Transcript Document

DEEP DIVE: Measurement for
Learning
June 15th, 2010
Checklist Planning Group & Guests
17-Jul-15
1
Checklist Action Series Hosts
Marlies van Dijk,
Western Node Leader Safer Healthcare Now! and
Moderator for Checklist Action Series DEEP DIVE
Leanne Couves, Improvement Associates Ltd. & Quality Moderator
for Checklist Action Series DEEP DIVE
Chantal Bellerose, Quebec Node SIA Safer Healthcare Now! &
French Liaison for Checklist Action Series
Tanis Rollefstad, Western Node SIA Safer Healthcare Now! &
Technical Host for Checklist Action Series
Angela Thiessen, Western Node Administrative & Technical
Support for Checklist Action Series
17-Jul-15
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Objectives for Today’s Call
• Identify your purpose for doing the
checklist
• Choose which measures to start
• Explore detailed definitions for key
measures, including data collection plans
• Using data for learning
Interacting in WebEx
Be prepared to use:
- Pointer Tool
- Raise Hand
- Chat “to all participants”
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What ideas have you tried?
Use the
pointer
• Measuring compliance with Y/N?
• Measured more than compliance?
• Measuring OR culture?
• Started measuring other items?
• Haven’t started measuring.
More on What Can Be Measured
17-Jul-15
Leanne Couves
Marlies vanDijk
Improvement Associates
Western Node Leader, SHN!
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Examples of Purpose
Statements
• Anticipate problems
• Prevent adverse events and/or
outcomes
• Prevent harm to patients
• Improve culture, teamwork and
communication
Use Pointer
to indicate which resonate with
your organization
Marlies van Dijk
POTENTIAL MEASURES
• Extended length of anesthesia due to delays
Data Display for Checklist Family of Measures
Percent Surgical Cases with Checklist Done
Percent Cases Abx Given within 60 Min
% Cases with Abx Given Within 60 Min
% Cases with Checklist Done at all 3 Phases
100
100%
75
75%
50
50%
25
25%
Dec10
Nov10
Oct10
Sep10
Aug10
Jul10
Jun10
May10
Apr10
Mar10
Jan10
Staff Satisfaction
Feb10
0%
Week 9
Week 8
Week 7
Week 6
Week 5
Week 4
Week 3
Week 2
Week 1
0
Number of Good Catches
% Staff Rating Ease of Speaking Up in a Case
Number of Good Catches
100%
25
20
Axis Title
75%
50%
25%
15
10
5
0%
Sept
Aug
Jul
Jun
May
Apr
Mar
Feb
Jan
Sept
Aug
Jul
Jun
May
Apr
Mar
Feb
Jan
0
Measures
using Small
Multiples:
Overall System
and 4 sites
OUR SITE
100
90
90
80
80
70
70
60
60
50
50
40
40
30
30
20
20
10
10
0
0
Apr
Jun
Aug
Oct
Dec
Feb
Apr
Jun
Aug
Oct
Dec
Apr
Jun
Aug
Oct
Dec
Feb
Apr
Jun
Aug
Oct
Dec
Jun
Aug
Oct
Dec
SITE4
SITE3
100
Overall
Outcome
Measure
SITE2
100
100
90
90
80
80
70
70
60
60
50
50
40
40
30
30
20
20
10
10
0
0
Apr
Jun
Aug
Oct
Dec
Feb
Apr
Jun
Aug
Oct
Dec
Apr
Jun
Aug
Oct
Dec
Feb
Apr
These graphs are called small multiples. They are designed for a quick
visual comparisons of the data from each site The graphs are all
presented on the same scale (both x and y axis)
Meaningful Measures followed
by a Quebec Hospital
Chantal Bellerose
SIA Quebec Node
More on HOW to Measure
Small Group Discussions
Breakout Rooms
Led by Facilitators
Breakout Exercise Talk Through
Measurement Plan
What will you do
with the data?
What is your
purpose ?
How would
you collect the
data?
What’s your
measure?
How would you
define the
measure?
Sample Measurement Sheet*
*Adapted from Susan Macknak
http://www.uth.tmc.edu/schools/med/imed/
patient_safety/questionnaires/
Use text tool on next slide to record one idea from breakouts
BREAKOUT SESSION SUMMARY &
DEBRIEF
How Much Data is Enough?
Marlies van Dijk
Western Node Leader, SHN!
Data Collection Methods
• Observation (direct or indirect)
• Informal conversations
• Surveys and questionnaires (written, phone, oneon-one interviews)
• Focus groups / group interviews
• Direct experience “trading places”
• Quantitative measurements (manual or
electronic)
Sampling
• Random (from random number generator)
• Systematic random
e.g. every X (random number from generator) of Y
• Judgment (requires process knowledge)
– By time of day
– By location
– By patient population
e.g. first 5 cases of the day, Mondays and Thursday’s
Based on “The Data Guide” by Sandra Murray and Lloyd Provost
# 3 Present
to the OR teams and other
stakeholders
# 1 Goal for implementing
the Checklist
#2 Measures to support
your goal
Checklist Sampling Ideas
Adverse Events
Prevented
• Review incidents in the Glitch
book weekly and categorize them
Communication
Equipment
Medications/Blood
Wrong site
Lab work/chart issues
• Staff Room Display
Length of anesthesia reduced
with Checklist
• Hips and Knee procedures only
• Assign observational data
collection
• Every Thursday when Dr. X is
doing Hips
• Circulating Nurse will notate no.
of minutes delayed on white
board as they arise
• Assign responsibility for someone
to capture data after each case
• Review monthly
Checklist Sampling Ideas
Team work and
communication
•
•
•
•
•
•
Ask 5 questions on team work and
communication (5 min to fill out)
Capture discipline (nursing, surgery,
anesthesia)
Capture them during breaks and
lunch
Aim to get 10 people per discipline
10 nurses, 10 surgeons and 10
anesthesiologist, 10 others (RT)
Collate and feedback to staff
Compliance with Checklist
•
Choose method (observational or
audit form)
Audit:
• Yes/No tool to each of the 3 stages of
the checklist
• Choose surgical procedure (s) where
checklist is being used
• Sample 2 charts a day (random or
specific procedures)
• Sample 5 first charts once a week
before they go down to health
records
• Collate and feedback to staff
Open Mike on Measurement
Poll Questions
Relevance Check
Next Steps
ACTION Items
Between now and June 23rd
• Apply what you’ve learned today – start
your data collection plan
• Download session materials and see
examples of data collection tools – Sign up
on the SSSL Community of Practice
Advice to a “Newbie”
It’s not as simple as it
looks!
Retrieved from:
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QTNHOHIWANrOg7NsM&ved=0CC0Q9QEwBA
Thank You
•
•
•
•
•
You
Guest speakers
Faculty
Facilitators
Message from
Chantal
Questions?
Tanis Rollefstad, Safety & Improvement Advisor
Phone: 306.693.0780
Email:
[email protected]
Leanne Couves, Improvement Associates Ltd.
Phone: 780.446.9940 cell
Email:
[email protected]
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French Speaking Teams
Chantal Bellerose Dt.P.,M.Sc (cand).
Conseillère en matière de sécurité et
d'amélioration | Safety and Improvement
Advisor SHN
Campagne québécoise: Ensemble, améliorons la
prestation sécuritaire des soins de santé! |
Phone: 514‐340‐8222 #6705 et #4901
Email: [email protected]
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“See you” on June 23rd
0900-1030 PDT; 1000-1130 MDT; 1100-1230 CDT; 12001330 EDT; 1300-1430 ADT; 1330-1500 NDT
KEY THINGS TO CONSIDER WHEN
IMPLEMENTING THE CHECKLIST:
HIGHLIGHTS
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