Discuss the role of rapid cycle design and small test of change in the PDSA perf

Question

Discuss the role of rapid cycle design and small test of change in the PDSA performance improvement process for improving compliance and outcomes in healthcare settings. Please make an initial post by midweek, and respond to at least two other students' posts with substantial details that demonstrate an understanding of the concepts, and critical thinking. Remember that your posts must exhibit appropriate writing mechanics including using proper language, cordiality, and proper grammar and punctuation. If you refer to any outside sources or reference materials be sure to provide proper attribution and/or citation.

Explanation / Answer

In the healthcare settings there are many tools are available to support the process improvements (PI) and the process improvements is a analyzing and management changes implementation process. The available supporting tools are data collection surveys, analyzing the data to formulate an action plan, collaboration with teams to methods improvement, graphs and charts.

The rapid cycle improvement or PDSA cycle is a systemic approach and the acronym of PDSA stands for PLAN, DO, STUDY, and ACT. The main purpose of PDSA is to improve quality efforts is to establish a functional or causal relationship between changes in processes and outcomes. I am a Six Sigma Green Belt, which was obtained through my certification with Hewlett-Packard in 2005. After working a year nearly on my project and it is completely unrelated to my healthcare but I was still focused on the process improvement, which was saved the company around 30% in overhead costs. After the Enron accounting fraud scandal in 2001 many changes happened with respect to how revenue was recognized from a federal standpoint. This was a massive undertaking because it required educating the sales team on requirements and company guidelines that mandated essential documentation to be embedded before acknowledging a government purchase order. Before I initiated my project, the initial responsibility had been left up to the data entry specialists to spend cycles collecting this data which technically was not part of their job description. After several survey monkeys, Pareto charts, fish bone diagrams and collaborating with interdisciplinary sectors, we developed a checklist to accommodate HP and Federal Government Regulations. We also had to determine who owned this responsibility of data collection. The group determined that this responsibility resided with the sales team since they had direct interface with the customer. Upon compiling and documenting the PDSA cycles as well as conducting pilot roll outs of the checklist I had to present my project to the Six Sigma Board which consisted of 6 Black Belts. Needless to say I was a lot nervous! After they collaborated they determined that my project was viable to receive my certification. It was truly an awesome learning experience for me and even though this was not healthcare related I am still able to apply those skills as a nurse today.

With any PI there are questions that have to be addressed such as:

What is the ultimate outcome?

How will we know that the change has resulted in improvement?

What changes can we make that will result in an improvement or positive outcome?

Once these questions are thoroughly explored an AIM statement can be generated. An aim statement is a tailored description of the team's preferred outcome, which is demonstrated in a quantifiable and time-specific way.

After developing the AIM statement there are another set of questions that the team considers such as:

What is the current process?

How is that process executed?

What are the various intervals or steps of the that process?

Who does this process affect?

What do these individuals do?

What is done well?

Where could we do better?

At this time it may be a beneficial to develop a flow chart to visualize the current process and determine where the breaks occur. Once you have seen the flow you may consider:

How long does this process or flow take from beginning to end?

Is there any variation in the current process – are people taking short cuts or are they truly following the process in place?

Here is where you will need to identify and prioritize the current issues and develop a problem statement to verbalize why you have chosen to itemize the issues in this manner. Then develop an action plan to address each issue. This step will end the “planning” phase and begin the “do” phase. The “do” phase begins with the implementation of the action plan. You may want to consider using a tracking method to document occurrences or issues in the new plan such as a Pareto chart or scatter plot.

Next is the “study” phase where you compile your data and review the outcomes. Usually, you will develop visual aids such as control charts, run charts, and scatter graphs to depict progress. After a more focused analysis is completed and findings are thoroughly understood, it is time to reflect on the plan and outcomes. If this was a successful change then implement it and make it a standard practice! If the outcome wasn’t as meaningful as initially hypothesized then repeat the PDSA cycle. Observe and communicate the team’s accomplishments and standardize the new process. Make plans to continuing reviewing the progression until ultimate outcome is achieved!

Reference:

Hughs, R. Tools and Strategies for Quality Improvement and Patient Safety, Retrieved 5/01/16.

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