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Tools Used for Quality
    Improvement
        ACT
     Astrid Grgurich
Nolan’s Three Questions


 What are you trying to accomplish?


 How will you know a change is an improvement?


 What changes can you make that will result in an
 improvement?
Retrospective Event Analysis

 Utilises data from prior events as a marker to
 prevent recurrence.

 Data collected and given systematic format.


 Protocol .
Is this applicable to PPE
compliance?

 First, factors contributing to the incidence of PPE
 non-compliance must be identified....

   Very few facets contributing
   Could in theory be applicable
A very simple example...
Do you know       Ye    Is appropriate PPE
what PPE is       s     available?
required?

                        Ye            N
              N
                        s             o
              o

    Consult PPE
    guidelines
                       Apply
    specific to
                       PPE,
    patient.
                       attend to          Contact
                       patient.           relevant
                                          person
                                          to
                                          restock.
References
 Bassuck, S., & Manson, J. (2008). Lifestyle and
 risk of cardiovascular disease and type 2
 diabetes in women: Promoting healthy lifestyles:
 The role of the clinician. American journal of
 lifestyle and medicine, 2(3), 191-213.
 National Institute for Occupational Safety and
 Health (2009). National personal protective
 technology laboratory request your
 assistance. Retrieved from
 http://www.cdc.gov/niosh/npptl/pdfs/PotentialB
 arriersPPE.pdf
 Varkey, P. (Ed.). (2010). Medical quality
 management: Theory and practice. Sudbury, MA:
 Jones and Bartlett Publishers.

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Tools used for quality improvement act

  • 1. Tools Used for Quality Improvement ACT Astrid Grgurich
  • 2. Nolan’s Three Questions  What are you trying to accomplish?  How will you know a change is an improvement?  What changes can you make that will result in an improvement?
  • 3. Retrospective Event Analysis  Utilises data from prior events as a marker to prevent recurrence.  Data collected and given systematic format.  Protocol .
  • 4.
  • 5. Is this applicable to PPE compliance?  First, factors contributing to the incidence of PPE non-compliance must be identified....  Very few facets contributing  Could in theory be applicable
  • 6. A very simple example... Do you know Ye Is appropriate PPE what PPE is s available? required? Ye N N s o o Consult PPE guidelines Apply specific to PPE, patient. attend to Contact patient. relevant person to restock.
  • 7. References  Bassuck, S., & Manson, J. (2008). Lifestyle and risk of cardiovascular disease and type 2 diabetes in women: Promoting healthy lifestyles: The role of the clinician. American journal of lifestyle and medicine, 2(3), 191-213.  National Institute for Occupational Safety and Health (2009). National personal protective technology laboratory request your assistance. Retrieved from http://www.cdc.gov/niosh/npptl/pdfs/PotentialB arriersPPE.pdf  Varkey, P. (Ed.). (2010). Medical quality management: Theory and practice. Sudbury, MA: Jones and Bartlett Publishers.

Editor's Notes

  1. A good starting point for an improvement project is to pose Nolan’s 3 questions (Varkey, 2010).Jess answered the first question in the planning stage and gave some examples of tools that could be used to identify what we are trying to accomplish. Jade answered the second question by identifying tools that can be used during the study stage.My job now is to find a tool that determines whether or not the changes that can be identified in the earlier stages will result in an actual improvement.
  2. Retrospective event analysis is an analytical tool used to prevent the recurrence of a undesirable outcome. Data regarding the outcome is collected and presented in a systematic format, such as a flow chart, creating a protocol to follow for practice.
  3. This is an example of a retrospective event analysis. Through research, it is now well-known and supported that obesity and lack of exercise are contributing factors to cardiovascular disease. After a collection of data regarding this issue, a flow chart has been constructed to offer a systematic method of preventing the risk factors to cardiovascular disease in a bid to prevent the disease itself (Bassuk & Manson, 2008).Image taken from: http://img.medscape.com/fullsize/migrated/574/269/ajlm574269.fig4.gif
  4. The act portion of the PDSA cycle has more to do with measurement and evaluation, a topic we will explore in the next session. So I have briefly considered whether the tool is appropriate for our needs today.PPE compliance is a much simpler problem to improve than prevention of cardiovascular disease, however in theory, the retrospective event analysis tool could still be applicable.Factors contributing to the non-compliance of PPE in hospitals have been identified through research as ability to access and acquire the proper PPE, discomfort and burden of PPE, ability to perform work tasks while wearing PPE, multi-tasking and the need for changing or removing PPE between activities and/or patients are barriers to using PPE effectively (National Institute for Occupational Safety and Health, 2009).This being the case, it is reasonable to assume that action plan flow charts outlining improved processes could be employed in hospitals in situations requiring PPE to encourage its staff compliance. The original purpose of the quality improvement, to improve PPE compliance, could be achieved with the use of a systematic flow chart.