Sequence to Achieve Change

• Assemble a team that represents all areas & roles of the clinic; consider including patients on your team.

• Articulate the problem you want to solve. Use evidence & data to strengthen your rationale (e.g., HQCA Physician Panel Report).
• For improvement projects with higher complexity, create a project charter.

• Visually depict the sequence/steps of events in a process; identify gaps.
• Document the new, interim, and final processes.

SET AN AIM STATEMENT

• The aim should be time-specific and measurable; it should also define the specific population of patients or other system that will be affected.

IDENTIFY MEASURES

• Determine the baseline – the measure of how you are currently doing.
• Use process, outcome, and balancing measures to check if you are improving.

SELECT CHANGES OR ‘POTENTIALLY BETTER PRACTICES’ TO TEST

• Ideas for change may come from people who actually perform the work, or from the experience of others who have successfully improved (e.g., evidence).

TEST CHANGES

• The Plan-Do-Study-Act cycle is shorthand for testing the potentially better practices in the real work setting — by planning it, trying it, studying the results together, and acting on what is learned.

• Complete periodic measures; display your results.

• After successful implementation of a change, or package of changes for a pilot population, the improvement team can spread the changes to other parts of the clinic or to other clinics

• Plan to celebrate at milestones along the improvement journey, as well as when you achieve your aim.
• Recognize and highlight the efforts and accomplishments of the team.