1. Steps in QI

Step 1: Identifying a problem, forming a team and writing
             an aim statement

Step 2: Analyzing the problem and measuring quality
             of care

Step 3: Developing and testing changes

Step 4: Sustaining improvement

2. Session I

► You will learn
      ♦ How to review data to identify problems
      ♦ How to prioritize which problems to work on
      ♦ How to form a team to work on that problem
      ♦ How to write a clear ‘aim statement’

3. How to identify a Problem

4. How to review data

5. Make a List of what you don’t like

6. Choosing a Problem

► Simple , easy to fix & amenable to change
► Value for patient ( impact )
► Dose not need much resources
► Short turn about time - early results

► Avoid - Long term projects
    ♦ Mortality as outcome e.g. 12 in a year ,
      difficult to document
    ♦ Hemorhagic disease in newborn
      (vitamin K related) – Follow up required

Early success motivates Team

7. Prioritize the Problem

8. Planning

9. Select Your Team

► Are involved-they are already doing the work that needs
    change

► Look for volunteers
      ♦ Are enthusiastic – they want to make changes
      ♦ Are influential - others people listen to them and
        they can get things done

10. Select Your Team Members

► Identify who need to be in Team
      ♦ at every level
      ♦ from all department
      ♦ from administrators to cleaners
      ♦ pick – Leader ,Recorder ,Communicator

11. Why Teamwork is important for improvement ?

► Healthcare setting = Range of people

► Given the opportunity ,staff can identify problems and
    generate ideas to resolve them

► Participation improves ideas , increases buying-in , and
    reduces resistance to change

► Accomplishing things together increases the confidence
    of each member

12. Aim statement

► Description of a team's desired outcome

► Expressed in a measurable and time-specific way

13. Aim statement

► Characteristics of Good Aim Statement

► States a clear specific aim

► Linked to specific patient population

► Should include a goal
      ♦ Neither too difficult nor too long to achieve

Includes a solution
      ♦ Do not include possible, yet unproven solutions

14. SMART Aim

15. Aim statement

► Problem: Central line associated blood stream infections
    in Medical ICU

► To reduce the incidence of Central line associated blood
    stream infections in Medicine ICU of AIIMS New Delhi
    from 30% to 10% in next 6 weeks.

► Who (which patients )- Patients admitted in Medicine
    ICU of AIIMS New Delhi
► What (the outcome)-Central line associated blood
    stream infections
► How much (the amount of desired improvement )-
    from baseline rate of 30% to <10%
► By when (time over which change will occur)- within
    6 weeks

16. Aim statement Choose most appropriate

17. Aim statement