Creating a Quality CultureDiaries of a

Performance Improvement Consultant

BCPSQC Quality Forum 2013March 1, 2013

Sophie Clyne, MS Quality Improvement Specialist

Francisco Velazquez, MBA, MHAChange Specialist

Video

The Project

• Social Media – Using the Blogging phenomenon • The Health Care Blog – open dialogue & feedback;

90% of people ages 18-24 said they would trust health information obtained from social media channels

• How it impacted the way we were thinking

– Opportunity to reflect on conversations • The experience of keeping a diary– Different approaches to keeping a diary

Quality Improvement Structure at PHC

• Three support groups – Administrative Decision Support– Change Initiatives– Quality Improvement

• Creation of THINK PHC– Co-located– Integration

• Concerted effort to use evidence for decision-making, and to leverage the expertise of the different support groups

Life as a PIC

• Job Description: 0.5FTE – all duties as assigned– Workplan– Accreditation – Building capacity – Unit-level to PHC Board of Directors

• Reporting at a Program Level – Program Director – Physician Program Director

•

• Reliance on and faith in data

• Physician and Leadership style

• Clinical ‘on the floor’ feel

• Experience of the Leadership Team

• Experience of the PIC

• Upcoming changes to the Program

• Upcoming projects within Program

• Relationship histories

• Research priorities

Assigning PICs to programs

Background of PICs

Performance Improvement

Consultant

Myers Briggs

RENALC: ENTP

SURGERY M: ENFP

CRITICAL CAREJ: ESTJ

CARDIACFrancisco: ISFJ

ELDERS: ISTJ

MEDICINESophie: ENFJ

HIV/ URBANE: ENFP

MENTAL HEALTHB: ISTJ

SJ

SJ

SP

SP

SJSJSP

SJ

NF NF

PICs as a Team

• Team agreement• Bi-weekly Meetings with a rolling chair

– Co-location

• Retreats• Management Support

Support from the PICs

“It already feels like the kind of group where I could comfortably disagree with all the team members (in a good way!), and I see lots of opportunities moving forward.”

August 23rd 2012: Sophie

“I had a couple of deadlines last week where I was doing presentations for training and meetings…..now feeling less of the pressure……I feel really supported by the other consultants - I've had lots of offers for help when I know they must also be busy. It feels like I'm now getting to have two teams - the clinical team in Medicine, and the consultant team back at the ranch! ”

October 29th 2012: Sophie

Naming of the PIC

Performance

Improvement

Change Manager Lead

Super-Specialist

Improvement

Consultant Specialist

Leader

Quality

Sophie

• “I really feel like this new set up is a good one- having the chance to know and engage with what's happening on a strategic level will make a huge difference on working with the unit teams.”

Sept 26th 2012

How it fits: • Big picture to detail• Problem solving • Practical AND Strategic

Where I struggle: • Over enthusiasm - can’t

understand when others aren't as excited

• When to scale it back and keep it simple

Francisco

• “There are a number of committees currently in place which now will all be linked, and provided with a mechanism to implement recommendations. ” October 11th 2012

How it fits: • Complete understanding of

a Program• Connecting the dots• The right things are driving

the work

Where I struggle: • Easily pulled into different

projects• Managing the passion for

improvement– Applying methodological

processes to ensure success

What's next? • There will be an increased focus on:– Metrics• Evidence to support the initiatives • Ensuring that the Quality Improvement opportunities

are aligned with the Program’s and Organizational priorities

– Finance• Operating in a fiscally responsible manner

– Rotation of PICs• To continue to standardize work through the

organization • Share work completed to date

The PIC Survival Guide

• √ Creativity• √ Enthusiasm• √ Fun• √ Relationships• √ Determination• √ Perseverance

• √ Problem Solving• √ Teamwork• √ Patience • √ Strategic Thinking• √ Support• √ Reflection

Time for one question!

Thank you!