Quality Improvement in Healthcare
ฝัง
- เผยแพร่เมื่อ 25 พ.ย. 2014
- Thanks to St. Michael's Hospital www.stmichaelshospital.com, Health Quality Ontario www.hqontario.ca, and Institute for Healthcare Improvement www.ihi.org
Check out our new website www.evanshealthlab.com/
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Dr. Mike Evans is a staff physician at St. Michael's Hospital and an Associate Professor of Family Medicine. He is a Scientist at the Li Ka Shing Knowledge Institute and has an endowed Chair in Patient Engagement and Childhood Nutrition at the University of Toronto.
Written, Narrated and Produced by Dr. Mike Evans
Illustrations by Liisa Sorsa
Directed and Photographed by Mark Ellam
Produced by Nick De Pencier
Editor, David Schmidt
Story/Graphic Facilitator, Disa Kauk
Production Assistant, Chris Niesing
Director of Operations, Mike Heinrich
©2014 Michael Evans and Reframe Health Films Inc.
I love the connection made between motivational interviewing with quality improvement.
Watched this for a class and woah did I learn a lot. This is the most helpful and clear video on QI I've seen to date. Thank you so much. The lessons and wisdom you share can be applied to so much more than healthcare. I even took parenting and general life lessons from here. Than you, really.
Watched this video for a class and it is the most helpful video I have seen on QI! Thank you so much Dr. Mike! Your messages are very crucial to the healthcare system.
Watching for my QI in healthcare class in 2017, still relevant, glad I found it!! Thank you!
Everyday we try to improve something about ourselves or the way we go about things. Some improvements are so minuscule that we do not even notice them. However, something we can all appreciate is the quality improvement of healthcare. Some errors are over looked and do not even come into discussion where we can improve. Take the washing hand statistic. 44,000-98,000 people in the U.S. die from preventable errors every year. We do not need to flip the entire system, but the objective is to become more efficient in what we do in the healthcare field. With improvement comes change and not everyone is okay with change. As Dr. Evans stated "people can become overwhelmed with change." As humans we like to be set in routines that go smoothly. Any bump in the road can steer us in the wrong direction and become lost. Small changes can be good and overtime can accumulate into something greater. Take the study of fractured hip patients in St. Micheal's Hospital. The tweak in the system of getting to the patients in the ER bumped the percentage of patients receiving surgery in a 48 hour period from 66% to 90%. Even though not every change will make that big of an impact it is still a goal to improve.
Still extremely relevant and a powerful education tool to share to understand QI in Healthcare. Congratulations
Bob Emerson
I am currently working on my degree in Healthcare management. There are many articles and publications available for research.
This information is direct and to the point. As a healthcare provider and manager we put too much emphasis on the big picture. I enjoyed this article because the Patient Discovery and Motivational Interviewing is it is what is all about.
Thank You
Wanted an overview that wasn’t the rambling 58 minute uploaded lecture that got straight to the point without a ton of tangents, thanks for making this.
A wonderful video with a great message. Thank you, Dr. Mike! I will be sharing this and your other videos with my healthcare students in the future.
Fantastic presentation. Will share with my nursing students.
I saw this 4 years ago and it really helped me, and I just watched it today, and its still very good information. Thank-you, and I like the video in the clip it does make it better.
I love these videos so, so much.
I agree video in video is fine but so long as short and not detracting from Liisa's amazing work.
:-)
This was a great video! Definitely gets you thinking about how big changes can be made in small practical steps!
Being a system thinker is definitely useful in QI initiatives. Constant curiosity and asking how we can improve makes us better leaders. Quality Improvement is a continuous process. Always finding ways how we can do things better.
I love this, simple and understandable thank you
this was great, very thought provoking and interesting!
I like the link between MI and QI; I have found it useful in my practice, especially when combined with teach back.
I was mesmerized by the drawings...I think the content really stuck more because I was so fascinated!
Love this!!! Will use all that I learn from this on my nursing licensure exam, and in my day to day activities!
Thanks Dr Evans for making it easy to understand QI and how to apply PDSA in practice
A very thought provoking and engaging video! Thank you!
Congrats! This video was very instructional and fun at the same time. I find the way you included the video was great: short, right to the point and it felt like it belonged with the drawings.
this is really nice!! glad i found your channel dr.mike. keep ‘em coming!
A very insightful video and applicable to more than just the healthcare system. The methods discussed can be used in people's day to day lives to achieve personal goals, as well as to improve business productivity, and processes involved in specific industries. It seems a huge problem we have is to focus on the problems but we forget that we have the power to change them. It may not be possibly to implement a quick fix to rectify an issue, however, with small steps that lead to a planned goal, change can be implemented.
Oh, and I found the 'video within a video' quite appealing and thought it was beneficial to put a quote from another thinker in there.
I enjoyed watching and learning from your video. The drawings along with the words and narration made it very easy to understand and apply the knowledge. Thanks!
Great presentation. Very practical & effective.
Very interesting approach .
thanks, this helped with my HIT course
Great video! The illustrations were wonderful and kept it interesting - thanks for the encouragement!
Appreciate the video. A lot covered with use of the drawings. Starting simple is best. Making small incremental steps is what many of us overlook. Thanks for reminding me of what is necessary to be a change agent. keep them coming.
Great, succinct, engaging video
"Some is not a number and soon is not a time."
My professor recommended this video! I enjoyed Thanks!
The videos are perfect to reach a wide audience. Thank you for these.
Vids in Vids work when kept short and relevant. Sometimes the best way to say something comes from the person who said it. I say keep it.
Of note, I've been involved in QI in US Navy hospitals for years. Your talk describes Franklin Covey's 4 Disciplines of Execution approach (similar to your PDSA) and the end of your video describes Appreciative Inquiry (building on the ideas of others).
I've seen many ways to slice it, but in the end, you nailed it with staff attitude. 20% of your staff are the go-getters trying to influence 60% of the staff to think like they do. (The last 20% are averse to change and generally can't be helped).
Great videos - keep them coming!
Great video and good examples. I actually discovered I actually discovered IHI during my MBA and used QI techniques partly learned from the organisation.
This gave me a better understanding of QI and the processes involved to bring about change. I highly recommend this to everyone, not just those who are working in healthcare, but those in other industries working towards making them better.
Loved this!
,
This was a very helpful video to me by teaching me, by thinking about how every step no matter how small is, is a step towards future end goal.
Thank you Dr. Mike that was wonderful!
This video is priceless. Thank you
Thanks Dr. Evans for making an entertaining and very educational and thought provoking video. This has change my attitude about QI and it was a delight to learn through your fun presentation. Love the drawings :-) God bless you and your team. Que Dieu vous benisse... ;-)
OMG!!!- your introduction to QI ia faaaaantastic. Its just what I was looking for. A breif intervention for QI ludites. EVERYONE should watch it.
This is great! thank you!
Loved the video! As a Public Health student studying for an upcoming exam on quality of care, hearing about quality improvement in an easily understandable way is quite helpful. :)
Thank you, awesome video, on target with message.
Great video as always! Do you happen to have a link to the study you mentioned (at 5:35) regarding a handwashing poster creating a 1/3 improvement in handwashing over a 2 week period?
Enjoyed your Video!!! I'm a visual learner. The concepts and images you used created a mental picture of what continuous quality improvement means.Good Job!
I liked the video and the illustrations are fantastic. Very informative.
Dr Mike;
An excellent and "good news" presentation. Some of the improvements obtained were really amazing. The dropped-in video was a very good idea. It lets us see the human face of improvement.
One comment about quality improvement and control. In industry, the word quality means making sure that the standards and procedures are followed exactly.But when this word gets it out of its cage and into the hands of non technical and or non business types like medical practitioners, its meaning changes. This is no surprise, the general population thinks of quality as well designed, effective, reliable and even beautiful.
What you are really talking about with these improvements, as Deming would say, is "continuous improvement" of a delivery system, or "kaizen" in Japanese. As examples, quality control of handwashing is making sure that doctors and nurses do this exactly as instructed. Quality improvement and continuous improvement gets more interesting. Now you ask are they all using enough soap and washing long enough? Do all the dispensers contain the same soap? Are the ingredients really anti-bacterial?
Are there better, more expensive ingredients that are much more effective? Some harmful ingredients were removed from the dispensers in hospitals last year. There are no signs or recordings warning people with colds to wear masks as they enter the hospital !!
Now when we come to continuous improvement, you touched on this in your video, when you said we must be sure that the handwashing really works. A systems approach would look at all factors that cause illness in the hospital setting. This gets back to what you did in your 23-1/2 hour video. Viruses are very common causes of diseases in emergency rooms. Why don't doctors and nurses wear masks when they themselves are breathing the air around patients and carrying the viruses from room to room? Why are old bandages, pads and syringes often seen on the floor of emergency rooms? Are the rooms really cleaned thoroughly? What are the most effective ways to really scrub C. Diffficile and other nasty viruses from rooms? Hydrogen peroxide? Irradiation of rooms? What about the air filtration systems in hospitals?
Yes, it gets very complicated and expensive quickly. But some of the low hanging fruit is not being plucked. Doctors and nurses do not wear masks all the time, probably because they don't wearing them. When they tried to force nurses who didn't get the flu shot to wear masks, this was more about forcing everyone to comply and support the drug industry than help patients.The chemicals used to wash floors and walls do not appear to be especially effective. Like you say, it's actually very fascinating, not boring.
so touching for an excellent video
amazing video, current mhs student specializing in leadership. very helpful video, alot of insight!
I think "dropping a vid in a vid" worked very well here!
Thank you for the information. I am looking for information on the Donebedian model and found this. You make the process a little easier to understand. Just need more input at this time. P.S. The vid-in-vid is a nice touch.
What a great video. The ideas to adapt into practice simple and realistic and I feel would be very effective, will be adapting my practice to include these ideas.
A career in this field would be amazing!
I love this video! It also led me to IHI
Great video with great concepts and illustrations. Video in video was fine - I enjoyed putting a face with a name. I appreciated that you highlighted the potential for innovation fatigue. As an RN, I am often "overloaded with requests for practice change" as you mentioned. I would venture to guess that innovation fatigue is directly related to nurse fatigue... I guess I have my next quality improvement project. :)
The vid dropped in was good :-)
It TOTAL this was a great presentation 😀👍🏾
very good presentation. thx
Great video!
Great, very helpful for my healthcare project 👍🏻 thanks
Loved this video - really simplifies and takes the mystery out of QI . Thought the video inside the video was great example of mixed media
Great Video. Very Informative.
This is also applicable to animal medicine as well. Great information here! Thanks!
What kinds of Software did you use to make this animation video sir?
So fantastic !
I agree with this video. If doctors and physicians expect their patients to adjust their daily life, patients should be able to expect health care professionals to do the same. There is a difference between recognizing something is wrong in healthcare, compared to knowing how to prevent it. Seemingly small behaviors such as improving hand washing technique can have a positive ripple effect throughout the healthcare system. Healthcare needs to be able to measure if changes actually lead to improvement. In the video they discussed the PDSA cycle and I highly agree with it. However, I feel that most hospitals either disregard or slack when it comes to this cycle. If hospitals are motivated enough to see improved they will do this cycle of planning a change, doing the change, study the change results, then act on those results. Health care professionals need to adapt, adopt, or discard the results of these changes. I believe hospitals and their employees need to view this video and learn more about quality improvement.
Love the video in the video! =)
Very informative video, thank you
This was good. Wow some pretty crazy statistics in this video. Got me thinking
Thanks, this is very understandable and relates to my career
Excellent simple video, thank you!...wish this could be the intro to the QI concept in medical school and residency as this is so much more engaging than that with which we're usually presented!
thank you!
I know this is a little late...but I liked the video in a video. Helps put pieces together as I've used some IHI stuff before. Thanks!
i really liked the video within the video to help clarify!!! plus your voice is so soothing thank you so much for that clarification
Thank you I really enjoyed this. It was fast paced (I had to press pause a few times to make notes !!) but that wasn't a problem and the cartoons provided energy. I thought a video within this video worked well.
Great video and videos overall. Topics that make one think and superbly presented. Embedded videos are fine as long as they contextual snippets kept at a reasonable length.
great effort
Is there a way to review the study you reference about the hospital in Timmins? I am working toward my MPH and writing a piece on using the Donebedian Model to improve patient outcomes. Thank you for your help.
can i get a reference list this is really excellent
The video definitely helps. Thanks
Still absolutely relevent, and a great summary of quality improvement.
I think it would be good to include videos into your videos. Just make sure there are not too many and they're kept short. I still want to see your drawings!
I second this
Great I loved the animation and the video within the video worked, very engaging!
this has helped me in my meeting as I suggest improvements in workflow!
Thanks for this intro to QI in healthcare, a nice overview
Nice!! well done -- learn a lot, difference point of view on healthcare improvements
This is so helpful, pls make more videos.on the topic
very good, thanks a lot
Nice video!!
can you give me the link to the article about timmins
love your vids :D
I thought this was a great video and I liked the Don Berwick piece. I already find him inspiring though. Thank you!
Is hanging a different handwashing sign really something that gives a sustained effect, or is that a short-term "Hawthorne Effect" at work? Dr. Deming would have taught to look at data over time, not just a two data point comparison of before and after.
+Mark Graban... 'sustained effect' only matters if you are eager to eliminate the cost of Logo Writers and Poster Painters. But re the video, I suspect "regularly changing the hand-washing sign" is the intervention.
Hi Doctor, IATF: 16949 or AS9100 are QMS standards widely known in Auto and Aero industry. Can you name similar level stds in healthcare for me to read further.
I thought the added video was very useful it validated the point more clearly.
The video drop was good. Not too long but added a change up in delivery.
I find it of the upmost importance to ensure that healthcare improves. Many people are killed or injured from simple error of healthcare professionals. I understand some mistakes can simply not be avoided and we are indeed human, but many mistakes are just careless error and I find this unacceptable. I believe healthcare workers should always make quality healthcare their first priority, and do their best to leave their personal lives 'at the door' as they walk into work. I found it astonishing that one study showed that 247 deaths happen each day from hospital infections in the US from inadequate hand washing. This is an area that can easily be fixed by paying close attention to basic standards of healthcare. I agree with the videos three standards of change. Simple practices such as documenting hand washing can make a huge difference in the future. I also agree with how difficult it may be to get people to change. With collaboration and time, I believe it can get done. One study showed the importance of patient centered care, and how it increased quality improvement in healthcare. As a future OT, client centered practice is one area that we always focus on. My professors always stress the importance of making the treatment meaningful to the individual for maximal benefit. I am glad to see that other practices are adopting this mindset as well.
i have a 10 powerpoint presentation in university, I have to think of a service improvement and talk about it... so worried as i have no idea; especially since i havent had any experience...
Very Helpful and I love your graphics. Also hello from Perth Western Australia.