Process of Quality
Improvement—
The Colorado Experience
Leslie Jameson MD
University of Colorado
Department of Anesthesiology
Change!!!!
Who?
Me??
You??
Everyone!!!
Why?
PUBLIC ïƒ Regulatorsïƒ Medical Community
Want to create change in medical practice
Result in improved measured outcome
Patient satisfaction (high hospital ratings)
Lower morbidity (eg, infection, readmission, LOS)
Reduced medical costs (no morbidity)
Motivator
Personal satisfaction (the most effective motivator)
Money (2015 CMS ïƒ QCDR )
Money (Credentials)
Money (Highly rated hospital-Patients)
Money (Licensure, ABA certification)
How?
MEASURE discrete a selected medical process
(eg, SCIP, PQRI requirements)
Assess DOCUMENTED Care that is important
EDUCATE participants
Make a group process or an individual one
MEASURE for Change in Practices
Maintain gains
PROVIDE CONTINOUS PERFORMANCE
REASSESSMENT–Medicine and public
Lucian Leap’s Statement on
Change
(Author of Too Err is Human IOM Report)
1. Errors & Failure are caused by system breakdowns not
individual carelessness.
2. Changing systems (clinical actions) is hard work and
requires serious commitment, leadership and
perseverance.
1. Must overcome TRADITION, TRADITION
while we MOTIVATE MOTIVATE MOTIVATE!!!
3. Most powerful method for reducing harm is feed back, learning
from the best, and working in collaboration .
Adapted from JAMA FEB 3 2015; 313(5):467-8)
ASPIRE