The Science Journal of the American Association for Respiratory Care

2003 OPEN FORUM Abstracts

IMPROVING THE PERFORMANCE OF YOUR PERFORMANCE IMPROVEMENT (IPPI)

Ruth Krueger BS, RRT, Jerald W. Roberts BA, RRT Sioux Valley Hospital USD Medical Center, Sioux Falls, SD

Background: JCAHO standards require that performance improvement (PI) be planned and systematic using Failure Mode Effects Analysis rather than the traditional Root Cause Analysis. In this department of 85 therapists, PI projects and monitors were developed retrospectively with little input coming from the staff. Monitors were continued year to year without significant analysis of the data collected. The project objective was to design a planned and systematic PI approach that involves the staff more in identifying PI opportunities. METHOD: A prospective PI calendar was designed that indicates what area of focus to solicit from staff and which supervisor is scheduled to report their monitoring analysis. The calendar assures that each area of respiratory care is reviewed every six months. The respiratory therapy (RT) areas included on the calendar and in the monthly question to the staff are: bronchodilator therapy, bronchial hygiene, volume expansion, oxygenation, critical care, neurodiagnostics , pulmonary function testing, bronchoscopy and patient education. The format for the monthly question is "What can we do better in the area of ________(focus area from calendar)?" Suggestions from the staff are evaluated at a bi-monthly PI meeting. The individual with the winning project suggestion is rewarded and the project is implemented or set up on a monitor for further evaluation. 

RESULTS: RT PI projects increased from two projects prior to implementing the calendar to twelve projects in one year post implementation. Staff involvement in PI increased from 0 to 21 suggestions in the same time frame and 68% of 85 therapists surveyed felt they had more input into the PI process after implementation of the project. The calendar is in its third year of rotation with recognition hospital wide for its innovation. Staff input has stimulated projects associated with nursing, health unit coordinators, physicians, and other allied health providers as well as all of the disciplines within the RT department. RT is recognized as a leader in performance improvement at this institution and as word spreads, other departments are requesting to model the calendar and incorporate its use into their areas. 

Conclusions: A planned and systematic PI calendar increases staff involvement and improves the quality of projects by making them prospective rather than retrospective. IPPI has shown a widespread organizational effect on many dimensions of care including efficacy/effectiveness, safety, efficiency, economics, and appropriateness.

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