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The Monash Health Quality & Safety Unit recommends the Model for Improvement developed by Associates in Process Improvement. 

Why use the Model for Improvement?

"The model for improvement provides a framework for developing, testing and implementing changes leading to improvement. It is based in scientific method and moderates the impulse to take immediate action with the wisdom of careful study." (NHS, n.d.)

Model for Improvement

The Model for Improvement begins with three key questions:

1.      Aim: What are we trying to accomplish?

2.      Measures: How will we know a change is an improvement?

3.      Changes: What change can we make that will result in improvement?

"When planning any improvement or change to work processes, it is essential to know what you want to achieve, how you will measure improvement and to be explicit about the idea to be tested. You may not get the results you expect so it is safer and more effective to test out improvements on a small scale before implementing them across the board." (NHS, n.d.)

Plan-Do-Study-Act Cycle

After establishing the changes, applying the Plan-Do-Study-Act (PDSA) cycle helps to develop, test and implement changes. The four-phase process is a way to quickly test changes as necessary, and then test again – before implementing anything on a broad scale. Instead of spending weeks or months planning out a comprehensive change, then putting it into practice, only to find that it’s fundamentally flawed, the PDSA cycle enables rapid testing and learning.

Image: Associates in Process Improvement. (n.d.). https://www.apiweb.org/


What is the model for improvement? (3 mins)

This brief clip from the Institute for Healthcare Improvement introduces the Model for Improvement and PDSA cycles.


Visit the IHI video library or YouTube channel to view more videos.

IHI video library

IHI on YouTube

PDSA Cycles

 More information about each phase of the Plan-Do-Study-Act cycle can be found in the image below. Visit the Getting Started page for toolkits and templates.

Principles and Models of Quality Improvement: Plan-Do-Study-Act |  Anesthesia Key


The PDSA Cycle: Part 2 (3 mins 48 secs)

This video demonstrates how you would use a PDSA cycle to improve discharge planning as part of a hypothetical improvement project. From the Institute for Healthcare Improvement's Open School.


PDSA cycles are often run sequentially, so that knowledge gained over time can be used to refine each subsequent cycle until the aim is achieved.

Imagehttps://wcwpds.wisc.edu/organizational-development/organizational-process-improvement/plan-do-study-act-pdsa-collaborative/stage-5-act/


Further reading

What is co-design?

Put simply, co-design involves partnering with those who have direct experience with the problem that you are trying to solve. The principles below guide co-design in healthcare. 

"1. There is an equal and reciprocal relationship between all stakeholders, enabling them to design and deliver services in partnership with one another.
2. Planning, designing and producing services with people that have experience of the problem or service means the final solution is more likely to meet their needs.
3. This way of working demonstrates a shift from seeking involvement or participation after an agenda has already been set, to seeking consumer and clinician leadership from the outset so that consumers and clinicians are involved in defining the problem and designing the solution."

-- Agency for Clinical Innovation. (n.d.). What is co-design? https://aci.health.nsw.gov.au/projects/co-design

 

What is co-design?

Image: Metro North Health. (n.d.). https://metronorth.health.qld.gov.au/get-involved/co-design/what-is-co-design


Monash Health frameworks

Below are links to download relevant documents directly from PROMPT. These links will only work while onsite or via Citrix while offsite. Login with your Monash Health username and password when prompted.

Consumer, Carer and Community Partnerships Framework

Health Literacy Framework


Co-Design 101 (1 min 25 secs)

This short video from VicHealth explains what co-design is and its benefits.


Further reading

Resources & toolkits

What is design thinking (DT)?

Design thinking methods focus on understanding users' perspectives, needs, and behaviours, and taking these into account when designing and testing creative solutions. It asks three core questions:

  • Desirability: What makes sense to people and for people?
  • Feasibility: What is technically possible within the foreseeable future?
  • Viability: What is likely to become part of a sustainable business model?
     

 

Image on left: B. McWeeney. (2017). https://medium.theuxblog.com/my-user-centered-design-mashup-defining-process-and-communicating-value-65df72f5648a
Image on right: S. Abookire et al. (2020). https://www.frontiersin.org/articles/10.3389/fpubh.2020.00459/full

 

"...DT methods are specifically designed to capture the human perspective in a system, generating deep insights into how users feel and act, identifying unmet emotional needs that drive behaviour and designing solutions directly addressing those needs. Moreover, DT methods foster dialogue and creativity among teams in powerful ways, leading to better alignment around the contribution of emotions and behaviours to systems issues and generating human-centred solutions." (Crowe et al., 2022, p. 70)

Design thinking for quality improvement (22 mins 10 secs)

In this webinar from the California Primary Care Association, Stephen Horan, PhD, introduces design thinking and demonstrates how it can be used to improve healthcare quality.


Further reading

Acknowledgement of Country

Monash Health acknowledges the Traditional Custodians of the land, the Wurundjeri and Boonwurrung peoples, and we pay our respects to them, their culture and their Elders past, present and future.

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