Improvement Series Wrap-Up

August 26, 2010 at 7:26 pm Leave a comment

OK, it’s time to put this series to bed.  If you look back through the related posts you have a fairly comprehensive set of suggestions for how to go about a systematic, sustainable, repeatable approach to improvement initiatives in your organization. So here are the last few suggestions.

Create an implementation plan

Without implantation, no change occurs. Make it happen. The implementation plan is the set of tasks required to develop the countermeasures, put them in place, and realize the desired condition.  For each task, a person responsible for that task is listed along with a deadline for task completion.  It may also be helpful to list the expected outcome of each task. The plan should include:

  • Actions are to be taken
  • The responsible person
  • When steps should be done, times and dates
  • The expected outcome for each step

If the person conducting the improvement process is not final decision maker, it’s imperative to remember the importance of obtaining approval from the important management leaders in your organization to carry out the proposed plan. The leaders should verify that the problem has been sufficiently studied and that all affected parties are “on board” with the proposal.  Management may then approve the change and allow implementation.

Test the Desired Condition

In some instances it may important to simulate the process or set up a test environment to check the proposed process. The test should have time limits and be safe for problem-solvers to be creative and experiment. The deep understanding achieved earlier in the process should make risk minimal. Testing allows you to tweak the system before full-blown implementation. Once the test is done and implementation is authorized, the newly designed work can proceed.

Remember to Consider Costs

Nothing happens at not cost. Be very careful in determining the direct and indirect costs of you improvement effort. Consider the costs of:

  • Materials
  • Equipment
  • IT services
  • Staff time
  • Training
  • New steps in the process
  • Data collection and analysis
  • Etc.

Develop a clear understanding of the direct and indirect cost of the actions to be taken. Do a brief budget. Gain agreement that the costs are worth the effort.

Evaluate the Actual Outcomes

Process improvement should not end with implementation.  It is very important to measure the actual results and compare them to what you predicted should happen. Plan in advance how to collect the data to later evaluate and check the effectiveness of the actions taken in your improvement effort. If possible, verify the effectiveness of the actions taken one by one.

Some tips for the evaluation:

  • Make clear who will help collect the data and how frequently.
  • Measure and re-measure to see if the changes have had the predicted impact.
  • Be sure to use the same measures that were used for baseline assessment for the follow-up evaluation.
  • Make the outcomes of the effort public.

If the actual results differ from the predicted ones, research needs to be conducted to figure out why, modify the process and repeat implementation and follow-up (i.e., repeat the A3 process)

Develop a follow-up plan with predicted outcomes

After you have gone through an improvement initiative you want the positive changes to stick. You don’t want things to slide back to where they were before you started. Improvements need to become the standard mode of operation. Do whatever it takes to standardize the improvements. Change policies. Change protocols. Change processes. Make the new way the work is done the only way that is acceptable.

Another thing to consider is looking around in your organization for similar processes that might benefit from the countermeasures you implemented. Yo might be able to get more mileage out of your efforts.

And consider whether others in the organization not directly involved in the work you changed should be made aware of the change for the purpose of improving future processes.

Final Word

Improvements in organizations are best made by the people doing the actual work you are trying to improve. We can learn a set of skills that can be used by every CME provider to improve their own organization. That same set of skills can be taught to and learned by our physician constituents to engage in improvement efforts in their own patient care. All CME is improvement focused.

Having a systematic, sustainable, repeatable approach to improvement is a great skill set o master. Become proficient in improvement and you will add value to your CME operation regardless of the setting you are working in.


Entry filed under: CME, Improvement, PI CME.

CME Professionals Have Performance Gaps Too CME in the News and on the Blogs – August 31, 2010

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