During my fifteen years in Healthcare Quality, I’ve had the opportunity to oversee and support colleagues in creating and managing hundreds of Quality Improvement (QI) projects. The challenges faced in creating sustainable Performance Improvement Plans (PIP’s) were nearly always the same;
Accurate and easily repeatable data collection
Identifying what the specific improvement opportunity is
Deciding the appropriate course of action
Measuring results, and
Maintaining the change once implemented
Utilizing these five building blocks to create an effective PIP will help your organization in identifying and managing nearly any Healthcare Quality Issues:
More times than not, the most complicated and extensive issues stem from a lack of basics – basic policy, basic skill set or a basic communication plan. Everyone gets caught up in workarounds, quick steps and the absence of recent errors; unfortunately, these ‘patches’ will one day be exposed leaving behind a large, gaping hole.
Once an opportunity is identified, it is imperative to identify the “true” root cause, which isn’t always as easy as it sounds. You can’t initiate a plan assuming you know where the crux of the problem lies - involve others in this process and keep an open mind. Once you’ve validated the root cause, the improvement plan will generally present itself.
It sounds rhetorical, but too many steps in a PIP are a prescription for failure. Simplify your problem, your aim, the plan, monitoring improvement and most importantly, the follow up and maintenance plans once improvement has occurred and stabilized. Simple PIP plans are historically the most successful.
Once the PIP is working and the project work is completed, the work is far from finished. Moving your PIP to the monitoring and maintenance phase should include two key elements, future reporting and accountability without an anticipated end date. The better your organization becomes at identifying issues or slight shifts in performance the less likely you will need to repeat a detailed Quality Improvement Plan.
If necessary, don’t hesitate to step back, re-evaluate and create a new plan. Your goal is correcting a problem, not having a concise, error free plan. Every plan has rewrites, smudges, dog ears, strikethroughs and writing in the margins. Quality Improvement is a never-ending and continual work in progress.
A PIP is simply a map to guide you through a process requiring special attention and actions for improvement. Once the root cause of a problem is identified, the plan can be clearly laid out. Once you’re comfortable creating a PIP and have buy in from the team, you will be well on your way to improving your organization’s Healthcare Quality Assurance Program.