How to Conduct an Effective QI Team Meeting

Transcription

1 How to Conduct an Effective QI Team Meeting CQN2 QI Tool of the Month: November, 2011 QI meetings need to be as efficient (short!) as possible, while assuring that the team has a shared vision with enough specificity that each team member is clear about what is to be accomplished by when. There are two kinds of QI meetings: the QI Team Huddle and the QI Team Meeting. Either of these meeting formats are considered a team meeting in the practice narrative report question, How many times has the QI team met this past month? QI Team Huddles: These short meetings (no more than 20 minutes) are utilized when the team is reviewing details regarding PDSA cycles. If other clinic members are involved in the PDSA, include them in the huddle! Tips for effective QI Team huddles: We recommend that the team huddle frequently. Determine a time that the QI team can usually huddle, and make it a standing time. Pick a time early in the week so that you can focus the huddle on what will be tested that week. Based on the testing you are doing, your group can decide how frequently you will need to huddle. For example, depending on your test, you may need to huddle every other day or even several times a day so that you can course correct as you are going (see text box below for an example). Use the PDSA worksheet every huddle as your means of data capture and setting the huddle agenda. The worksheet includes all of the relevant information needed to conduct the test and capture relevant information to understand later what you did and whether it worked. Determine how data will be captured and who will be responsible for data collection Remember to use a PDSA worksheet for each test. As your team becomes more adapt in testing, it is not unusual to be conducting several PDSA s simultaneously (for example, a team may be testing work flow around incorporating the asthma action plan and another test around successful completion and feedback of the pulmonary function report of FEV1) Assign a team member to own the PDSA worksheet. This person will fill in the content based on the decisions at the huddle, and come with an updated worksheet reflecting all that happened during the testing. The more notes and annotations along the way, the easier it will be to remember what happened 6 months from now! EXAMPLE: XYZ Pediatrics wanted to test their hypotheses that they would improve % of patients receiving self management support by delineating role of team members. They wanted to determine who might be the best person to provide self management support materials and/or education. They huddled on Monday AM and determined that they would have the MOA for Dr. J provide materials for 2 days (cycle 1). They then huddled on Wed AM and determined that perhaps the nurse should provide materials, as many parents were asking for more detail information and needed education (cycle #2). On Friday, they huddled to discuss the outcomes including the impact on access to exam room for the next patient.

2 How to Conduct an Effective QI Team Meeting CQN2 QI Tool of the Month: November, 2011 QI Team Meetings: These are generally 60 minutes in length, and are needed to review data, develop hypotheses and ideas for future PDSA cycles and develop strategies to overcome barriers and assure all physicians and staff are informed and engaged. We recommend at least one QI team meeting per month. Often QI teams meet twice a month for the first 4 6 months of a learning collaborative, when they are in the developmental stages and need the traction to make significant progress early. Tips for an Effective QI Team Meeting: Set the date of the QI team meeting to correspond to the posting of monthly data Create an agenda with time assigned to each topic. Assign a facilitator who is comfortable keeping folks on task. Assign a note taker. If laptop is available, this allows the note taker to enter notes just in time (during the meeting), or alternatively hand written notes will work! (See Agenda Template) STICK to the agenda. Use the parking lot for topics not on the agenda Typical QI meeting agenda topics include: o Kudos and acknowledgements (what went well since last time you met?) o Review of latest monthly data reports o Review/populate change activity log (see Change Activity Log) o Discuss areas of testing for next 2 4 weeks o Define barriers and key issues that need MD lead/leadership support o Determine communication needed (including display boards, staff meetings, etc) o Review next steps and assignments Limit the number of topics to 6 or less (not including your acknowledgements!). Assign a time for each topic. End the meeting on time. Make sure team members get the notes w/in 24 hours of the meeting. If parking lot topics are identified, consider building these topics into future agenda or identify who will be addressing the topic. (We have built this into our meeting template with a place to capture those topics).

3 PDSA worksheet plan - do - study - act team title change cycle # Describe your team s objective for this cycle (what you hope to learn) and describe the test of change: Example: We want to improve % of parents receiving self management support materials by delineating roles of clinic team members PDSA Leader Dr Jay When Thursday Afternoon Where Exam room Specific questions to address: 1. Will delineating team roles around self management provide a more reliable system of distribution? 2. Will parents need education, and if so, should an RN be responsible for this aspect of the visit? 3. What happens to cycle time for the exam room when we provided materials and support? PLAN: Plan for change or test: who, what, when, how and where; Plan for data collection: who, what, when, how and how long List the tasks needed to set up this test of change 1. Develop cursory tracking sheet (see do ) 2. Flag Dr J s asthma patients for the week 3. Identify where to put materials 4. Determine work flow (in exam room or triage room?) 5. Determine next huddle to evaluate data Person Responsible Nurse J MOA When Where Predictions/Hypotheses What do you think will happen when test is done: When another team member (other than the physician) has the responsibility for self management support, the family will receive more tailored information and it will increase changes that it will happen for every patient. Measures to determine if prediction succeeds: % receiving self management support (will increase). DO: Carry out the change/test. Collect data. Note when completed, observations, problems encountered, and special circumstances: CYCLE #1: FIRST 1O PATIENTS W/ ASTHMA, DR. J S TEAM. TRACKING SHEET TO COLLECT DATA ON WHAT WHO PROVIDED MATERIALS, WHETHER THEY REQUESTED EDUCATIONAL SUPPORT, AND HOW MUCH TIME IT TOOK. STUDY: Analyze data (quantitative and qualitative). Summarize data: Review tracking sheet. Determine if the exam rooms get backed up if we provide materials and educ after the md has left. ACT: Document what was learned. Are you confident that you should expand size/scope of test or implement? What modifications/refinements are needed for the next cycle? PDSAworksheet page 1 of 1

4 (Name of Practice) QI Team Meeting AGENDA and NOTES Aim Statement: Put your customized aim statement here Goals: Put your stated goals here. (DATE AND TIME) Participants: (LOCATION) Facilitator: Timekeeper: Note-taker: TOPIC Announcements and Kudos DECISIONS/ACTION ITEMS Review of Monthly Data (Who/Time) Review of PDSA s to date and Update of Change Activity Log (Who/Time) PDSA s for next 2-4 weeks Discuss key barriers as they relate to CQN2 implementation Communication Review next steps and assignments Next meeting scheduled: PARKING LOT ISSUES (Topics brought up during the meeting that need further discussion at a later date) Deadlines: Time Away Upcoming CQN2 Learning Events: CQN2 Page 1 5/16/2012

5 CQN2 Asthma Collaborative - Change Activity Log Practice Name, Month/Year (Directions: Review with QI Team Monthly and save as Practice Name_Change Activity Log_Today s Date) Key Driver/ High leverage changes LEAD / STATUS OF PDSA CYCLE NEXT STEPS 1) Engaging Your QI Asthma Team and Your Practice 1a 1b 1c Ex: QI Team Huddles to move forward PDSA cycles QI Team Meetings to plan and communicate 1d 2) Using A Registry to Manage Your Asthma Population 2a 2b Dr. Powell/Starting tests of weekly huddle w/ QI teams starting Nov 7 Dr Jay/Monthly meetings will begin the 3 rd Wed of each month at noon Standing huddles time on Tues and Thurs Dr Jay to develop agenda based on CQN2 agenda template 2c 2d 3) 3a 3b Using a Planned Care Approach to Ensure Reliable Asthma Care in the Office 3c 3d 3e 3f 4) Developing an Approach to Employing Protocols 4a 4b 4c 4d 4e 4f ChangeActivityLogTemplateCQN2 QI Tool of the Month, November 2011 page 1 of 2

6 CQN2 Asthma Collaborative - Change Activity Log Practice Name, Month/Year (Directions: Review with QI Team Monthly and save as Practice Name_Change Activity Log_Today s Date) Key Driver/ High leverage changes LEAD / STATUS OF PDSA CYCLE NEXT STEPS 4g 4h 4i 4j 5) Providing Self Management Support 5a 5b 5c 5d 5e 5f 5g ChangeActivityLogTemplateCQN2 QI Tool of the Month, November 2011 page 2 of 2