RWH unit 6
MentorsRWH unit 6
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files (2)QIToolkit_PDSAWorksheet.pdf
powerpoint6-5-241.pptx
QIToolkit_PDSAWorksheet.pdf
QI Essentials Toolkit:
PDSA Worksheet The Plan-Do-Study-Act (PDSA) cycle is a useful tool for documenting a test of change. Running a PDSA cycle is another way of saying testing a change — you develop a plan to test the change (Plan), carry out the test (Do), observe, analyze, and learn from the test (Study), and determine what modifications, if any, to make for the next cycle (Act).
Fill out one PDSA worksheet for each change you test. In most improvement projects, teams will test several different changes, and each change may go through several PDSA cycles as you continue to learn. Keep a file (either electronic or hard copy) of all PDSA cycles for all the changes your team tests.
Copyright © 2017 Institute for Healthcare Improvement. All rights reserved. Individuals may photocopy these materials for educational, not-for-profit uses, provided that the contents are not altered in any way and that proper attribution is given to IHI as the source of the content. These materials may not be reproduced for commercial, for-profit use in any form or by any means, or republished under any circumstances, without the written permission of the Institute for Healthcare Improvement.
IHI’s QI Essentials Toolkit includes the tools and templates you need to launch and manage a successful improvement project. Each of the nine tools in the toolkit includes a short description, instructions, an example, and a blank template. NOTE: Before filling out the template, first save the file on your computer. Then open and use that version of the tool. Otherwise, your changes will not be saved.
• Cause and Effect Diagram • Driver Diagram • Failure Modes and Effects
Analysis (FMEA)
• Flowchart • Histogram • Pareto Chart • PDSA Worksheet
• Project Planning Form • Run Chart & Control Chart • Scatter Diagram
QI ESSENTIALS TOOLKIT: PDSA Worksheet
Institute for Healthcare Improvement ∙ ihi.org
Instructions
Plan: Plan the test, including a plan for collecting data.
• State the question you want to answer and make a prediction about what you think will happen.
• Develop a plan to test the change. (Who? What? When? Where?)
• Identify what data you will need to collect.
Do: Run the test on a small scale.
• Carry out the test.
• Document problems and unexpected observations.
• Collect and begin to analyze the data.
Study: Analyze the results and compare them to your predictions.
• Complete, as a team, if possible, your analysis of the data.
• Compare the data to your prediction.
• Summarize and reflect on what you learned.
Act: Based on what you learned from the test, make a plan for your next step.
• Adapt (make modifications and run another test), adopt (test the change on a larger scale), or abandon (don’t do another test on this change idea).
• Prepare a plan for the next PDSA.
QI ESSENTIALS TOOLKIT: PDSA Worksheet
Institute for Healthcare Improvement ∙ ihi.org
Example: PDSA Worksheet Objective: Test using Teach-Back (a closed-loop communication model, in which the recipient of information repeats the information back to the speaker) with a small group of patients, in hopes of improving patients’ understanding of their care plans.
1. Plan: Plan the test, including a plan for collecting data.
Questions and predictions:
• How much more time will it take to use Teach-Back with patients? It will take more time at first (5 to 10 minutes per patient), but we will start to learn better communication skills and get more efficient.
• Will it be worthwhile? The extra time will feel worthwhile (and possibly prevent future rework).
• What will we do if the act of “teaching back” reveals a patient didn’t understand the care plan? If a patient is not able to explain his or her care plan, we will need to explain it again, perhaps in a different way.
Who, what, where, when:
On Monday, each resident will test using Teach-Back with the last patient of the day.
Plan for collecting data:
Each resident will write a brief paragraph about their experience using Teach-Back with the last patient.
2. Do: Run the test on a small scale.
Describe what happened. What data did you collect? What observations did you make?
Three residents attempted Teach-Back at the end of the day on Monday. Two residents did not find anything they needed to ask patients to Teach-Back. Jane found that her patient did not understand the medication schedule for her child. They were able to review it again and, at the end, Jane was confident the mother was going to be able to give the medication as indicated.
QI ESSENTIALS TOOLKIT: PDSA Worksheet
Institute for Healthcare Improvement ∙ ihi.org
3. Study: Analyze the results and compare them to your predictions.
Summarize and reflect on what you learned:
• Prediction: It will take more time at first (5 to 10 minutes per patient), but we will start to learn better communication skills and get more efficient. Result: Using Teach-Back took about 5 minutes per patient.
• Prediction: The extra time will feel worthwhile (and possibly prevent future rework). Result: Jane felt the time she invested in using Teach-Back significantly improved the care experience.
• Prediction: If a patient is not able to explain his or her care plan, we will need to explain it again, perhaps in a different way. Result: After a second review of the medication orders, the patient was able to Teach-Back the instructions successfully.
In addition to the team confirming all three predictions, Jane realized the medication information sheets she had been handing out to parents weren’t as clear as she thought. She realized these should be re-written — maybe with the input of some parents.
4. Act: Based on what you learned from the test, make a plan for your next step.
Determine what modifications you should make — adapt, adopt, or abandon:
Jane is planning to use Teach-Back any time she prescribes medication. Although it may take more time, she now understands the importance. The other residents are going to work on using Teach-Back specifically for medications for the next week.
They would like to pull together a team to work on some of the medication information sheets with parent input, but they are first going to gather more information through more interactions in the coming days.
QI ESSENTIALS TOOLKIT: PDSA Worksheet
Institute for Healthcare Improvement ∙ ihi.org
Before filling out the template, first save the file on your computer. Then open and use that version of the tool. Otherwise, your changes will not be saved.
Template: PDSA Worksheet Objective:
___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________
1. Plan: Plan the test, including a plan for collecting data.
Questions and predictions:
• _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________
• _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________
Who, what, where, when:
___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________
Plan for collecting data:
___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________
2. Do: Run the test on a small scale.
Describe what happened. What data did you collect? What observations did you make?
___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________
QI ESSENTIALS TOOLKIT: PDSA Worksheet
Institute for Healthcare Improvement ∙ ihi.org
3. Study: Analyze the results and compare them to your predictions.
Summarize and reflect on what you learned:
___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________
4. Act: Based on what you learned from the test, make a plan for your next step.
Determine what modifications you should make — adapt, adopt, or abandon:
___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________
- Objective 1:
- Questions and Predictions:
- Questions and Predictions 2:
- Who, what, where, when::
- Plan for collecting data::
- Describe what happened:
- Summarize and reflect:
- Adapt, adopt, or abandon::
powerpoint6-5-241.pptx
"Improving Patient Compliance with Diabetic Monitoring: A Technology Integration Approach"
Herzing University
Ramona Wilkerson
June 5, 2024
Objective
Objective: Enhance patient compliance with diabetic monitoring through the integration of technology.
Improve accessibility to essential monitoring equipment, medications, and food.
Empower patients to manage their diabetes effectively.
Reduce the risk of complications associated with uncontrolled diabetes.
Enhance overall patient health outcomes and quality of life.
The purpose of this project is to raise patient’s compliance and integrate technology into the process of diabetes treatment. By pursuing these goals, we will improve the availability of monitoring devices, drugs and proper diets in diabetic patients. As a result, patients will be in a position to manage their diabetes to avoid complications that are as a result of poor diabetes management (Warren & Hixenbaugh, 2020). Additionally, it will also seek to enhance the overall health of any patient by providing them with products and information to manage the condition properly.
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Current Practice State
Limited accessibility to affordable diabetic monitoring equipment.
Patients may face challenges in accessing essential medications and nutritious food.
Manual tracking of blood glucose levels and medication adherence.
Lack of personalized support and guidance for diabetic management.
Suboptimal patient engagement in self-care activities.
This is as a result of unavailability of affordable diabetic monitoring equipment, diabetic drugs, and quality diabetic foods for the diabetic patients. Currently, they are required to track blood glucose level and medication administration, which is tiresome and not very accurate. Furthermore, the lack of adequate counseling and care coordination contributes to patient apathy in terms of diabetic management and self-care practices (Kap et al., 2021). This shows that it is high time the challenges are dealt with in a more coordinated and through embracing of technology.
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Desired Future State
Seamless access to affordable diabetic monitoring equipment, medications, and nutritious food.
Integration of technology to automate tracking and monitoring of blood glucose levels.
Personalized support and guidance through mobile applications or telehealth services.
Enhanced patient education and engagement in self-care activities.
Improved health outcomes and quality of life for diabetic patients.
The future state concerns the situation where all diabetic patients should be able to have easy and cheap access to devices for monitoring diabetes, medication, and healthy foods. With technology assistance, there is a possibility of tracking and monitoring of blood glucose level and constant support to the patient through mobile applications or telehealth services. The use of this approach will go a long way in increasing the level of awareness and involvement of the patients in the management of their disease besides improving the quality of life of diabetic patients.
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Identified Gap
Gap: Limited accessibility to affordable diabetic monitoring equipment, medications, and nutritious food.
Insufficient use of technology to facilitate remote monitoring and support.
Lack of personalized interventions to address individual patient needs.
Inadequate patient education and engagement in self-management.
Suboptimal utilization of available resources to promote diabetic health.
The defined gap is a lack of access to affordable diabetic monitoring equipment, medicines, and healthy food, along with low technology usage to address diabetic patients remotely. Finally, there is no focus on individual patients and adapting plans to suit the patient, which hinders the optimal use of resources in enhancing diabetic health (Kap et al., 2021). Addressing this gap requires a proactive strategy that incorporates technology implemented solutions with patient support and related community demands.
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Proposed Remedy
Implement a comprehensive technology solution to address accessibility issues.
Develop a patient questionnaire to identify barriers to access.
Integrate telehealth services for remote monitoring and support.
Provide educational resources and personalized guidance through mobile applications.
Collaborate with community resources to enhance access to affordable medications and nutritious food options.
Thus, in order to fill the above mentioned gap, it is suggested to use an extensive technology support system together with the assistance of the community. This entails creating a patient survey to establish the perceived barriers to access, incorporating telehealth for remote monitoring and follow-up services, education, and mobile applications for specific, individualized support, and working with local resources in order to facilitate access to affordable medications and healthy foods (Warren & Hixenbaugh, 2020). Using the above strategies, we want to increase the availability of resources and care support to patients, which will help to increase the quality of diabetic health.
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Gap Analysis Spectrum
Current State: Limited accessibility to affordable equipment and resources.
Desired State: Seamless access to essential monitoring equipment, medications, and food.
Identified Gap: Lack of technology integration and personalized support.
Proposed Remedy: Implement comprehensive technology solution and enhance community collaboration.
With regards to patient compliance with diabetic monitoring, the gap analysis spectrum shows the current state, desired state, identified gap, and recommended solutions for closing the gap. At the moment, there is also a lack of affordable equipment and materials for diabetic patients who need them. However, the desired state states that there should be easy access to monitoring equipment, medications and food (Kap et al., 2021). In an attempt to fill this gap, there is a need to incorporate technologies and promote engagement of the communities. This multi-faceted approach is designed to fill the identified gap in a comprehensive manner and enhance the well-being of diabetic individuals.
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Implementation Plan
Conduct a needs assessment to understand patient barriers and preferences.
Select and customize technology solutions based on patient feedback and usability.
Collaborate with healthcare providers, community organizations, and technology vendors.
Pilot test the technology integration in a small patient population.
Collect feedback and iterate on the solution based on user experience.
Scale up implementation to a larger patient population.
Evaluate outcomes and make continuous improvements based on data analysis and feedback loops.
The action plan highlights the approaches that can be used in the healthcare process to make the use of the technology solutions as efficient as possible. It involves identifying barriers and actual need for changes from the patients, following with the selection of appropriate technologies according to the input gathered from the patients and their experiences with the technology, working with the healthcare providers, other organizations, and the vendors of the technologies, implementing the technology in a small group of patients to get the first feedback, adjusting the solution according to the feedback received, expanding the implementation process and monitoring the effects to be able to improve the system. This structured approach guarantees that technology solutions will be enhanced and implemented to enhance patient adherence to diabetic monitoring.
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References
Kap, Ö., Kılıç, V., Hardy, J. G., & Horzum, N. (2021). Smartphone-based colorimetric detection systems for glucose monitoring in the diagnosis and management of diabetes. Analyst, 146(9), 2784-2806. https://pubs.rsc.org/en/content/articlehtml/2021/an/d0an02031a
Warren, L., & Hixenbaugh, P. (2020). Adherence and diabetes. In Adherance to Treatment in Medical Conditions (pp. 423-453). CRC Press. https://www.taylorfrancis.com/chapters/edit/10.1201/9781003072348-21/adherence-diabetes-laura-warren-paula-hixenbaugh
