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Implementation and Evaluation of  Revised CDS Tool January 8 th , 2008 LEADERS SYMPOSIUM “ Strategic Planning to Inform a Funded Project on how to Achieve Workflow Integration in Developing  and Implementing CDS for CRC Screening”
Key Informant Interviews  of site-specific best-practices for integration of colorectal cancer screening CDS into workflow Direct Observation  of colorectal cancer screening CDS for barriers and facilitators to workflow integration Implementation in primary care clinic after simulation study Rapid Prototyping  of CDS design alternatives based on Phase 1 findings Simulation Study  to test impact of CDS design alternatives on efficiency, usability, and workload Evaluation  in primary care clinic after simulation study Figure.  Project Overview Phase 1 Phase 2 Phase 3
Implementation/Evaluation Overview ,[object Object],[object Object]
Implementation Oversight ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Implementation Oversight (con’t) ,[object Object],[object Object],[object Object]
Lean Process Design… Identifying and Eliminating Operational Barriers within Patient Treatment Processes Materials Step 3
Reducing sources of variation… ,[object Object],[object Object],[object Object],[object Object],Every caregiver and staff member must be active in reducing variation.
What factors impact Diffusion? ,[object Object],[object Object],[object Object],[object Object],[object Object],Berwick DM. Disseminating innovations in health care.  JAMA. 2003 Apr 16;289(15):1969-75
Implementation Teams in Action Courtesy Peter Woodbridge
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Implementation Teams Develop Future State Process Process Control Strategy Baseline Current Processes Identify  Operational Barriers Define the Problem
[object Object],[object Object],[object Object],Implementation Teams Develop Future State Process Process Control Strategy Baseline Current Processes Identify  Operational Barriers Define the Problem
Lean Tools Develop Future State Process Process Control Strategy Baseline Current Processes Identify  Operational Barriers Define the Problem Process Observation Worksheet Spaghetti Diagram 5S, Visual Controls, Constraint Management Process Map Check sheet Process Control Plan Project Charter Voice of the Customer
Example Implementation Team Schedule ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PDSA Plan PDSA Do Study Act Plan the process  change, collect Baseline Output data Try out the test, collect Output data from the new process Examine the process/data  to determine failure modes Refine the test, based on failure modes
Where is PDSA used within the Lean Cycle? Develop Future State Process Process Control Strategy Baseline Current Processes Identify  Operational Barriers Define the Problem PDSA PDSA PDSA
Evaluation ,[object Object],[object Object],[object Object],[object Object]

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Heather Woodward Slides from AHRQ Kick-Off

  • 1. Implementation and Evaluation of Revised CDS Tool January 8 th , 2008 LEADERS SYMPOSIUM “ Strategic Planning to Inform a Funded Project on how to Achieve Workflow Integration in Developing and Implementing CDS for CRC Screening”
  • 2. Key Informant Interviews of site-specific best-practices for integration of colorectal cancer screening CDS into workflow Direct Observation of colorectal cancer screening CDS for barriers and facilitators to workflow integration Implementation in primary care clinic after simulation study Rapid Prototyping of CDS design alternatives based on Phase 1 findings Simulation Study to test impact of CDS design alternatives on efficiency, usability, and workload Evaluation in primary care clinic after simulation study Figure. Project Overview Phase 1 Phase 2 Phase 3
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  • 6. Lean Process Design… Identifying and Eliminating Operational Barriers within Patient Treatment Processes Materials Step 3
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  • 9. Implementation Teams in Action Courtesy Peter Woodbridge
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  • 12. Lean Tools Develop Future State Process Process Control Strategy Baseline Current Processes Identify Operational Barriers Define the Problem Process Observation Worksheet Spaghetti Diagram 5S, Visual Controls, Constraint Management Process Map Check sheet Process Control Plan Project Charter Voice of the Customer
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  • 14. PDSA Plan PDSA Do Study Act Plan the process change, collect Baseline Output data Try out the test, collect Output data from the new process Examine the process/data to determine failure modes Refine the test, based on failure modes
  • 15. Where is PDSA used within the Lean Cycle? Develop Future State Process Process Control Strategy Baseline Current Processes Identify Operational Barriers Define the Problem PDSA PDSA PDSA
  • 16.