. Goal of KA for Health Care Process
Analysis and Redesign
• Elicit and document workflow information
about a clinical practice so that technology
can be leveraged and patient care can
ultimately be improved.
5
6. Why Do We Need to Acquire
Knowledge?
• Clinicians and information technology
professionals generally have different
knowledge
– Clinicians → Providing care
– IT professionals → How computers work
• We need to make computers “work”
effectively in clinical settings
6
7. Why is it Called Knowledge
Acquisition?
• Gathering and capturing knowledge
• Used in many other disciplines:
– Management science
– Computer science
– Artificial intelligence
– Cognitive psychology
• There is no one general KA method
7
12. Acquiring Clinical Process Knowledge
Summary - Lecture a
• Knowledge Acquisition (KA) goals
• Importance of KA
• Categories of knowledge
• Knowledge and the Capability Maturity
Model (CMM)
12
13. Acquiring Clinical Process Knowledge
References – Lecture a
References
Gaines, Brian R. (n.d.) Organizational Knowledge Acquisition. Retrieved from
http://pages.cpsc.ucalgary.ca/~gaines/reports/KM/OKA/index.html
Milton, N. R. (2007). Knowledge Acquisition in Practice: A Step-by-step Guide (Decision Engineering).
London: Springer-Verlag.
Passive Knowledge Versus Active Knowledge, March 4, 2010. Retrieved from
http://www.beyonduni.com/2010/03/passive-knowledge-versus-active-knowledge/
Images
Slide 8: Gaines, Brian R. (n.d.) Organizational Knowledge Acquisition Retrieved from
http://pages.cpsc.ucalgary.ca/~gaines/reports/KM/OKA/index.html
Slide 10: Gaines, Brian R. (n.d.) Organizational Knowledge Acquisition Retrieved from
http://pages.cpsc.ucalgary.ca/~gaines/reports/KM/OKA/index.html
Slide 11: Gaines, Brian R. (n.d.) Organizational Knowledge Acquisition. Retrieved from
http://pages.cpsc.ucalgary.ca/~gaines/reports/KM/OKA/index.html
Slide 12: Source: Meredith Nahm, PhD.
13
14. Acquiring Clinical Process Knowledge
Lecture a
This material was developed by Duke
University, funded by the Department of
Health and Human Services, Office of the
National Coordinator for Health Information
Technology under Award Number
IU24OC000024. This material was updated
by Normandale Community College, funded
under Award Number 90WT0003.
14
Editor's Notes
Welcome to Health Care Workflow Process Improvement, Acquiring Clinical Process Knowledge, lecture a.
Objectives for this lecture are to:
Identify how the strategic goals and stakeholders for a given health care facility can influence workflow processes in that facility,
Compare and contrast different types of knowledge and their impact on organizations, and
Analyze a health care scenario according to CMMI levels,
“Before you attempt to set things right, make sure you see things right.” – Blaine Lee
This quote gets at the heart of knowledge acquisition. It means that we must understand a process before we attempt to change it. Knowledge Acquisition is the necessary step of gathering information. In our case, that is gathering information about the processes at a healthcare facility before we change the process. This is particularly important in health care, where errors and process problems can harm people.
This unit is about knowledge acquisition, an early and necessary step in process improvement.
Blaine Lee, Ph.D. was a founding vice president of Covey Leadership Center and a contributing author to books by Stephen R. Covey and Norman Vincent Peale.
Lecture a covers background for knowledge acquisition (KA). The topics covered in this lecture include:
Knowledge Acquisition (KA) goals in healthcare,
Importance of KA,
Categories of knowledge, and
Knowledge and the Capability Maturity Model (CMM).
The Goal of Knowledge Acquisition for Health Care Process Analysis and Redesign is to elicit and document workflow information about a clinical practice so that technology can be leveraged and patient care can ultimately be improved.
Knowledge acquisition, also called KA, is the way that we gain a thorough and accurate understanding of the present state. Knowledge acquisition is a necessary step that allows us to identify salient workflow issues, for example:
Which processes are the most important?
Which are the high volume processes?
Which processes will present the greatest challenge to implementation of HIT?
Which processes will need to be revised?
Which processes will disappear?
Clinicians and IT professionals have different expertise. However, in order to make computers and information systems effective in clinical settings, knowledge from these two disciplines must be combined or integrated. The knowledge gap between these disciplines is often filled by a health informaticist or a health IT professional. We’ll call this individual an analyst. Either the analyst can work with clinicians and practice staff to understand their workflow, or the analyst can train and facilitate practice staff in doing part of this work. Methodology for the latter is covered in a separate unit. This unit focuses on methodology for an analyst to gather information and document clinic processes such that appropriate technology can be leveraged to improve clinic processes and ultimately patient care.
Knowledge acquisition means what you would think from everyday use of the words: gathering and capturing knowledge.
Knowledge acquisition is a broad term, i.e., it is used in many other disciplines:
Management science,
Computer science,
Artificial intelligence, and
Cognitive psychology.
There is no one definitive method. Further, methods are customized for particular disciplines and for the level of detail needed. As Aristotle wrote, “It is the mark of an instructed mind to rest satisfied with the degree of precision which the nature of the subject admits and not to seek exactness when only an approximation of the truth is possible.”
What he meant was that it is a bad idea to do a more detailed analysis than what is required to accomplish your goal. Simply put, too much detail wastes time and other resources. Therefore, we present here a method that
is focused on health care and matching health IT to clinic processes, and
is only as detailed as necessary.
Brian Gaines, a recognized Knowledge Acquisition expert from the University of Calgary, conducted a research project where he worked with managers involved in an ongoing project on knowledge modeling of manufacturing processes in small companies. This provided us a concept map (reproduced here from Gaines’ research report) of the routine ways in which organizations acquire knowledge, i.e., the universe and scope of Organizational Knowledge Acquisition. (Gaines, n.d.)
Several of these methods are applicable to our work in Health IT adoption and clinic process improvement. For example, the clinics who hire process analysts and redesign specialists or who receive this expertise through their regional extension center are “Recruiting people with expertise” and “Gathering advice from consultants.” Professional process analysts routinely “gather advice from professional literature” through conferences and reading trade and scientific journals. Some of the Regional Extension Centers are establishing local support groups that give clinic leadership and staff the opportunity to “participate in communities of practice.” When clinics approach a Regional Extension Center, they are “contracting with other organizations.” Through working with the Regional Extension Centers, clinics are engaging in “process improvement through experience in use,” “process improvement through process analysis,” and “process improvement through purchase of technology.” This and related units teach methodology for “process improvement through process analysis,” and “process improvement through purchase of technology.” (Gaines, n.d.)
Without spending too much time on theory related to Knowledge and Knowledge Acquisition (and there is a lot of it), we present two important concepts in this and the next slides. Seven aspects of knowledge are given. The important thing to understand is that knowledge is what we call a multi-dimensional concept, that is, there are different aspects. Gaines’ work does not provide definitions for each of the dimensions. However, we can explain them by example. Let’s look first at internal versus external knowledge. Some knowledge is internal to us or in our minds while other knowledge is external or in the world. When we use a GPS while driving, it is usually because we do not know the way, or maybe the quickest way, thus we do not have internal knowledge and we rely on the external knowledge that resides in the GPS system. (Gaines, n.d.)
Knowledge can also be classified as coded or tacit. (Gaines, n.d.) Tacit knowledge is knowledge that individuals have that is difficult to transfer. When we hire a senior craftsman or performing artist, they are special because they can do something in a way that no one else can. In cases like this, their knowledge that enables them to such unique and expert performance is innate. It is not written down. There is no step-by-step process that one can follow. In fact, such experts often cannot articulate the knowledge that is the core of their expertise. This is tacit knowledge. Coded, also called explicit, knowledge, on the other hand, is knowledge that is written down in step by step manner such that others can use and apply it. In clinical practices, there is a lot of tacit knowledge and part of the job of an analyst acquiring knowledge is to take in this knowledge, document it in writing or diagrams, i.e., turn it into coded knowledge and thus, make it explicit.
Still, others have made the distinction between active and passive knowledge in the way that knowledge is used by the knower. Active knowledge is something that is used by the knower to do something. For example, Nurses use their knowledge every day to take care of patients. Passive knowledge is different, it is knowledge or experience that is encoded by the knower but not in actual use. In passive knowledge, the knower is not applying the knowledge. (Gaines, n.d.) Another way to look at knowledge is whether the knowledge has been or is best learned through transmission, i.e., taught or read, or whether the knowledge is experiential, i.e., learned by doing.
Probably the most widely-used dimension is declarative versus procedural knowledge. Declarative knowledge is the knowledge of facts, i.e., properties between things and concepts and the relationships between them. Procedural knowledge, on the other hand, is the knowledge of how to do something. (Milton 2007) A standard operating procedure is an example of coded procedural knowledge. A recipe has aspects of both declarative and procedural knowledge. The ingredients list is declarative knowledge, whereas the statements about the sequence of mixing and procedure for cooking are procedural knowledge. Gaines and others have described other aspects of knowledge that are, for example, properties of an organization’s intent for acquiring the knowledge, or how it will be used, but these are not properties of the actual knowledge and are less important for our work here.
The two-by-two diagram adapted from Gaines, shows the relationship between passive, active, tacit, coded, sticky , transmittable, and declarative and procedural knowledge. A third dimension was added to this framework, declarative and procedural knowledge. In the left upper quadrant is experience. Experience is both passive and tacit knowledge. Through science or reflective learning, tacit knowledge can be acquired and captured in coded form. Coded knowledge is in the right upper quadrant. Coding tacit knowledge creates information, i.e., facts – declarative knowledge. Creation of coded knowledge adds immense value because then, the knowledge is accessible to others. For example, where an organization has coded knowledge, that knowledge resides with the organization and provides consistency of performance, rather than residing and leaving with individuals. Where knowledge resides with individuals rather than with the organization, organizations are NOT in control of their consistency and ultimately quality and performance. Coded knowledge is transmittable, manageable, and sharable. Importantly, active, coded knowledge, lower right quadrant, is coded knowledge in action, i.e., know-how that can be transmitted to others. Moving back to the left, in the lower left quadrant lies skill. Skill is tacit, active knowledge. It is the alternative to coded knowledge, skill is sticky knowledge, i.e., it comes and leaves with individuals.
Through its immense amount of contracting experience, and prompted by contracting for software, the United States government realized the need to be able to assess an organization’s likelihood to consistently deliver a quality product on time. This is described by the Capability Maturity Model, initially developed by the Software Engineering Institute (SEI) at Carnegie Mellon University. The Capability Maturity Model (CMM) was developed through a US Department of Defense-funded research project where data was collected from organizations that contracted with the U.S. Department of Defense. At its heart, the Capability Maturity Model describes five levels of increasing codification and institutional management of knowledge. The uppermost (5th) level is an ideal state where processes are systematically managed by a combination of process optimization and continuous process improvement. The CMM or CMMI model is important to have a feel for, because as an analyst, you will encounter clinics at all levels of process maturity. Your job will differ depending on the CMM level at which the clinic operates. For example, if you find an organization at a lower level, much of your time will be spent eliciting tacit knowledge and helping the clinic leadership and staff codify it. The knowledge acquisition and process analysis phase will take longer where this is the case. Alternatively, when you encounter a clinic at the higher levels, there will be existing documentation of clinic processes that you can use as a source, and your acquisition and analysis phase will be shorter. When you encounter a clinic at level 5, your work as a process analyst may fit into their existing process improvement framework as part of their continuous improvement.
There are five levels of the Capability Maturity Model:
Level 1 - Initial (Chaotic)
It is characteristic of processes at this level that they are (typically) undocumented and in a state of dynamic change, tending to be driven in an ad hoc, uncontrolled and reactive manner by users or events. This provides a chaotic or unstable environment for the processes.
Level 2 - Repeatable
It is characteristic of processes at this level that some processes are repeatable, possibly with consistent results. Process discipline is unlikely to be rigorous, but where it exists it may help to ensure that existing processes are maintained during times of stress.
Level 3 - Defined
It is characteristic of processes at this level that there are sets of defined and documented standard processes established and subject to some degree of improvement over time. These standard processes are in place (i.e., they are the As-Is processes) and used to establish consistency of process performance across the organization.
Level 4 - Managed
It is characteristic of processes at this level that, using process metrics, management can effectively control the As-Is process (e.g., for software development). In particular, management can identify ways to adjust and adapt the process to particular projects without measurable losses of quality or deviations from specifications. Process Capability is established from this level.
Level 5 - Optimized
It is a characteristic of processes at this level that the focus is on continually-improving process performance through both incremental and innovative technological changes/improvements.
This concludes lecture a of Acquiring Clinical Process Knowledge. Lecture a covered background principles relevant to knowledge acquisition including:
Knowledge Acquisition goals in healthcare,
Importance of Knowledge Acquisition,
Categories of knowledge, and
Knowledge and the Capability Maturity Model (CMM).