[SOUND] Welcome to the application section of the course, Take the Lead for Quality Improvement. This section is specifically for putting your knowledge from the theory into action. Course objective is really to apply what you're learning then and engage in quality improvement projects. I really think that this is where the rubber's hitting the road, where you're really making improvement through the confidence you've built through this course. You're going to have eight assignments then that we're going to guide you through to make you feel comfortable about how this improvement process works. And, this course will end in you completing a storyboard of your project, that actually you could submit to the Institute For Healthcare Improvement to disseminate your important work that you're engaging in. These are the eight assignments that you will be engaging in over the course of these ten modules. For this first module one, you're going to be creating a worksheet and filling it in on the global aim, and on baseline data. You may feel very stretched, and you may not feel confident at this point. But I will assure you that through this course, you'll be driving away in a speedy way with the confidence that you need to insure you are making good improvement in the work that you are doing. Here's an example of the outcome of this course. These are two of our students and physicians story boards that they submitted an application for to disseminate at the Institute for Healthcare Improvement and they were accepted. And actually, they won some awards on the work that they were doing. This is what these assignments then will result in, the storyboard. But there is a little bit of preparation work that you need to do. And that is that if you really are interested in doing an improvement project on your unit or in your facility, or your organization, and you're committed to doing an organizational project for this course, then you really need a sponsor at your institution. You need to really pick somebody who is going to support you in this journey. They are going to play a vital role in the development of your project. This organizational sponsor will provide mentoring so that you can apply what you're learning here, in this course, to real life experiences of health care improvement. The organizational sponsor also has other roles. They're going to provide information regarding the organizational structure, and the culture of your organization, and the goals that they're interested in. They're also going to introduce you to organizational members that will help you and will be involved in your process of improvement. They'll also provide education to the organizational members about this course and about your role in this course, and about your enthusiasm for doing an improvement project where you work. The sponsor then will also provide organizational networks for you, including setting up access to necessary information, departments, managers and staff. This role of the sponsor will be essential for your success. It will provide you the exposure and the resources that will be necessary for completion of these assignments. Now what is your role? Well, really your role is to clearly define this project, your proposal, including what other updates you may have as you progress through the program in the course. And revisions that you're going to make to this project proposal. Your role is also to participate in the scheduling requirements and meetings. And that includes your initial site visit where you're meeting with your sponsor and the other people that the sponsor feels is important to have at that meeting. And then also to participate in scheduling weekly updates. Communication with the sponsor is essential so that they see what information that you're getting, where you're meeting barriers or obstacles so that they can then assist you with the success of your project. Finally, your role in this application piece is your final presentation. And you really want to schedule a time when you present your important work to your organizational team. Now, if you're unable to do an organizational quality improvement project, then I would suggest that you determine a specific personal improvement project, where you identify something about your life or your work that you personally would like to improve. Now, you don't need an organizational sponsor for an improvement project that is personal. However, I really would invite you to include a partner to work with you. So that you can share your ideas, share your progress, and then also to have them as a support structure in order to ensure that you have a successful personal improvement journey. So I've created a worksheet to guide your progress. The worksheet is two pages, and includes the whole journey. The ten module journey. Use this worksheet each week to guide the application section of this course. And I want you to share the worksheet each week with your organizational sponsor or your support person, so that they can understand your movement and your journey. Here's the side A of this worksheet. And as you can see, there is a general goal for your project, also identification of your team members, and then there's three steps on the first page. And this is the second side of the worksheet, and you can see then there are four steps on this side. So, I'd like to now then, just start with module one of the application. And here again is where you're putting your knowledge into action. In module one, we'll be doing one section of that worksheet. For module one, what your application will be, is determining what the overall goal of your project is. So what is it about your work that you would like improve. Where do you see the gaps in the care that you deliver or your unit delivers. Second in this module application, you're going to identify who are the essential team members to include on your project team. And then we're going to engage in step one, identifying your problem, and then establishing a global aim, and then collecting some baseline data. This is the first side of the worksheet, of which we'll be engaging in now. The first step is to identify your goal. What's the problem that you're interested in improving on your unit or in your work? I've included in here the Institute of Medicine aims on quality. As you remember also from module one, we're really interested in identifying the quality improvement gap. So what's the gap between what you know you should be doing -- or you know what the nurses or physicians, or other therapists on your floor should be doing -- and what are you actually doing? This is the improvement gap that will be essential for you to think about when you identify your goal for your project. Also reflect on the goals of quality improvement from the Institute of Medicine. Where the Institute of Medicine states that quality is about safe care. What have you noticed in the care that you deliver on your unit that isn't really safe? Have you been observing that maybe patients are falling more? Or, have you been observing that nurses are not following infectious control protocols for going into rooms where patients have diseases that need to be prevented? Care needs to be effective. Have you been observing in your unit, any opportunities where care should be based on evidence but isn't? Also, care should be efficient. Have you been noticing that people are waiting long time for services? Such as in diagnostic areas. Or do you feel like the costs of care are not being addressed, and that you have some ideas of where you could reduce the costs of care. Think too, about timely care, so that there should be no waits or delays that should occur in receiving care. Is there something about your clinical practice, maybe in your patient centered medical home, where patients are waiting in the waiting areas too long. Or maybe not being provided diagnostic testing as quickly as they should be. Also you could thing about patient centeredness. Are there any examples in your care where you feel like we're not really delivering patient centered care? One example of this would be a patient admitted to a skilled nursing facility for transitional care after hospitalization, where the person could be taking their medications on their own and really would like to. So a project for this skilled nursing facility example would be allowing that patient, or patients, who come to their facility to be able to take their own medications. Also, think about equitable. Are there examples in your care that are examples or opportunities to bridge the gap in disparities in care? Once you determine your goal, and this should be something that you're passionate about, that you really want to make an improvement on. It should also be something that your sponsor feels is doable. So, you really need to be talking to your sponsor right at this first step. The next step then is for you to really think about who are the team members that need to be on your team for this improvement journey. Think hard and deep, don't just stick with your own discipline, think out of the box to other disciplines, other staff members in your facility. This is an area really where its very important to get people who understand the process step, in this area, or problem area, that can help you identify how we can improve as a team. The question is, who do you want on your team? And so, for your organizational team, I kind of did talk about some people that would important to include. And that would include managers, quality center staff, administrators, maybe even business people to help you with the cost of care. For your personal project, of course, you're going to be your main team member. But as I mentioned before, it really is important to have some other support people on your personal project team. Here is a list of the organizational project team members: sponsor, administrator, experts who are very close to the process who can help you with understanding ways to make that process better. And then other personnel such as maybe the environmental services staff or maybe the information technology staff. These are critical members to your team. For your personal improvement project, again, having a support person and the support person can also function as a coach to help you through the process. Back to the worksheet where we now move into step one where we're looking at problem identification and baseline data. For the problem identification, we take that big goal that we determined a little while earlier and just narrow it down. And we're going to create a global aim. So something a little bit more specific as to particular piece of improvement that we want to engage in. Then, we also in this step want to collect some data, some survey data or interview data that's going to help give us an idea as to really, what are some of the things that are going on regarding this global aim. I've created this worksheet, of which you can obtain if you look at the tab for this module. And for you this week, I would like for you to then create your global aim. This worksheet will help you. Our global aim is to, and then write in there what you would really like to improve. And then state in the location. So, is it your unit? Is it your facility? Is it in your clinic? For this global aim then the last part is to write what you expect that by working on this problem that you are going to benefit from. So, list some benefits of studying this problem. There again, you're going to collect some baseline data. And the data then can include some surveys. So, you can just go around and just interview staff who will work with you regarding the process or the problem, and have them fill out quick surveys. So and example of giving a survey is if you did determine that the rate of aspirin administration in your clinic was low, and you wanted to find out the perception of aspirin administration with the providers in your clinic. So you could provide them with a quick survey to determine what their attitudes and perceptions are of that issue. You can also interview staff to find out what their perceptions or their knowledge are, or their attitudes regarding the improvement that you want to make. So it's also important to collect some outcome data so that you can understand the severity or the relevance of your issue in the area where you're working. So remember, quality improvement is about doing your work and improving your work. And I really see some real improvement in your future. Thanks for your time on this module in the orientation to the worksheet, and your beginning work on applying the concepts that you're learning to an improvement project. Thanks. [MUSIC]
