QI 102: How to Improve with the Model
for Improvement Exam
The Model for Improvement begins with three questions designed to clarify the following
concepts: - 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?).
Applying the Model for Improvement to the clinic's improvement goal, which of the
following is the most reasonable aim statement? - Answers -Increase the number of
patients reporting they are "very satisfied" with the clinic's scheduling by 50 percent
within six months.
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.
What is the team's next step? - 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!
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? - 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).
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: - 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.
Having a clear aim statement is important in quality improvement work because: -
Answers -Aim statements provide a clear and specific goal for the organization to reach.
Whether you're trying to reduce your commute time or cut down on the incidence of
surgical-site infections, having a clear and specific aim statement makes your project
more likely to succeed. Good aim statements include a specific, measurable goal, a
deadline for achieving the goal, and information about which population will be affected:
how good, by when, for whom. They do not, however, remove all obstacles from the
process. And while many funding requests and leaders require strong aims, it's not
always a requirement.
An aim statement should include the following: - Answers -Numeric goals, specific time
frame, and the patient population or system affected
Aim statements should specify measurable numeric goals, a time frame for attainment,
and the group or system affected. Costs and team members, while important to the
success of the quality improvement project, are not part of the aim statement itself.
Which of the following is the most effective aim statement for this project? - Answers -
Within three months, the emergency department will administer all pain medications
within 45 minutes of order time.
Effective aim statements contain a time frame, a definition of the population to be
affected, and specific, measurable goals. Answer B meets all three of these criteria.
While answers A and C may be useful process changes to reduce the delay between
the ordering and administration of medications, they are not aims in and of themselves.
Option D is not specific enough, as it does not contain information about how much the
department should improve.
The charge nurse in the emergency room asks Brenda to assemble a team to improve
the delivery of pain medication. As she considers who to place on the team, Brenda
should: - Answers -Review the aim statement to make sure the team includes
representatives of all processes affected by the team's aim.
Including the right people on the change team is crucial to a project's success. The
team should include representatives of all processes affected by the team's aim, which
is why Brenda should review the aim statement. Further, it should include people with
enough authority in the system to remove barriers and implement changes; people with
clinical or technical expertise; and people who can drive the project on a day-to-day
basis. A team representing just one profession is rarely as effective as an
interprofessional team.
During Brenda's first group meeting, the members ask to review the aim statement to
make sure they agree it addresses the current problem. With Brenda's approval, they all
decide to rewrite it. However, when they meet to consider what would be a better aim
statement, the group loses direction. In order to help them, Brenda might want to: -
for Improvement Exam
The Model for Improvement begins with three questions designed to clarify the following
concepts: - 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?).
Applying the Model for Improvement to the clinic's improvement goal, which of the
following is the most reasonable aim statement? - Answers -Increase the number of
patients reporting they are "very satisfied" with the clinic's scheduling by 50 percent
within six months.
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.
What is the team's next step? - 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!
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? - 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).
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: - 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.
Having a clear aim statement is important in quality improvement work because: -
Answers -Aim statements provide a clear and specific goal for the organization to reach.
Whether you're trying to reduce your commute time or cut down on the incidence of
surgical-site infections, having a clear and specific aim statement makes your project
more likely to succeed. Good aim statements include a specific, measurable goal, a
deadline for achieving the goal, and information about which population will be affected:
how good, by when, for whom. They do not, however, remove all obstacles from the
process. And while many funding requests and leaders require strong aims, it's not
always a requirement.
An aim statement should include the following: - Answers -Numeric goals, specific time
frame, and the patient population or system affected
Aim statements should specify measurable numeric goals, a time frame for attainment,
and the group or system affected. Costs and team members, while important to the
success of the quality improvement project, are not part of the aim statement itself.
Which of the following is the most effective aim statement for this project? - Answers -
Within three months, the emergency department will administer all pain medications
within 45 minutes of order time.
Effective aim statements contain a time frame, a definition of the population to be
affected, and specific, measurable goals. Answer B meets all three of these criteria.
While answers A and C may be useful process changes to reduce the delay between
the ordering and administration of medications, they are not aims in and of themselves.
Option D is not specific enough, as it does not contain information about how much the
department should improve.
The charge nurse in the emergency room asks Brenda to assemble a team to improve
the delivery of pain medication. As she considers who to place on the team, Brenda
should: - Answers -Review the aim statement to make sure the team includes
representatives of all processes affected by the team's aim.
Including the right people on the change team is crucial to a project's success. The
team should include representatives of all processes affected by the team's aim, which
is why Brenda should review the aim statement. Further, it should include people with
enough authority in the system to remove barriers and implement changes; people with
clinical or technical expertise; and people who can drive the project on a day-to-day
basis. A team representing just one profession is rarely as effective as an
interprofessional team.
During Brenda's first group meeting, the members ask to review the aim statement to
make sure they agree it addresses the current problem. With Brenda's approval, they all
decide to rewrite it. However, when they meet to consider what would be a better aim
statement, the group loses direction. In order to help them, Brenda might want to: -
