NUR 455 IHI QI 105: Leading Quality Improvement Solved 100% Correct!!

Lesson 1: The Four Phases of a Quality Improvement Project ... What are the four phases of an improvement project? Innovation-Pilot-Implementation-Spread The four phases of an improvement project are "Innovation-Pilot-Implementation-Spread." Plan-Do-Study-Act (PDSA) cycles are tests of change that improvers conduct during different phases of their improvement projects. How should Sandy and her improvement team try out the new process for improving pain control? Test the new process with one patient and closely review the results. The best answer is "test the new process with one patient on and closely review the results." Sandy and her team have an innovation and are ready to conduct a pilot. (Every organization is different, so just because the idea worked at another hospital does not mean it will work here.) Piloting involves starting small, such as with one patient, and carefully refining the change to make sure it works. After a successful pilot, which of the following should Sandy's improvement team undertake as a next step? A and B The best answer is "A and B." After a successful pilot, they should move on to the implementation phase. This phase includes actions to "hardwire" the change, such as making it standard policy and training new staff on it. In implementing the change, the team will continue to run PDSAs: making predictions, carrying out the test, collecting data, and refining the change based on results. (Note that compared to PDSAs in the pilot phase, these tests will require significantly more people, time, and resources.) What improvement project phase have Heather and her team just completed? Pilot The team has just completed the improvement stage that consists of early, rapid-cycle tests of change: the pilot phase. Heather and her team continue to test the new idea. Assuming things continue to go well, what might they eventually do? All of the above. The best answer is "all of the above." After a successful pilot, the next steps are implementation and spread. IHI's Framework for Spread, which includes developing a communication and dissemination plan, is a helpful tool to use during the final phase of an improvement project. Lesson 2: Change Psychology and the Human Side of Quality Improvement ... According to Herbert Kaufman, which of the following are reasons health care workers commonly resist change? All of the above The best answer is all of the above. In his book The Limits of Organizational Change, Herbert Kaufman identified all of these as potential barriers to implementing change in health care. In the example, which of the following is a process change? The planned nap The process change is the planned nap. It is the method by which the organization hopes to decrease worker fatigue. Which of the following represents a culture change? The belief that a planned nap can support patient safety The culture change is the fundamental belief that a planned nap can support patient safety and that napping is okay during a shift. What's the likeliest reason the program failed? The culture of the organization did not support napping during a shift. The program probably failed because the culture of the organization did not support napping on the job as a way to decrease worker fatigue and boost patient safety. What would be a good way for the team to respond to the resistance to the change? Share data that shows the process change is associated with a decrease in adverse events. The best answer is to share data that shows the process change is associated with a decrease in adverse events. Many people find compelling data to be persuasive. Some people are more motivated by stories. However, the story needs to be directly related to the change in order to be persuasive. Lesson 3: Working with Interdisciplinary Team Members ... In designing a performance improvement team, it is helpful to: Have a mix of different types of people on the team A healthy mix of personality types helps ensure a team captures many perspectives on an issue. Personality and work style profile assessments can help to: Identify the personalities present and work to everyone's strengths. Personality and work style profile assessments help us understand how different people prefer to perceive the world and make decisions. This can be valuable — particularly if team leaders appreciate these differences and design the work to accommodate diverse preferences. Which of the following are strategies to help members of a QI team establish common goals? All of the above The best answer is all of the above. Some strategies to help get everyone on the same page include: Create a team roster so everyone knows who is on the team and how to reach each other, share stories to establish why the QI project is personally meaningful to people, and write out a work plan. What is the order of the four steps teams typically follow to get to a place where they are running smoothly? Forming, storming, norming, performing Mary Dolansky explained a four-step process by which teams to get to a place where they are running smoothly: forming, storming, norming, and — finally — performing. You're on a team seeking to improve the process for treating patients with sepsis. (Sepsis occurs when chemicals released into the bloodstream to fight infection trigger inflammatory responses throughout the body). Which of the following is an example of "advocacy"? Stating your idea for updating the sepsis protocol. The best answer is stating your idea for updating the sepsis protocol. Advocacy is making your own views known (including why you feel or think the way you do). Inquiry is seeking the views of others. The key to being an effective team member is balancing advocacy and inquiry.