Identification of problems for QI Step 4

  • Introduction...
  • 1. Learning Object...
  • 2. Hardwiring of Q...
  • 3. Tinkering VS Sy...
  • 4. How To Keep Mem...
  • 5. How To Motivate...
  • 6. Visual Display ...
  • 7. Sustenance Of T...
  • 8. Choosing New Pr...
  • 9. Story of Teamwo...
  • 10. New Problem Ar...
  • 11. Making Policie...
  • 12. Keys To Susten...
  • 13. Key Messages...
  • 10. THANK YOU...


Nurse Educator

WHO Collaborating Centre for Training and Research in Newborn Care,
All India Institute of Medical Sciences,
New Delhi, India

1. Learning Objective

You will learn

► How to embed successful changes into health system
    to sustain the improvement in quality of care

► Engage and motivate team to view QI as culture by
    improvement thus improving work culture across
    health facility for providing better care

2. Hardwiring of QI Project

► Documenting the flow of the new process

► Providing training on the new process

► Teaching people new skills that might be required
    of them

► Making changes in job description, policies

► Addressing supplies and equipment issues

► Removing any barriers so as to prevent slippage back
    to old process

3. Tinkering VS System Change

4. How To Keep Members Involved In QI ?

► Regularly share run chart/data

► Reminders on SMS/ what’s app

► Involve Head of Department and Faculty on floor

► Share the stories with Nursing Officers / MS

5. How To Motivate Team Members ?

► Give opportunities to team to share experience
    in physicians and nurses workshops

► Assigning QI to multiple team leaders who are

► Everyone reports to QI leader in joint meetings

6. Visual Display of Data

► Regular sharing of data of QI project

► Display on board and communicate to others

► After the project has shown positive results continue
    on regular epochs with eye on measurement

7. Sustenance Of The Expressed Breast Milk

8. Choosing New Problems By Consensus

► Easy ,simple to solve, within our control

► Are impactful and are important for improving care

► No additional resources are needed

► Ideas emanate from discussions within the unit

9. Story of Teamwork With Sustenance

Involving parents ,nurses & doctors

► Staff did a QI project in increasing duration of KMC

► Team consisted of mothers , nurses & doctors

► The unit implemented changes as per suggestion of
    team members during weekly meetings

► Able to sustain the gains with regular feedback
    and reminders during rounds by faculty

10. New Problem Arose

► Breakages of warmer probes while mother were
    providing KMC to sick babies

► Despite nurses education and being diligent,
    probes life still remained short

► Mother’s education using flip charts in local
    language resulted in increasing life of probe !


11. Making Policies for Continuous QI

Implementation of better communication skills

QI to prevent hypothermia at NICU admission among preterm neonates

12. Keys To Sustenance

There is more !

► Celebrate success

► Team of volunteers and highly motivated participants

► Recognising champions

► Positive attitude

► Inculcating QI as a culture

13. Key Messages

Sustenance often requires system changes (like ensuring breast pumps for expression)

Changes which lead to less work (like changing process flow in labor room) or made life easier for the health workers or regular visual display of data (run charts for KMC duration) are more sustainable

Making policy , so that new recruits are exposed to standards of care

Leadership involvement is crucial to success