QI 102: HOW TO IMPROVE WITH THE MODEL FOR
IMPROVEMENT
The Model for Improvement begins with three questions designed to clarify the following
concepts:
(A) Plan, do, act
(B) Mission, goal, strategy
(C) Aims, measures, changes
(D) Will, ideas, and execution - Answers- Aims, measures, changes
The Model for Improvement begins with three fundamental questions about any given
improvement, designed to address the aim (what are we trying to accomplish?), the
measures to be used (how will we know a change is an improvement?) and the
changes to be used (what changes can we make that will result in an improvement?).
An orthopedic clinic in a busy metropolitan area would like to improve its patient
scheduling process. More specifically, the clinic wants to improve its efficiency and the
satisfaction of its patients.
Applying the Model for Improvement to the clinic's improvement goal, which of the
following is the most reasonable aim statement?
(A) Implement two PDSA cycles within six months of beginning the project.
(B) Increase the number of patients reporting they are "very satisfied" with the clinic's
scheduling by 50 percent within six months.
(C) Modify the scheduling process to allow both front desk staff AND nurses to directly
schedule appointments.
(D) Create an efficient process for scheduling return appointments at the time of
checkout. - Answers- Increase the number of patients reporting they are "very satisfied"
with the clinic's scheduling by 50 percent within six months.
After assembling a team and working through the three questions of the Model for
Improvement, the orthopedic clinic decides to implement an automated reminder phone
call 24 hours prior to each clinical appointment. The clinic's improvement team hopes
that this small change will improve scheduling.
What is the team's next step?
(A) Take a well-deserved break.
(B) Develop their project-level measures.
(C) Test their change plan using the PDSA cycle.
(D) Report their results to clinic leadership and prepare a poster for a national meeting.
- Answers- Test their change plan using the PDSA cycle.
Once you have worked through the first three questions of the Model for Improvement
— the questions about aims, measures, and changes — it's time to do a small test of
change using the PDSA cycle. The clinic should have already developed their
, measures, and now is not the time for a break — because the hard work of
improvement is just beginning!
An orthopedic clinic in a busy metropolitan area would like to improve its patient
scheduling process. More specifically, the clinic wants to improve its efficiency and the
satisfaction of its patients.
The orthopedic clinic plans the change to improve scheduling, and then it carries out a
small test of change with three patients on Tuesday morning. What's the next thing the
clinic's improvement team should do?
(A) Change their measures.
(B) Measure to see if the change led to improvement.
(C) Report their results to the clinic leadership and prepare a poster for a national
meeting.
(D) Implement the new scheduling process based upon their initial impressions of how
everything is working. - Answers- Measure to see if the change led to improvement.
The team has planned a test of change and now they've done the test. The team must
now study how the test went (the "S" part of the PDSA cycle). They can look at a mix of
process measures (such as how often appointments started on time) and outcome
measures (such as how satisfied the patients were with the new process).
An aim statement must specify "how good, by when." Improving patient satisfaction with
scheduling is a reasonable goal. Answer D is best described as an opportunity
statement, as it contains no specifics about how much the clinic must improve, nor by
when. Answer C is more of a "change" statement than an aim statement.
An orthopedic clinic in a busy metropolitan area would like to improve its patient
scheduling process. More specifically, the clinic wants to improve its efficiency and the
satisfaction of its patients.
When trying to improve a process, one reason to use PDSA cycles rather than a more
traditional version of the scientific method (such as a randomized, controlled trial) is
that:
(A) PDSA cycles are easier to run with a large team of people.
(B) The results of PDSA cycles are more generalizable than other methods.
(C) PDSA cycles are simpler to use than other methods.
(D) PDSA cycles provide a mechanism to adjust improvement ideas as the project
progresses.
(E) Both C and D - Answers- Both C and D
PDSA cycles allow for rapid and frequent review of data and then adjusting the test of
change based upon those findings. For example, if a new guideline that's meant to
improve pneumonia care isn't working, PDSA cycles allow you to change the guideline
quickly and test its efficacy, rather than waiting until the end of a long study period.
IMPROVEMENT
The Model for Improvement begins with three questions designed to clarify the following
concepts:
(A) Plan, do, act
(B) Mission, goal, strategy
(C) Aims, measures, changes
(D) Will, ideas, and execution - Answers- Aims, measures, changes
The Model for Improvement begins with three fundamental questions about any given
improvement, designed to address the aim (what are we trying to accomplish?), the
measures to be used (how will we know a change is an improvement?) and the
changes to be used (what changes can we make that will result in an improvement?).
An orthopedic clinic in a busy metropolitan area would like to improve its patient
scheduling process. More specifically, the clinic wants to improve its efficiency and the
satisfaction of its patients.
Applying the Model for Improvement to the clinic's improvement goal, which of the
following is the most reasonable aim statement?
(A) Implement two PDSA cycles within six months of beginning the project.
(B) Increase the number of patients reporting they are "very satisfied" with the clinic's
scheduling by 50 percent within six months.
(C) Modify the scheduling process to allow both front desk staff AND nurses to directly
schedule appointments.
(D) Create an efficient process for scheduling return appointments at the time of
checkout. - Answers- Increase the number of patients reporting they are "very satisfied"
with the clinic's scheduling by 50 percent within six months.
After assembling a team and working through the three questions of the Model for
Improvement, the orthopedic clinic decides to implement an automated reminder phone
call 24 hours prior to each clinical appointment. The clinic's improvement team hopes
that this small change will improve scheduling.
What is the team's next step?
(A) Take a well-deserved break.
(B) Develop their project-level measures.
(C) Test their change plan using the PDSA cycle.
(D) Report their results to clinic leadership and prepare a poster for a national meeting.
- Answers- Test their change plan using the PDSA cycle.
Once you have worked through the first three questions of the Model for Improvement
— the questions about aims, measures, and changes — it's time to do a small test of
change using the PDSA cycle. The clinic should have already developed their
, measures, and now is not the time for a break — because the hard work of
improvement is just beginning!
An orthopedic clinic in a busy metropolitan area would like to improve its patient
scheduling process. More specifically, the clinic wants to improve its efficiency and the
satisfaction of its patients.
The orthopedic clinic plans the change to improve scheduling, and then it carries out a
small test of change with three patients on Tuesday morning. What's the next thing the
clinic's improvement team should do?
(A) Change their measures.
(B) Measure to see if the change led to improvement.
(C) Report their results to the clinic leadership and prepare a poster for a national
meeting.
(D) Implement the new scheduling process based upon their initial impressions of how
everything is working. - Answers- Measure to see if the change led to improvement.
The team has planned a test of change and now they've done the test. The team must
now study how the test went (the "S" part of the PDSA cycle). They can look at a mix of
process measures (such as how often appointments started on time) and outcome
measures (such as how satisfied the patients were with the new process).
An aim statement must specify "how good, by when." Improving patient satisfaction with
scheduling is a reasonable goal. Answer D is best described as an opportunity
statement, as it contains no specifics about how much the clinic must improve, nor by
when. Answer C is more of a "change" statement than an aim statement.
An orthopedic clinic in a busy metropolitan area would like to improve its patient
scheduling process. More specifically, the clinic wants to improve its efficiency and the
satisfaction of its patients.
When trying to improve a process, one reason to use PDSA cycles rather than a more
traditional version of the scientific method (such as a randomized, controlled trial) is
that:
(A) PDSA cycles are easier to run with a large team of people.
(B) The results of PDSA cycles are more generalizable than other methods.
(C) PDSA cycles are simpler to use than other methods.
(D) PDSA cycles provide a mechanism to adjust improvement ideas as the project
progresses.
(E) Both C and D - Answers- Both C and D
PDSA cycles allow for rapid and frequent review of data and then adjusting the test of
change based upon those findings. For example, if a new guideline that's meant to
improve pneumonia care isn't working, PDSA cycles allow you to change the guideline
quickly and test its efficacy, rather than waiting until the end of a long study period.
