The document provides an agenda and materials for a session on using data for improvement as part of an Advanced Team Based Care Learning Collaborative. The session will include theory bursts on displaying data over time, types of variation, and run charts. Teams will present examples of data they have collected, including cycle time data and diabetes monitoring. The session aims to help teams learn how to use data to identify improvement opportunities and track changes over time.
This document provides information about career training courses offered by the British Medical Association (BMA) for doctors at different stages of their careers. It outlines a range of teaching sessions focused on topics like communications, management, leadership, and career development. The sessions are designed to support doctors throughout their professional journey from foundation years through to consultant roles. The BMA prides itself on understanding the changing medical landscape and providing practical career support resources tailored to individual needs.
Un Hito en la Historia Educativa del ParaguayFabiola Oviedo
La Ley N° 4088/10 es considerada un hito en la historia educativa de nuestro país por el Informe Integrante de la Iniciativa Global por los Niños Fuera de la Escuela, Perfiles de la exclusión educativa en la República del Paraguay, de OOSCI, Unicef-UIS y Unesco, entre otros factores, porque se creció en inclusión, no solamente en términos verificables en dígitos, sino también en la internalización de estos derechos sobre todo por parte de los sectores más vulnerables.
Để xem full tài liệu Xin vui long liên hệ page để được hỗ trợ
:
https://www.facebook.com/garmentspace/
https://www.facebook.com/thuvienluanvan01
HOẶC
https://www.facebook.com/thuvienluanvan01
https://www.facebook.com/thuvienluanvan01
tai lieu tong hop, thu vien luan van, luan van tong hop, do an chuyen nganh
Lifetime membership allows you to "own" a week every year at any of our resorts, or any other affiliated resort in India & abroad for the next ____ years to enjoy great holidays with your family in world class resorts.
EU: Coffee Extracts, Essences and Concentrates – Market Report. Analysis and ...IndexBox Marketing
This document provides a market report on coffee extracts, essences and concentrates in the EU from 2007-2015, with forecasts to 2020. It finds that the market volume grew between 2007-2015 but declined in recent years. Domestic production supplies most of the EU market but imports are increasing in some countries. Exports have also increased over time. The report includes detailed data on production, trade, prices and consumption in EU countries. It analyzes trends in the market and provides forecasts for future growth.
This document provides information about career training courses offered by the British Medical Association (BMA) for doctors at different stages of their careers. It outlines a range of teaching sessions focused on topics like communications, management, leadership, and career development. The sessions are designed to support doctors throughout their professional journey from foundation years through to consultant roles. The BMA prides itself on understanding the changing medical landscape and providing practical career support resources tailored to individual needs.
Un Hito en la Historia Educativa del ParaguayFabiola Oviedo
La Ley N° 4088/10 es considerada un hito en la historia educativa de nuestro país por el Informe Integrante de la Iniciativa Global por los Niños Fuera de la Escuela, Perfiles de la exclusión educativa en la República del Paraguay, de OOSCI, Unicef-UIS y Unesco, entre otros factores, porque se creció en inclusión, no solamente en términos verificables en dígitos, sino también en la internalización de estos derechos sobre todo por parte de los sectores más vulnerables.
Để xem full tài liệu Xin vui long liên hệ page để được hỗ trợ
:
https://www.facebook.com/garmentspace/
https://www.facebook.com/thuvienluanvan01
HOẶC
https://www.facebook.com/thuvienluanvan01
https://www.facebook.com/thuvienluanvan01
tai lieu tong hop, thu vien luan van, luan van tong hop, do an chuyen nganh
Lifetime membership allows you to "own" a week every year at any of our resorts, or any other affiliated resort in India & abroad for the next ____ years to enjoy great holidays with your family in world class resorts.
EU: Coffee Extracts, Essences and Concentrates – Market Report. Analysis and ...IndexBox Marketing
This document provides a market report on coffee extracts, essences and concentrates in the EU from 2007-2015, with forecasts to 2020. It finds that the market volume grew between 2007-2015 but declined in recent years. Domestic production supplies most of the EU market but imports are increasing in some countries. Exports have also increased over time. The report includes detailed data on production, trade, prices and consumption in EU countries. It analyzes trends in the market and provides forecasts for future growth.
This document provides an agenda and notes for a session of the Team Based Care Learning Collaborative. The session began with introductions of participating teams and their members. Teams then shared their experiences implementing various aspects of team-based care over the past six weeks, including adjusting team structures, practicing effective meeting skills, testing daily huddles, collecting data, and refining roles. New improvement skills and methodology were taught, including process mapping and the PDSA cycle. Teams received guidance on next steps and were assigned tasks for the coming period to continue working to implement team-based care models in their practices.
This document summarizes a learning session on implementing team-based care. It includes:
- Presentations from various health centers on their work refining core and extended team structures, running effective team meetings, and implementing daily huddles.
- A discussion of assessing roles and responsibilities to reduce duplication and standardize processes. Progress made in the first six-week action period is reviewed.
- The agenda for the second half of the session focuses on refreshing skills in developing process maps, writing specific aims, and applying the PDSA quality improvement methodology. Assignments for the next six-week action period are also reviewed.
- Dr. Modak discussed how he supports his team at El Rio by attending weekly meetings, helping to problem solve challenges, and providing resources to test changes.
- He emphasized the importance of standardizing processes and spreading successful changes to improve access and care quality.
- Dr. Modak also works to address any gaps in readiness for change identified in staff surveys.
Here are some questions teams have about core and extended teams, pre-visit planning/huddles, self-management goal setting workflows, and coaching roles:
Core and Extended Teams:
- How are you identifying your patient care teams (PODS) so patients know their team?
- What specific roles have you seen change on teams and how?
- How are you training staff on team-based care?
- How do you maintain team integrity with turnover/MAs covering multiple teams?
- Are managers/leaders part of your core and extended team model?
Pre-Visit Planning/Huddles:
- How do you manage prep time for huddles? Are you using E
Here are some questions teams have about core and extended teams, pre-visit planning/huddles, self-management goal setting workflows, and the coaching role:
Core and Extended Teams:
- How are you identifying your patient care teams (PODS) so staff and patients know their team?
- What specific roles have you seen change on teams and how?
- How are you training staff on team-based care?
- How do you maintain team integrity with turnover/MAs covering multiple teams?
- Are managers/leaders part of your core and extended team model?
Pre-Visit Planning and Huddles:
- How do you manage prep time for huddles? Are
2018 TBC Learning Collaborative Session 3, Aug 01 2018CHC Connecticut
The document provides information about an online learning session on implementing team-based care. It includes:
1) An agenda for the session which focuses on reviewing progress made in the previous period through specific aims and quality improvement projects, discussing the role of medical assistants in team optimization, and planning next steps.
2) Updates from various health center teams on the specific aims they are working on related to conditions like hypertension, diabetes, and cancer screenings.
3) A refresh on quality improvement methods like the PDSA cycle and using data for improvement.
4) An overview of assignments for the next period which include continuing previous work, developing specific aims, process mapping, and beginning tests of change.
The document provides information for a Team Based Care Learning Collaborative session taking place on September 12, 2018, including objectives, agenda, presentations from participating health centers, and assignments for an upcoming action period. The session aims to help participant teams advance team-based care, share challenges and successes, and learn quality improvement concepts to achieve their specific aims around issues like diabetes management and cancer screenings.
This document provides an agenda and materials for a session on team-based care. The session will include discussions of action period milestones, physician role challenges, and presentations from several teams on their specific aims and tests of change. Teams will discuss their progress implementing team-based care, including standardizing processes, implementing daily huddles, continuing assessments, and conducting PDSA cycles to improve access, efficiency, and care coordination. The goals are for teams to learn from each other's work and get guidance on next steps in their improvement efforts.
Are you involved in supporting or leading organisational change? As a result of work within our Mental Health Quality Improvement programme, we have developed a one-page visual roadmap for those involved in supporting or leading organisational change.
Based on well-established quality improvement methodology the roadmap outlines 12 steps that walks you through the central elements required for successful change.
The document provides an agenda and instructions for a learning collaborative session on developing a post-graduate residency program curriculum. It includes details on turning on webcams, muting during presentations, and sending attendance via chat. The agenda covers program curriculum, curriculum development, schedules and resources, marketing, recruitment, applications, a presentation from Western North Carolina Community Health Services, and a QI theory burst on process mapping. Attendees are asked to continue working on their communications and marketing plans, map out a schedule skeleton, develop a list of key clinical topics, and post successes or challenges to the discussion forum before the next session.
1) The document describes a simulation activity designed to improve the turnaround time for laboratory tests in an emergency department. Participants form groups to pass a tennis ball representing a lab test between steps in the testing process.
2) The goal is to cut the time in half through testing changes using Plan-Do-Study-Act cycles. Participants identify potential changes, test them on a small scale, and analyze the results to plan further improvements.
3) The document discusses using rapid PDSA cycles to test changes, collecting data to learn what works and adapt the changes to the local environment with the goal of accelerating improvement.
Health Care Homes: Creating Effective Practice TeamsMelissa DeBilzan
The document discusses creating effective practice teams in healthcare. It emphasizes that teams require the right people in the right roles, clear communication, and a focus on common goals. Leadership must set the culture and vision for team-based care. Effective teams also standardize workflows, involve patients, and continuously measure and communicate their progress.
The document provides guidance for preceptors on their roles and responsibilities. It discusses defining preceptor roles, distinguishing them from regular staff roles, outlining Benner's levels of nursing practice, and listing available preceptor resources. It also covers establishing goals for orientees using the SMART method, applying principles of adult education, and effectively documenting an orientee's progress.
The document provides advice to someone who feels overloaded and powerless at work. It suggests 10 actions they can take to change their situation: 1) Create a clear strategy and vision; 2) Implement consistent reporting and KPIs; 3) Carefully delegate responsibilities; 4) Schedule time to connect with employees; 5) Manage relationships with supervisors effectively; 6) Communicate goals and progress regularly; 7) Adopt good time management practices; 8) Provide constructive feedback to employees; 9) Limit unproductive email use; 10) Maintain a healthy work-life balance and human connections. Taking these actions would help share the workload, empower employees, and reduce stress.
Job analysis is a systematic exploration of the tasks, duties, and responsibilities involved in a job. It identifies the key aspects of the job and provides essential information for human resource functions like recruitment, selection, training, and performance appraisal. The common methods used for job analysis include observation, interviews, questionnaires, technical conferences, and diaries. The key outputs of job analysis are the job description, job specification, and job evaluation. The job description outlines the key purpose, duties and responsibilities of the role, while the job specification defines the minimum qualifications required. Job evaluation determines the relative worth of different jobs in an organization.
This document discusses strategies for improving recruitment and retention of direct support professionals (DSPs) through organizational culture change. It recommends showing DSPs respect and support through recognition, participation in organizational activities, professional development opportunities, employee training, and performance coaching. Frontline supervisors are key to DSP retention, so the document also discusses training supervisors to better orient, support and develop DSPs. Overall the strategies presented aim to develop DSPs' skills and careers, improve job satisfaction and commitment, and lower high turnover rates in the sector.
The document discusses becoming a data analyst and the role of a data analyst on a PBIS (Positive Behavioral Interventions and Supports) team. It describes the responsibilities of a data analyst which include preparing data summaries before meetings, presenting data at meetings to help identify problems and evaluate solutions, and being prepared to generate custom reports during meetings. It also provides examples of how to use SWIS (School-Wide Information System) data to define problems precisely in order to develop effective solutions.
The document summarizes recommendations for improving the onboarding process for new RCTs at a living facility. It conducted interviews, focus groups, and surveys that found inconsistencies in onboarding across units. It recommends: 1) Applying best practices used by some units consistently, 2) Developing a comprehensive new employee toolkit with checklists and timelines, and 3) Modifying training to address information overload and better prepare RCTs. The goal is to standardize the process, increase consistency, and improve the experiences and retention of new RCTs.
This document provides an overview of a webinar on gaining buy-in for quality improvement projects. It introduces the faculty members and discusses the community health center's founding and profile. The webinar covers strategies for engaging leadership, stakeholders, and team members in a project. It emphasizes understanding perspectives, conducting a stakeholder analysis to prioritize groups, and evaluating data to communicate the need for change. Tools discussed include developing communication plans and using a GRPI framework to assess project setup. The webinar aims to help participants effectively gain support and manage resistance when introducing changes.
The COVID-19 pandemic has created several challenges for our country’s health care infrastructure, and the community health center workforce is no exception. Join us as we describe strategies to get patients back into dental care. Along with these strategies, participants will learn how to recognize challenges in dental practices, as well as how to engage the interdisciplinary care team through role redesign and integration to increase access to comprehensive care.
NTTAP Webinar Series - June 7, 2023: Integrating HIV Care into Training and E...CHC Connecticut
In order for health centers to provide compassionate and respectful HIV prevention, care, and treatment in comprehensive primary care settings, the clinical workforce must be knowledgeable, confident, and competent in their ability to do so.
We’ll explore the need to integrate HIV care into training and education for the clinical care team, as well as educational models to train the next generation. Using Community Health Center Inc.’s Center for Key Populations Fellowship for Nurse Practitioners (NPs) as a framework for best practices, experts will discuss how to implement specialty care for key populations in your training programs. Additionally, participants will gain awareness of the importance of training the clinical workforce on key population competencies in HIV programs (e.g. HCV, MOUD, LGBTQI+ health, homelessness, and harm reduction).
This document provides an agenda and notes for a session of the Team Based Care Learning Collaborative. The session began with introductions of participating teams and their members. Teams then shared their experiences implementing various aspects of team-based care over the past six weeks, including adjusting team structures, practicing effective meeting skills, testing daily huddles, collecting data, and refining roles. New improvement skills and methodology were taught, including process mapping and the PDSA cycle. Teams received guidance on next steps and were assigned tasks for the coming period to continue working to implement team-based care models in their practices.
This document summarizes a learning session on implementing team-based care. It includes:
- Presentations from various health centers on their work refining core and extended team structures, running effective team meetings, and implementing daily huddles.
- A discussion of assessing roles and responsibilities to reduce duplication and standardize processes. Progress made in the first six-week action period is reviewed.
- The agenda for the second half of the session focuses on refreshing skills in developing process maps, writing specific aims, and applying the PDSA quality improvement methodology. Assignments for the next six-week action period are also reviewed.
- Dr. Modak discussed how he supports his team at El Rio by attending weekly meetings, helping to problem solve challenges, and providing resources to test changes.
- He emphasized the importance of standardizing processes and spreading successful changes to improve access and care quality.
- Dr. Modak also works to address any gaps in readiness for change identified in staff surveys.
Here are some questions teams have about core and extended teams, pre-visit planning/huddles, self-management goal setting workflows, and coaching roles:
Core and Extended Teams:
- How are you identifying your patient care teams (PODS) so patients know their team?
- What specific roles have you seen change on teams and how?
- How are you training staff on team-based care?
- How do you maintain team integrity with turnover/MAs covering multiple teams?
- Are managers/leaders part of your core and extended team model?
Pre-Visit Planning/Huddles:
- How do you manage prep time for huddles? Are you using E
Here are some questions teams have about core and extended teams, pre-visit planning/huddles, self-management goal setting workflows, and the coaching role:
Core and Extended Teams:
- How are you identifying your patient care teams (PODS) so staff and patients know their team?
- What specific roles have you seen change on teams and how?
- How are you training staff on team-based care?
- How do you maintain team integrity with turnover/MAs covering multiple teams?
- Are managers/leaders part of your core and extended team model?
Pre-Visit Planning and Huddles:
- How do you manage prep time for huddles? Are
2018 TBC Learning Collaborative Session 3, Aug 01 2018CHC Connecticut
The document provides information about an online learning session on implementing team-based care. It includes:
1) An agenda for the session which focuses on reviewing progress made in the previous period through specific aims and quality improvement projects, discussing the role of medical assistants in team optimization, and planning next steps.
2) Updates from various health center teams on the specific aims they are working on related to conditions like hypertension, diabetes, and cancer screenings.
3) A refresh on quality improvement methods like the PDSA cycle and using data for improvement.
4) An overview of assignments for the next period which include continuing previous work, developing specific aims, process mapping, and beginning tests of change.
The document provides information for a Team Based Care Learning Collaborative session taking place on September 12, 2018, including objectives, agenda, presentations from participating health centers, and assignments for an upcoming action period. The session aims to help participant teams advance team-based care, share challenges and successes, and learn quality improvement concepts to achieve their specific aims around issues like diabetes management and cancer screenings.
This document provides an agenda and materials for a session on team-based care. The session will include discussions of action period milestones, physician role challenges, and presentations from several teams on their specific aims and tests of change. Teams will discuss their progress implementing team-based care, including standardizing processes, implementing daily huddles, continuing assessments, and conducting PDSA cycles to improve access, efficiency, and care coordination. The goals are for teams to learn from each other's work and get guidance on next steps in their improvement efforts.
Are you involved in supporting or leading organisational change? As a result of work within our Mental Health Quality Improvement programme, we have developed a one-page visual roadmap for those involved in supporting or leading organisational change.
Based on well-established quality improvement methodology the roadmap outlines 12 steps that walks you through the central elements required for successful change.
The document provides an agenda and instructions for a learning collaborative session on developing a post-graduate residency program curriculum. It includes details on turning on webcams, muting during presentations, and sending attendance via chat. The agenda covers program curriculum, curriculum development, schedules and resources, marketing, recruitment, applications, a presentation from Western North Carolina Community Health Services, and a QI theory burst on process mapping. Attendees are asked to continue working on their communications and marketing plans, map out a schedule skeleton, develop a list of key clinical topics, and post successes or challenges to the discussion forum before the next session.
1) The document describes a simulation activity designed to improve the turnaround time for laboratory tests in an emergency department. Participants form groups to pass a tennis ball representing a lab test between steps in the testing process.
2) The goal is to cut the time in half through testing changes using Plan-Do-Study-Act cycles. Participants identify potential changes, test them on a small scale, and analyze the results to plan further improvements.
3) The document discusses using rapid PDSA cycles to test changes, collecting data to learn what works and adapt the changes to the local environment with the goal of accelerating improvement.
Health Care Homes: Creating Effective Practice TeamsMelissa DeBilzan
The document discusses creating effective practice teams in healthcare. It emphasizes that teams require the right people in the right roles, clear communication, and a focus on common goals. Leadership must set the culture and vision for team-based care. Effective teams also standardize workflows, involve patients, and continuously measure and communicate their progress.
The document provides guidance for preceptors on their roles and responsibilities. It discusses defining preceptor roles, distinguishing them from regular staff roles, outlining Benner's levels of nursing practice, and listing available preceptor resources. It also covers establishing goals for orientees using the SMART method, applying principles of adult education, and effectively documenting an orientee's progress.
The document provides advice to someone who feels overloaded and powerless at work. It suggests 10 actions they can take to change their situation: 1) Create a clear strategy and vision; 2) Implement consistent reporting and KPIs; 3) Carefully delegate responsibilities; 4) Schedule time to connect with employees; 5) Manage relationships with supervisors effectively; 6) Communicate goals and progress regularly; 7) Adopt good time management practices; 8) Provide constructive feedback to employees; 9) Limit unproductive email use; 10) Maintain a healthy work-life balance and human connections. Taking these actions would help share the workload, empower employees, and reduce stress.
Job analysis is a systematic exploration of the tasks, duties, and responsibilities involved in a job. It identifies the key aspects of the job and provides essential information for human resource functions like recruitment, selection, training, and performance appraisal. The common methods used for job analysis include observation, interviews, questionnaires, technical conferences, and diaries. The key outputs of job analysis are the job description, job specification, and job evaluation. The job description outlines the key purpose, duties and responsibilities of the role, while the job specification defines the minimum qualifications required. Job evaluation determines the relative worth of different jobs in an organization.
This document discusses strategies for improving recruitment and retention of direct support professionals (DSPs) through organizational culture change. It recommends showing DSPs respect and support through recognition, participation in organizational activities, professional development opportunities, employee training, and performance coaching. Frontline supervisors are key to DSP retention, so the document also discusses training supervisors to better orient, support and develop DSPs. Overall the strategies presented aim to develop DSPs' skills and careers, improve job satisfaction and commitment, and lower high turnover rates in the sector.
The document discusses becoming a data analyst and the role of a data analyst on a PBIS (Positive Behavioral Interventions and Supports) team. It describes the responsibilities of a data analyst which include preparing data summaries before meetings, presenting data at meetings to help identify problems and evaluate solutions, and being prepared to generate custom reports during meetings. It also provides examples of how to use SWIS (School-Wide Information System) data to define problems precisely in order to develop effective solutions.
The document summarizes recommendations for improving the onboarding process for new RCTs at a living facility. It conducted interviews, focus groups, and surveys that found inconsistencies in onboarding across units. It recommends: 1) Applying best practices used by some units consistently, 2) Developing a comprehensive new employee toolkit with checklists and timelines, and 3) Modifying training to address information overload and better prepare RCTs. The goal is to standardize the process, increase consistency, and improve the experiences and retention of new RCTs.
This document provides an overview of a webinar on gaining buy-in for quality improvement projects. It introduces the faculty members and discusses the community health center's founding and profile. The webinar covers strategies for engaging leadership, stakeholders, and team members in a project. It emphasizes understanding perspectives, conducting a stakeholder analysis to prioritize groups, and evaluating data to communicate the need for change. Tools discussed include developing communication plans and using a GRPI framework to assess project setup. The webinar aims to help participants effectively gain support and manage resistance when introducing changes.
The COVID-19 pandemic has created several challenges for our country’s health care infrastructure, and the community health center workforce is no exception. Join us as we describe strategies to get patients back into dental care. Along with these strategies, participants will learn how to recognize challenges in dental practices, as well as how to engage the interdisciplinary care team through role redesign and integration to increase access to comprehensive care.
NTTAP Webinar Series - June 7, 2023: Integrating HIV Care into Training and E...CHC Connecticut
In order for health centers to provide compassionate and respectful HIV prevention, care, and treatment in comprehensive primary care settings, the clinical workforce must be knowledgeable, confident, and competent in their ability to do so.
We’ll explore the need to integrate HIV care into training and education for the clinical care team, as well as educational models to train the next generation. Using Community Health Center Inc.’s Center for Key Populations Fellowship for Nurse Practitioners (NPs) as a framework for best practices, experts will discuss how to implement specialty care for key populations in your training programs. Additionally, participants will gain awareness of the importance of training the clinical workforce on key population competencies in HIV programs (e.g. HCV, MOUD, LGBTQI+ health, homelessness, and harm reduction).
Utilizing the Readiness to Train Assessment Tool (RTAT™) To Assess Your Capac...CHC Connecticut
Improve educational training experiences at your health center by assessing your capacity and infrastructure to host health professions students.
Join the upcoming hands-on interactive activity session to learn how to utilize the Readiness to Train Assessment Tool (RTAT™). This tool was developed by HRSA-funded National Training and Technical Assistance Partners (NTTAP) at Community Health Center, Inc. (CHC) to understand organizational readiness to host health professions student training programs.
NTTAP Webinar Series - May 18, 2023: The Changing Landscape of Behavioral Hea...CHC Connecticut
The COVID-19 pandemic has resulted in significant shifts in the mode of care from face-to-face to virtual interactions. Join us as we discuss the challenges currently facing behavioral health care and at least one strategy for each. Along with these strategies, panelists will go over what integrated behavioral health care was and is before and following COVID-19, as well as what actions should be taken going forward to increase access to comprehensive care.
Panelists:
• Dr. Tim Kearney, PhD, Chief Behavioral Health Officer, Community Health Center, Inc.
• Melinda Gladden, LCSW, PMHC, Behavioral Health Clinician, Community Health Center, Inc.
• Jodi Anderson, LMFT, Virtual Telehealth Group Coordinator, Community Health Center, Inc.
Newborn screening involves testing newborns for treatable genetic and metabolic disorders through methods like dried bloodspot testing, hearing screening, and pulse oximetry. The goals are to identify at-risk newborns early before symptoms present, when treatment is most effective. Abnormal screening results require follow up diagnostic testing, education of families, and treatment if a condition is confirmed. Future directions may include expanded screening panels and genomic newborn screening, though these raise additional complex issues to consider.
Health Professions Student Training Webinar: Assessing Organizational CapacityCHC Connecticut
This document provides information about a webinar on assessing organizational capacity for health professions student training. It includes details about continuing education credits, speakers, objectives, and an overview of key aspects of assessing capacity. These include identifying willing and available faculty members, maintaining a spreadsheet of available preceptors, conducting a secondary review of space, training, and onboarding needs, and negotiating placements with academic affiliations. It also discusses best practices for clinical observation and feedback forms, and introduces some preceptor panelists. Finally, it provides an overview of the Readiness to Train Assessment Tool (RTAT) and how it can be used to understand an organization's capacity based on survey results.
Training the Next Generation: Investing in Workforce TrainingCHC Connecticut
This document provides information about an upcoming webinar on workforce training. The webinar will discuss why health centers should invest in health professions education and training programs, how to assess organizational readiness to implement such programs, and best practices for developing replicable training models. Attendees will learn how workforce development planning makes business sense by reducing costs from employee turnover and increasing access to care. A tool called the Readiness to Train Assessment can help organizations evaluate their capacity and motivation to engage in training programs. Successful training requires identifying qualified preceptors and building a culture of learning in the organization.
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.
Addressing Genetics Workforce Shortage - April 11, 2023CHC Connecticut
The document discusses the shortage of geneticists and genetic counselors in the United States. It notes that there are currently only around 1,240 medical geneticists and 4,700 genetic counselors serving the population, below the recommended levels. Many states have fewer than the recommended number of geneticists per population. The document explores ways primary care physicians can help address gaps, such as playing a more active role in selected genetic situations like cancer risk assessment. It also identifies growing the educational opportunities in genetics as important for increasing the workforce.
Implementation of Timely and Effective Transitional Care Management ProcessesCHC Connecticut
Join us to discuss best practices for integrating daily follow-ups for patients recently hospitalized for health emergencies. Effectively following up with patients is a critical responsibility for integrated care teams.
Experts will share how their teams respond to patients to identify care gaps and support the transition of care. Workflow descriptions will provide participants with the tools to support their work to adapt specific steps into their model of team-based care.
Panelists:
• Mary Blankson, DNP, APRN, FNP-C, FAAN, Chief Nursing Officer, Community Health Center, Inc.
• Veena Channamsetty, MD, FAAFP, Chief Medical Officer, Community Health Center, Inc.
• Bibian Ladino-Davis, Behavioral Health Coordinator, Weitzman Institute
Direct to Consumer Test and Ancestry Testing - March 14, 2023CHC Connecticut
Direct to Consumer Genetic and Ancestry Testing
This document discusses direct-to-consumer (DTC) genetic and ancestry testing. It defines DTC testing as testing that can be ordered by consumers without a health care provider. The document outlines the types of information provided by DTC tests, including ancestry, traits, disease risks, and results for some Mendelian conditions. However, it notes limitations like low predictive value without family history and risks of false positives. It provides examples of patients impacted by DTC testing results and emphasizes the need for confirmation of pathogenic variants by clinical genetics. The document also discusses privacy and legal issues related to DTC testing.
Implement Behavioral Health Training Programs to Address a Crucial National S...CHC Connecticut
Health centers are uniquely positioned to address the unprecedented need for behavioral health services but are challenged by the workforce shortage. Participants will gain the knowledge needed to begin conceptualization of a training pathway.
Join us to discuss the considerations of sponsoring an in-house training program across all educational levels, including the benefits, program structure, design, curriculum, supervisors' role, and required resources.
Experts will provide participants with examples from practicum and postdoctoral level training programs to help them gain confidence in developing a behavioral health training pathway.
Genetic Connections to Breast Cancer - February 14, 2023CHC Connecticut
This document discusses genetic connections to breast cancer. It begins by outlining the learning objectives, which are to understand the importance of collaboration between genetics and non-genetics experts for hereditary breast cancer patients, emphasize obtaining accurate family histories, and discuss benefits and limitations of next generation sequencing panel tests. It then discusses genetic counselors' role in oncology, hereditary cancer risks and patterns, BRCA genes, obtaining family histories, genetic testing options like multi-gene panels, interpreting results, cancer screening recommendations, and prophylactic surgery options. Resources and established risk models are also referenced.
Connective Tissue Disorders Slides - January 17, 2023CHC Connecticut
This document discusses several genetic connective tissue disorders including Ehlers Danlos syndromes, Marfan syndrome, Loeys-Dietz syndrome, Stickler syndrome, Shprintzen Goldberg syndrome, Cutis Laxa, and Osteogenesis Imperfecta. It highlights the importance of identifying these disorders to allow for timely detection of serious complications and management by multiple medical specialists. Connective tissues are the most abundant tissues in the body and connect, support, bind or separate other tissues. Identification of a connective tissue disorder through genetic diagnosis guides appropriate care.
Implementation of Facial Recognition Software for Clinical Genetics Practice...CHC Connecticut
This document discusses the potential uses of facial recognition software in clinical genetics practice and education. It provides 3 examples of how facial recognition software could help in rare disease identification and interpreting genetic testing results. The document also outlines learning objectives about identifying medical uses of facial recognition, using facial grids to match patterns to syndromes, and the importance of diverse training data.
HIV Prevention: Combating PrEP Implementation ChallengesCHC Connecticut
Expert faculty present case-based scenarios illustrating common challenges to integrating HIV PrEP in primary care. As part of improving clinical workforce development, this session will delve into a variety of specific PrEP implementation challenges. Participants will leave with strategies to overcome these obstacles to establish or strengthen their PrEP program.
Panelists:
• Marwan Haddad, MD, MPH, AAHIVS, Medical Director, Center for Key Populations, Community Health Center, Inc.,
• Jeannie McIntosh, APRN, FNP-C, AAHIVS, Family Nurse Practitioner, Center for Key Populations, Community Health Center, Inc.
NTTAP Webinar Series - December 7, 2022: Advancing Team-Based Care: Enhancing...CHC Connecticut
Join us as expert faculty outline the differences between case management, care coordination and complex care management to frame up a discussion on strategies to leverage effective models for both in-person and remote services.
Expert faculty will discuss the role of the medical assistant and the nurse in care management, as well as how standing orders and delegated orders support this work. This session will discuss how telehealth and remote patient monitoring enhancements can support complex care management for patients with chronic conditions.
Participants will leave this session with the knowledge and tools to begin or enhance implementation of chronic care management by enhancing the role of the medical assistant, nurse and the technology that supports the clinical care.
Panelists:
• Mary Blankson, DNP, APRN, FNP-C, Chief Nursing Officer, Community Health Center, Inc.
• Tierney Giannotti, MPA, Senior Program Manager, Population Health, Community Health Center Inc.
Genetics Cases and Resources Webinar Slides - November 8, 2022CHC Connecticut
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NTTAP Webinar: Postgraduate NP/PA Residency: Discussing your Key Program Staf...CHC Connecticut
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Training the Next Generation within Primary CareCHC Connecticut
This document summarizes a presentation about training the next generation within primary care. It discusses Community Health Center Inc.'s various workforce development programs, including clinical and non-clinical fellowships and student programs. Specifically, it focuses on administrative fellowships, outlining their purpose and key factors to consider when establishing one, such as the fellow's access and experiences. It also describes other opportunities at the Weitzman Institute for training students, such as research programs with Wesleyan University and health policy fellowships. The presentation emphasizes that community health centers are important training grounds and considers how to structure diverse programs to support succession planning.
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Binaural hearing using two hearing aids instead of one offers numerous advantages, including improved sound localization, enhanced sound quality, better speech understanding in noise, reduced listening effort, and greater overall satisfaction. By leveraging the brain’s natural ability to process sound from both ears, binaural hearing aids provide a more balanced, clear, and comfortable hearing experience. If you or a loved one is considering hearing aids, consult with a hearing care professional at Ear Solutions hearing aid clinic in Mumbai to explore the benefits of binaural hearing and determine the best solution for your hearing needs. Embracing binaural hearing can lead to a richer, more engaging auditory experience and significantly improve your quality of life.
International Cancer Survivors Day is celebrated during June, placing the spotlight not only on cancer survivors, but also their caregivers.
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The "Comprehensive Rainy Season Advisory: Safety and Preparedness Tips" offers essential guidance for navigating rainy weather conditions. It covers strategies for staying safe during storms, flood prevention measures, and advice on preparing for inclement weather. This advisory aims to ensure individuals are equipped with the knowledge and resources to handle the challenges of the rainy season effectively, emphasizing safety, preparedness, and resilience.
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2. Using Zoom
Turn your webcam on!
Please remember to mute
yourself during the presentations.
If you have a question, you may
un-mute yourself and ask after
each presentation, OR use the
Q&A button
3. Advanced Team Based Care (TBC)
Learning Collaborative
Welcome to Session 3
December 14, 2016
3:00 - 4:30 EST
Developing core and extended team capabilities for implementing an advanced team based care model.
4. Introductions
TBC Collaborative Design, Facilitation, Faculty
Ann Marie R Hess ANP, MS
National Cooperative Agreement
Anna Rogers, Director
Reema Mistry, Program Coordinator
Mentors , Coaching Faculty
Deborah Ward, RN (1:8)
Kasey Harding (1:8)
Evaluation Faculty
Kathleen Thies, PhD, RN
Improvement Science Faculty
Patti Feeney
Mark Splaine, MD
5. Objectives Session 3
Summarize Action Period 2 Milestones (6 weeks)
Learn how to use data for improvement
Learn from team Specific Aims and PDSAs
→Healthcare for the Homeless
→Carolina Family Health Center
→The Children's Clinic
Provide path forward and resources for Action Period 3
6. Session 2 Feedback
88%-100%
Visuals supported TBC content
Session met learning needs
Can apply information to our practice
Learned a moderate to great amount
Teaching methods were effective
Improvements
o Provide more examples of PDSA cycles and fishbone diagrams
o Send agenda and next assignments ahead of time
o Provide more examples of what it means to create a team environment
o We would like more statistics about what works and what does not work
o At the time of day for us, people tired even though sessions very educational
7.
8. 16 Teams : most teams adjusted core and extended
93 participating Core and Extended Team Members
Interact daily/weekly with patients and families
Roles: MD, NP, LPN, BH, Care Coordinator, CNA, FNP, Care Manager, MA, NP,
Front Desk, RN, LVN, Radiology Tech, LCSW, PNP, Interpreter, Case Manager,
Dental Coordinator, Pharmacist, Call Center Rep, Outreach Specialist, MSW
POD structure with multiple providers and dedicated MAs (4)
Other Leadership and Management : CQO, Quality Coord, Dir of Ops, Site Manager,
HR Dir, Data Analyst, Ops Specialist, Clinical Support Services Manager, Compliance,
COO, CMO, EMR Manager, Clinical Manager, IT, Patient Financial Coord, Dir Patient
Services, BH Manager, Medical Director, Chief Clinical Officer, CMO, Referral Manager
13. Agenda (3:00-4:30)
3:00 5 min Welcome and Introductions
Putting it All Together : Improvement Ramp
3:05 10 min Action Period 2 Milestones and Challenges
3:15 35 min Using Data for Improvement
3:50 30 min TBC Improvement Work
-Healthcare for the Homeless Team
-Carolina Family Health Center Team
-The Children’s Clinic
4:20 10 min Path Forward and Resources [ Introduce Progress Check List]
Action Period 3 Assignments
14. Improvement Science Theory Bursts (10 min)
Developing Capacity for Implementing Advanced TBC Model
Session 1 : Sept 21st
o Running effective team meetings using tools
o Developing and using a cause and effect diagram to inform PDSAs
o Writing a global and specific aim statement
Session 2 : Nov 2nd
o Developing a process map or current state workflow
o Applying PDSA methodology for improvement
Session 3 : Dec 14
o Using data for improvement (run charts, bar graphs, sampling)
Session 4 : Jan 25
o Standardizing (SDSAs) and Reliability Science
Session 5 : March 15
o Spreading Change
Session 6 : April 26
o Gantt Charting : 3-6 month Core Team improvement plan
15. Define Core and
Extended Team
Achieve multiple TBC
specific aims
Standardize (SDSAs)
roles and key processes
(Playbook, Spread Plan)
Improve team and coach
skills (improvement
science, team work,
coaching)
Move Practice
Assessment Data toward
Level A
Develop a post
collaborative team
action plan
TBC Learning Collaborative
90 min
Learning
Sessions
Between Session Action Periods (6 weeks)
Complete Assignments
Weekly Team Meetings , Daily Huddles
Monthly Reporting
Share Your Work – TBC Website (Moodle)
Developing Effective Meeting and Improvement Skills
Implementing Team Based Care – Small Tests of Change
Learning from Each Other
Action Period 3
Core and Extended Team
Refinements –
challenges
TBC Webinars
Effective Meetings and
Daily Huddles
Readiness Survey
Role Activity and Cycle
Time Data - deeper
Global, Specific Aims
Fishbone : Defining
Problem and PDSAs
Process Mapping :
Workflow and Roles
Brainstorming and
Benchmarking
PDSAs
SDSAs
Between Session
Mentoring and Faculty Support
Moodle Resources and Discussion Board
7
Sept 21 Dec 14 Jan 25 Mar 15 Apr 26 June 14Nov 2
16. Mentors Helping
Weekly Coach : Mentor Group Meetings, Individual as Needed
Teaching skills, reviewing tools (more skill building
needed from theory bursts, struggling with tools)
Addressing Online Learning Network Site (Moodle)
challenges
Advising difficulties getting meetings off the ground
(no time to meet), using roles (resistance)
Clarifying assignments, how to use assessment
tools
Providing advice for managing : ‘turmoil’,
‘overwhelming assignments’, ‘team and leadership
engagement issues’ , ‘team vs coach ownership’,
‘worried management will roadblock us’
Reminding : Start Where you Are, Use What you
Have, Do What you Can….
Weekly Meetings : Action Period 3
*no meeting tomorrow 3pm
Rate the Meetings
On average 8-9 (scale of 1 -10) .
Most helpful:
hearing report outs from other teams and
progress they are making,
reinforcing and learning new skills to help our
teams,
learning from how others are overcoming
challenges,
staying on track with assignments and getting
help with how to complete
getting help with how to use data
17. Action Period 2
Milestones
More than half the teams have been:
Refining their core and extended team structures
Defining roles and communication – both within
core team, and between core and extended team
Challenges:
• Keeping same staff in Core Team or a POD
• Staff pulled for coverage other shifts or sites
• Significant turnover (Providers, MAs, RNs)
• RNs more attracted to extended team role
• Other team members who cover us do not know
what we are doing…
18. Action Period 2 : Give Teams Time to Meet (webinar 1)
Challenges:
Time to meet. Getting time when ‘necessary people’ can get there.
Team members not engaged
Turnover – significant. Staff pulled for coverage other sites, departments
Provider not willing to delegate, when ultimately responsible if does not get done
Leadership support (e.g.’buy in’ to the process, communication about the work)
10 Teams (overcoming challenges)
working hard at sustaining 3 meetings/month, some 4-5/ month), 45-60 min
finding a good time to meet after trials of different times
learning who is required to attend – those needed to do the work, invite others when needed
meeting even if a few people (discipline and rhythm), start on time and do not wait for people
getting leadership support for protected time
sending meeting reminders (e.g. text 15 min ahead of meeting)
engaging team members
o using fishbone and process mapping (‘have stake in it’)
o rotating roles, assigning timekeeper for easy role
o posting work on the wall for input between meetings
6 Teams : meeting 2 or fewer times/month, working on unique challenges, different pace
20. Aim: Reduce waiting room time from 25 min
to 14 min By Dec 30
Weekly Data
5 Patients
To Date: 19 min from 25 min
Adding observation by Coach: MA Rooming
PDSAs :
Redesign and standardize MA Rooming Process
– more time with MA (value added)
Team Engagement
Peach Tree Healthcare
Action Period 2
Example : Data, Mapping, Aims, PDSAs
21. Early Stages of Change MA Role, RN Just Getting Started
(Use Your Data)
Peach Tree Healthcare
22. Holyoke Health Center
MA Role
RN Role
Insights 8 hours of Tracking
Significant Duplication of Efforts
Double Documentation (paper, EHR)
No Standards and Protocols for activities
‘Insufficient’ RN Care Management and
Coordination time – 16 min
Challenging Questions
What is ideal time for advanced activity?
All roles at once?
How do you narrow down roles and
activity to work on?
24. Role Activity Challenges (Action Period 3)
Common Challenges
Provider Completion of Role Activity
More differences than we anticipated
between what we are ‘currently doing’
and what we identified as ‘ideal’
Fears about giving things up, adding new
Lack of role delineation between LPN
and RN – and Provider duplication
Variation between same roles (2-3 MAs)
So many inefficiencies to tackle
Some Opportunities
Shadowing provider half day - activity
tracking. Shorter periods over days.
Activity analyses helping improve job
descriptions, role delineation, optimization
Transparency of work opportunity to ask –
We are doing ‘what’? We are putting it
‘where’? Why are we doing ‘that’?
Eliminating duplication of documentation
Reducing interruptions by optimizing EHR
messaging, workflows
25. Using Fishbone Long Cycle Time
to Identify Aims and PDSAs (Action Period 3)
Key Drivers
Pre Registered vs Not
On site lab delays
Early and late arrivals (team on time?)
AIM : Increase Percentage of Patients that
are Pre Registered from 26% to 29%
by Dec 31st
Team Engagement
High Leverage PDSAs
(Action Period 3)
Efficiency, Role Optimization
AM , PM Start Times
Rooming Standards
Daily Huddles (6 Teams)
Pre Visit Planning
Sumter Family Health Center
26. PDSA Discipline (Action Period 3)
Increase Complexity of Change
- Start Small Test, days –weeks
- Small Wins
- Each PDSA can have a measure
Increase number of patients
- Have standards and protocols
- Have standard workflows
- Hard to implement
Get it right , Fewer Patients- before
scaling up to a defined population
27. Daughters of Charity
80
0
10
20
30
40
50
60
70
80
90
October 2016
Total Cycle Time - Check In to Check Out
Use Your Data (Cycle Time) Track Over Time (Action Period 3)
(5 / week, 15/ month)
How long do we track it? Achieving results you wanted, sustaining results due
to standardization and process reliability, new habits in daily work
0
5
10
15
20
25
30
Check In
Time
Waiting
Room Time
Support
Staff Time
Exam Room
Wait Time
Time with
Provider
Check out
Time
Break Down of Cycle Time
Specific Aims
Goal: 30 min for 20 min appt type
28. Using Data for Improvement (Action Period 3)
66
86
76
68
91
0
10
20
30
40
50
60
70
80
90
100
Gathering and
Using Data Skills
Using Effective
Meeting Skills
Implementing
Daily Huddles
Using
Improvement
Skills
Applying
Teamwork Skills
%StronglyAgreeorAgree
Team Skills Self-Assessment Summary (N=68)
Percentage Strongly Agree or Agree are Competent
October 2016
30. Session on Data & Sampling
for the Team-Based Care Collaborative
Mark E. Splaine, MD, MS
December 14, 2016
31. Displaying Data & Sampling
• Three theory bursts
– Displaying data over time (5 minutes)
– Types of variation (5 minutes)
– Overview of run charts (5 minutes)
• Application exercise
– Interpreting a run chart example (10 minutes)
• Sampling for improvement work (5 mins)
• Questions and discussion (5 mins)
31
33. Time 1 October 26, 2016 33
0
20
40
60
80
100
120
140
160
180
total time in
office
check in time waiting room
time
time with the
nurse
exam room
wait time
time with
provider
check out
time
Mean Minimum Maximum
Cycle Time: Johnson City CHC
37. Time Plot
• A graph of data in time order
• Often kept to identify if and when problems
appear (proactive)
• Also used to see trends over time (reflection)
• Especially helpful when you implement a change
to follow the result
37
38. 60
80
100
120
140
160
180
200
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31
Diabetes Stratified Time Plot
Days
BloodSugar(mg/dl)
Morning Readings
Before Bed Readings
38
Goal
40. Two Types of Variation
• Random (common cause) variation
• Non-random (special cause) variation
40
41. Random Variation
• Typically due to a large number of small
sources of variation
– Example: Variation in arrival time of a patient
might include: weather, vehicle problems,
parking issues
• Usually requires a deep understanding of
the process to change
41
42. Non-Random Variation
• Are not part of the process all the time.
Arise from special circumstances
– Example: Patients arrive late for appointments
due to a bus strike
• Usually best uncovered when monitoring
data in real time (or close to that)
42
43. How to React to Variation
ActionProcess result
Process with
only random
variation
Not satisfied with result:
redesign process to get a better
result
Reduce variation:
make the process even more
predictable or reliable
Process
with non-
random
variation
Identify the cause:
If positive, then can it be
replicated or standardized.
If negative, then cause needs to
be eliminated
Target the special causes - to
get the process predictable
43
47. Non-Random Patterns
on Run Charts
• The presence of a shift in the process
– A “run” is one or more consecutive points on the same
side of the median
– A run that is too long (6 or more consecutive points on
one side of the median)
• The presence of a trend
– A run with consecutive increases or decreases in data
(5 or more consecutive points)
• The presence of too much or too little variability
– Too few or too many runs (depends on number of
points on the chart)
47Perla, Provost, and Murray. BMJ Qual Saf. 2011;20:46-51
48. Source: Perla, Provost, and Murray. BMJ Qual Saf. 2011;20:46-51
48
Table. Runs Rule Guidance
Number of observations excluding points
on the median
Lower limit for the number of
runs
Upper limit for the number
of runs
13 4 11
14 4 12
15 5 12
16 5 13
17 5 13
18 6 14
19 6 15
20 6 16
21 7 16
22 7 17
23 7 17
24 8 18
25 8 18
26 9 19
27 10 19
28 10 20
29 10 20
30 11 21
31 11 22
49. 60
80
100
120
140
160
180
200
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31
A Run is a point or group of consecutive points that fall
on one side of the median
Days
How to Count Runs
49
FastingBloodSugar(mg/dl)
50. Questions
1. What does the blue line on the graph
represent?
2. How many runs are there?
3. How many shifts do you see?
4. How many trends are in the data?
5. How many non-random patterns (special
cause signals) are met in this run chart?
6. What is your interpretation of the chart?
50
52. 60
80
100
120
140
160
180
200
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31
Q1. What does the blue line represent?
Days
Run charts use the Median as the
central tendency measure
The Median
52
FastingBloodSugar(mg/dl)
53. 60
80
100
120
140
160
180
200
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31
There are 14 Runs
Days
Q2. How many runs are there?
53
FastingBloodSugar(mg/dl)
54. 60
80
100
120
140
160
180
200
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31
There is ONE Shift
Days
Q3. How many shifts do you see?
54
FastingBloodSugar(mg/dl)
55. 60
80
100
120
140
160
180
200
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31
There are NO Trends
Days
Q4. How many trends are in the data?
55
FastingBloodSugar(mg/dl)
56. 60
80
100
120
140
160
180
200
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31
Runs = 14 Shifts = 1 Trends = 0
There is ONE Signal
Days
Non-random pattern (Shift)
Q5. How many non-random patterns?
56
FastingBloodSugar(mg/dl)
57. 60
80
100
120
140
160
180
200
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31
• There is non-random (special cause) variation present. One would need
to investigate why this occurred. Since the cause is in the wrong
direction, one would ideally like to eliminate this cause from the system.
• Note: upon talking to the patient, the special cause was related to him
eating dessert every night while on vacation. Some education about diet
could then eliminate the cause.
Days
Non-random pattern (Shift)
Q6. What is your interpretation of the chart?
57
FastingBloodSugar(mg/dl)
59. Two Type of Sampling
Random (Probability)
Samples
• Think of a pond or lake
• Water stays in place
Judgment Samples
• Think of a stream or river
• Water constantly moving
59
60. Improvement Work
• Benefits from judgment sampling
• What is judgment sampling?
– A nonprobability sample that is selected on the basis of
knowledge of the process or a subject matter expert
• Is there a trade-off to using judgment sampling?
– “We trade the ability to quantify the precision of estimation
and control the bias of selection of a defined population for
learning about variation in the fragments of experience we
are most interested in learning about – most often with an
eye toward efficiency and getting ‘just enough’ data to guide
our learning and subsequent testing” 60
61. Some Examples
61
Example Situation Probability Sample Judgment Sample
5
Nurse leader wants
to test impact of
new pressure ulcer
bundle
• Obtain list of all units
• Randomly select 50%
• Assess all patients on
selected units before
and once after
intervention
• Sample 5 patients each
week who are at highest
risk on the unit with the
highest risk patients
• Track data over time
6
Oncology manager
wants to know
whether patients
get proper
education after
flowsheet
initiation
• Simple random sample
of all patients in last 3
months
• Charts reviewed by
manager
• Select the most recent
patients
• Perform chart review
62. Summary
• Variation over time is intrinsic to all health care &
other work processes.
• Displaying data over time can help visualize the
variation present.
• Understanding that variation can help monitor,
adjust and improve processes.
• Studying variation with run charts can offer
insights about possible cause of that variation and
offer clues to the design of change.
62
63. What haven’t we figured out yet?
Questions or issues that remain unclear?
63
64. References
• Perla RJ, Provost LP, and Murray SK. The run chart: a
simple analytical tool for learning from variation in
healthcare processes. BMJ Qual Saf. 2011;20:46-51.
• Perla RJ and Provost LP. Judgment sampling: a healthcare
improvement perspective. Qual Manage Health Care.
2012;21(3):169-175.
• George ML, Rowlands D, Price M, and Maxley J. The Lean
Six Sigma Pocket Toolbook. New York, NY: McGraw-Hill,
2005. Chapters 6 and 7, pp 104-118.
65. Agenda (3:00-4:30)
3:00 5 min Welcome and Introductions
Putting it All Together : Improvement Ramp
3:05 10 min Action Period 2 Milestones and Challenges
3:15 35 min Using Data for Improvement
3:50 30 min TBC Improvement Work
-Healthcare for the Homeless Team
-Carolina Family Health Center Team
-The Children’s Clinic
4:20 10 min Path Forward and Resources [ Introduce Progress Check List]
Action Period 3 Assignments
66. Healthcare For The Homeless
Specific Aim and PDSAs
Referral Process : RN Role
Optimization Extended Team
67.
68. Manages Referrals to specialists
and community resources,
ensuring relevant clinical
information is provided
B C
72. Carolina Family Health Centers
Specific Aim : Cycle Time
Pre Visit Planning Daily Huddles
73.
74. 0
10
20
30
40
50
60
70
80
90
Total Cycle
Time -
Check In to
Check Out
Check In
Time
Waiting
Room Time
Support
Staff Time
Exam Room
Wait Time
Time with
Provider
Time at Lab Time at
Referrals
Check out
Time
Oct-16
Oct-16
Cycle Time : Average 78 minutes
81. Huddles
• What time of day, and how long are your huddles?
• What is the focus of your huddles?
• Are you using a tool?
• How are you including your Care Coordinator?
• How are you thinking about including your Patient
Service Representative?
84. Agenda (3:00-4:30)
3:00 5 min Welcome and Introductions
Putting it All Together : Improvement Ramp
3:05 10 min Action Period 2 Milestones and Challenges
3:15 35 min Using Data for Improvement
3:50 30 min TBC Improvement Work
-Healthcare for the Homeless Team
-Carolina Family Health Center Team
-The Children’s Clinic
4:20 10 min Path Forward and Resources [ Introduce Progress Check List]
Action Period 3 Assignments
86. Action Period 3 Assignments
1. Meet weekly as a Core Team
Problem solve ‘time to meet’
Practice effective meeting skills using tools, with coaching support
Define core and extended care team (members and roles)
2. Implement Daily Huddles
Work on improving (PDSAs) and standardizing (SDSAs)
Align Huddle intervention with a specific aim (e.g. reduce cycle time, increase screening)
3. Write specific aim(s) statements , using data and knowledge of problem
Continue Assessments (role activity, cycle time, other)
Complete Fishbone diagrams and process mapping
87. Action Period 3 Assignments
4. Implement PDSAs (small, measurable, rapid)
Share your work by uploading TBC website, discussion board
Use brainstorming and benchmarking to inform changes
5. Complete readiness survey ( 50 % ), data will be posted on TBD Website
Purpose : To assess whether an organization is ready and committed to the
implementation of a specific change, from the perspective of care team members.
Still time to complete Team Skills Assessment survey (50%)
6. Post Monthly Reports : Next Due January 10th , 2017
7. Watch Webinars (1-4)
8. Introduce Coaches to Progress Check List for tracking implementation, leadership reporting