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Survey staff views of current eol care 2 do analyze

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Survey staff views of current EOL care2. DO:Analyze survey results, identify gaps in careSelect interventions:Signage when patient actively dyingStaff communication sheet at bedsideStandardized order set for analgesia andsedation (after withdrawing care)Single room for dying patientsCase review rounds (EOL staff education)
18-04-3093.Study:Are the interventions ALL occurringconsistently? Why or why not?How are staff responding to the interventions(e.g., engaged, supportive, uninterested)?Are the interventions sustainable?4.Act:Committee discusses/reviews observationsabout interventionsRe-surveys staff to understand whichinterventions they like, what needs to betailored, other recommendationsSignage and order sets now used throughouthospitalSix Sigma“sigma” (σ) denotes standard deviation in statisticsSix sigma is a measurement-based strategy forprocess improvement done using a 5 stage process:DMAIC(define, measure, analyze, improve,control)PDSA and Six Sigma interrelated:PDSASix SigmaPlanDefining core processes &key customer requirementsDoMeasuring performanceStudyAnalyzingActImproving and IntegratingSource: Hughes, R.G. Senior Health Scientist Administrator at Agency for Healthcare Research and Quality(AHRQ). Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Chapter 44. Tools and Strategiesfor Quality Improvement and Patient Safety., pg. 3-1. 2008.Toyota Lean Manufacturing SystemContinuous improvement method, uses Six Sigmaeliminates non-value added activities (waste)Kaizen Events:Formalized, focused rapid improvement eventsRoot Cause Analysis:Uncovers underlying causes of an event or errorby looking at enabling factorsConcentrates on system and process factors, notindividual factors (consistent with IOM, 1999)successfully used in healthcare to increaseeffectiveness of patient care and decrease costs inpathology labs, pharmacies, and blood banksSource: Hughes, R.G. Senior Health Scientist Administrator at Agency for Healthcare Research and Quality(AHRQ). Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Chapter 44. Tools andStrategies for Quality Improvement and Patient Safety., pg. 3-1. 2008.
18-04-3010Video: Kaizen in HealthcareSmall Group AcRvity #1(Donabedian, FADE, PDSA)3. Logic ModelsSource:University of Wisconsin-Extension Cooperative Extension Program Development and Evaluation.Developing a logic model: Teaching and training guide. Website:.
18-04-3011Logic ModelsAntecedents and footprints of logic modelthinking are in TQM and other QI strategiesIn healthcare, often used by:public health organizations to design,evaluate and improve programsfunding agencies to understand the theoryunderlying a proposed program/project andhow outcomes will be achievedcan apply to a:small programlarge, multi-component programprocessbusiness or organization

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