Summary:

The meeting began with John Val providing an overview of the day's session, focusing on the importance of performance and process improvement. He outlined the topics to be covered, including quality improvement concepts, team collaboration, and the use of tools like LEAN, PDSA, and Six Sigma. John also discussed the importance of identifying methods to establish priority and evaluating the success of performance improvement projects, as well as the significance of team effectiveness and leading change. He shared insights on the CPHQ examination and introduced the Dunabedian model, emphasizing the need for improvement in healthcare and the impact on patients and business objectives.

John Val emphasized the critical role of structure, process, and outcome in healthcare delivery. He discussed the need for clear policies and procedures to guide employees and improve patient care, and the significance of measuring outcomes and the challenges of accurately attributing outcomes to healthcare, highlighting the role of quality professionals in this process.

The meeting covered the significance of team structure and function within an organization, emphasizing the need for alignment in values, roles, and objectives. John Val discussed various team structures, such as flat, hierarchical, functional, matrix, and divisional structures, explaining their differences and applications within different organizational contexts. He also highlighted the role of quality councils in overseeing quality performance activities within the organization.

John Val provided detailed insights into the construction and utilization of a prioritization matrix, outlining the specific criteria, scoring, and decision-making process involved in prioritizing projects within a healthcare setting. He underscored the importance of documenting prioritization results and integrating evidence-based practice into performance and process improvement efforts, emphasizing the need for involvement of top leadership and collaboration among healthcare systems. He highlighted the challenges and benefits of working collaboratively in a team setting.

Chapters & Topics:

Introduction and Overview of Performance and Process Improvement

John Val opens the meeting by ensuring that the slides are projected correctly and then proceeds to welcome the attendees. He discusses the agenda for the day, highlighting the focus on quality improvement concepts, team collaboration, and the use of tools like LEAN, PDSA, and Six Sigma. Additionally, he stresses the significance of identifying methods to establish priority and evaluating the success of performance improvement projects, while also mentioning the importance of team effectiveness and leading change.

* Quality Improvement Concepts

* Performance and Process Improvement

Understanding the Value of Quality

John Val shares personal anecdotes about cats and litter boxes to illustrate the significance of structure, process, and outcome in healthcare. He highlights the importance of clear policies and procedures to guide employees and improve patient care, emphasizing the need for a structured approach to healthcare delivery.

Quality of Service and Cost in Hospitals

John Val compares the quality of service and cost in private and government hospitals in the Middle East, emphasizing the excellent service and desirable outcomes in government hospitals despite lower costs. He highlights the well-equipped state-of-the-art technology in government hospitals and shares a personal experience of receiving high-quality care at a minimal cost.

Quality Indicators and Project Prioritization

John Val introduces the concept of quality indicators, using the analogy of a thermometer to explain their purpose. He highlights the significance of prioritizing projects due to resource constraints and the need to address organizational pain points. Additionally, he emphasizes the non-income generating role of certain departments and the financial and resource implications of undertaking improvement projects.

Decision Making and Prioritization

John Val leads a discussion on decision-making and prioritization, drawing on examples of selecting mobile phones and cars. Dr. Shama and Ms. Belsam explain their choices, highlighting the importance of trust in the product and achieving their desired goals, while also emphasizing the value of quality and familiarity.

Prioritization Matrix and Evidence-Based Practice

John Val leads a discussion on the construction and application of a prioritization matrix, highlighting the criteria used to prioritize projects and the scoring process involved. He also stresses the significance of documenting prioritization results and integrating evidence-based practice into performance and process improvement efforts, emphasizing the involvement of top leadership and collaboration among healthcare systems for successful improvements.

Importance of Team Structure and Function

John Val stresses the importance of team structure and function, emphasizing the need for alignment in values and roles within a team. He provides detailed explanations of various team structures, including flat, hierarchical, functional, matrix, and divisional structures, and discusses their differences and applications within different organizational contexts.

* Team Structure

Team Roles and Responsibilities

John Val explains the role of a sponsor as a senior figure in the organization who provides approval, signs off on budgets, and communicates with the board members about project completion. He also emphasizes the importance of a champion, who can provide project credibility and support the team leader, and discusses the responsibilities of team members who are responsible for executing the work on the front line.

* Sponsorship in Project Management

Stages of Team Development and Root Cause Analysis

John Val provides a detailed explanation of the stages of team development, highlighting the challenges and dynamics involved in each stage. He underscores the role of leadership and facilitation in navigating through the stages and fostering effective teamwork. Furthermore, he introduces the concept of root cause analysis as a critical skill in addressing issues and problems at their fundamental level.

* Stages of Team Development

* Root Cause Analysis

Understanding the Iceberg Model and Root Cause Analysis

John Val discusses the iceberg model, highlighting the visible and invisible aspects of individuals' behavior and emotions. He stresses the significance of addressing root causes and introduces the Five Whys tool as a method for conducting thorough root cause analysis in healthcare settings.

Medication Error Root Cause Analysis

John Val facilitates a detailed analysis of a medication error incident, exploring the nurse's actions and the organizational factors contributing to the error. The discussion uncovers staffing shortages, policy compliance issues, and the management's focus on building a new outpatient department as key root causes of the incident.

Evolution of Improvement Models

John Val provides a detailed overview of the evolution of improvement models, tracing the origins of the Schuhardt cycle and its three components. He then delves into Edward Deming's expansion of the cycle into four steps and its subsequent transformation into the plan, do, check model, highlighting the significance of implementing changes based on specific root causes and the importance of starting with small-scale pilot projects.

Continuous Improvement Process and AIM Statement Examples

John Val explains the continuous improvement process using the PDCA model, highlighting the iterative nature of making small improvements until the target is achieved. He illustrates this with an example of reducing hospital-acquired infections and emphasizes the need for sustained efforts and spreading successful changes to other departments. Additionally, he discusses the importance of specific and measurable AIM statements in setting improvement goals.

* Donabedian Model

Six Sigma Methodology and Tools

John Val provides a detailed overview of the Six Sigma methodology, stressing the significance of defining problems and processes, measuring current status, analyzing data, implementing improvements, and maintaining control. He delves into the use of tools like project charter, value stream map, swim lane map, and voice of the customer, illustrating their relevance in addressing issues and enhancing processes.

Explanation of Six Sigma Roles and Levels

John Val provides an overview of the various roles in Six Sigma, such as yellow belt, orange belt, green belt, black belt, and master black belt, along with their respective training durations. He also delves into the levels of defects in Six Sigma, illustrating the impact of defects on manufacturing and the cost of poor quality. Additionally, he contrasts Lean and Six Sigma methodologies, highlighting their different focuses and approaches.

* Lean Six Sigma Methodology

Process Analysis and Supplier Input

John Val provides a detailed explanation of the process analysis tool, using the example of venipuncture or blood collection. He breaks down the steps involved in the process, identifies the suppliers, their input, and the customers, and emphasizes the significance of analyzing potential failure modes in each process to improve efficiency and quality.

Change Management and Strategies for Accelerating Change

John Val highlights the significance of change management, citing examples from the healthcare industry. He stresses the need for a planned and productive approach to managing change, involving leadership and stakeholder engagement. Additionally, he discusses the stages of change behavior and introduces upcoming topics on change models and innovation perceptions.