Tab	Things you can learn...	Resources	Resources Zip File
Project Selection	What is an appropriate project How to prioritize projects -- including time evaluation Evaluating time & effort required Evaluating impact versus effort	Project Ideas Form Prioritization Rationale Form Time & Effort Required Form Impact versus Effort Form
Defining the Project	Mapping the project Creating a problem statement Creating a goal statement using SMART goals How to identify project benefit How to identify project scope	Process Map Form Problem Statement Form Goal Statement Form Project Benefit Form Project Scope Form
Looking Toward Results	How to use a "5 WHYS" Form and Cause & Effect Diagram to drive specific questions and results How to use a Driver Diagram to evaluate your project How use a completed Driver Diagram to finalize your project plan	Data Summary & Expectations Form IHI "5 WHYs" Form IHI Cause & Effect Diagram IHI Driver Diagram Final Project Selection Form IHI Project Planning Form

Project Selection
Defining the Project
Looking Toward Results

💡 Learning Objective

1. Prioritize project choices by time and effort required, as well as by impact.

Project Selection

Selecting the Project - Infographic.png

🛠️ Resource - Project Ideas Form

Determine your own project idea considering the sources listed in the infographic above. Click here to download the form.

🗺️ Background - Prioritization Rationale

How can the list of potential topics be prioritized to make a final selection?

Two major considerations for selection are “WHY” (Why the intervention is important, and how important is it?”) and “HOW MUCH” (How much time and effort will an intervention require?)

For the "WHY", consider:

How will the intervention affect patients? (safety, care quality, opportunity for increased satisfaction)
How important is it to the organization? (cost savings, efficiency, staff impact, patient outcomes)
How does it align with other MMC initiative priorities?
What is the urgency of the change needed? (safety first!)

Important – Obtain input! Discuss potential projects with attending physicians and staff who will be needed for participation in a potential project, or who will be impacted by a project, for their opinions.

🛠️ Resource - Prioritization Rationale Form

Complete your own prioritization rationale table, listing your potential projects and justification (WHY) in order of how you want to do them. Click here to download the form.

🗺️ Background - Time & Effort Required

HOW MUCH time and effort will a project require?

Consider:

Will you have autonomy over the project, and control over systems changes needed? Or will factors such as budgetary constraints impact the project and limit your ability to achieve success? Will you need to coordinate a very large team with conflicting schedules while you are on busy clinical rotations, or will you be able to work on it more intensely on lighter months?

How realistic is the timeline for successful completion? Can you realistically complete what you set out to, including, sampling the baseline data, designing and implement an intervention, and obtaining follow up data?

🛠️ Resource

Consider how much time and effort each project will take. This form prompts you to list your potential projects from highest to lowest time and effort intensity; this will help you to consider whether or not the time and effort of each project matches how much you can put into your project. Click here to download the form.

🗺️ Background - Impact versus Effort

After prioritizing projects by potential impact, and effort required, factors can be combined for final project selection, as in the table below. Ideal projects will generally rank “high” in potential impact and “medium” in effort required. See the table below. Module 1 - Assignment 4, Impact and Effort Table.png

🛠️ Resource - Impact versus Effort

Using your Prioritization Rational and Time & Effort form from this module, complete the exercise as illustrated above. Place each project concept in the appropriate box, categorizing by anticipated impact and effort required. Click here to download the form.

Before continuing take the following into consideration:

- - If you have a mentor, consult with them prior to your final selection.
  - Complete a draft of the background portion of your abstract.

💡 Learning Objectives

1. Illustrate process from beginning to end to gain a better understanding of the project.
2. Construct a problem and goal statement based on project benefit and scope.

Defining the Project

Defining the Project - Infographic.png

🗺️ Background - Process Map

An important step in understanding your process is to visualize the process from beginning to end. A process map provides an excellent tool to both define your process (including identification of stakeholders), and to help specify possible points within your process for intervention. This example, from the IHI toolkit provides a model for reference as you complete a draft of your process.

Module 2 - Assignment 1 - Image (a).png

🛠️ Resource - Process Map

Complete your own process map. Click here to download the form.

Flowchart Source: http://www.ihi.org/resources/Pages/Tools/Flowchart.aspx
- Click here for full IHI Flowchart PDF

🗺️ Background - Problem Statement

The next step is to draft your problem statement. Consider the following:

WHAT (specifically) is the problem? The problem should be measurable and can be described as an opportunity.
WHY (at least 3 reasons) does it need to be addressed? How critical or severe is the problem (quantify)? How large or wide is the impact presented by the problem?
WHO are the customers and what is not meeting their expectations?
WHERE and when does the problem occur?

An example of a problem statement:

Consult visits account for 40% of our practice visits. Currently, our time from visit to “follow up letter send time” ranges from 16 hours to 5 days. Our administrative staff receives approximately five calls per week from outside offices requesting consult visits letters which had not been received. Additionally, patients are admitted to the hospital on an average of twice per month prior to completion of the office dictation. These problems are leading to referral source dissatisfaction as well as to safety concerns when patients are admitted with incomplete record availability.

Criteria for a problem statement:

A well-written problem statement should be data based, should have been validated as important by your customers, should not include a root cause or solution, and should not be too narrow or broadly defined.

🛠️ Resource - Problem Statement

Complete your own problem statement. Click here to download the form.

🗺️ Background - Goal Statement

The next step in defining the project is to develop the goal statement. Determining goals helps to define project success and drives the project forward. Goals and objectives should be “SMART”:

Smart Goal Statement - Graphic.png

An example of a goal statement:

Achieve an interval from consult visit to electronic upload of consult summary letter of less than 72 hours in 100% of patient cases by October 1, 2020.

🛠️ Resource - Goal Statement

Complete your own goal statement. Is it "SMART"? Ensure that it meets the criteria above. Click here to download the form.

🗺️ Background - Identifying Project Benefit

Potential benefits of your successful project should be included in a formal project charter. These typically include quantifiable metrics.

An example of a benefit statement:

Reduction in time interval from consult to upload of dictation may decrease phone calls for front staff, increase customer satisfaction, and increase efficiency in triage. Estimated project benefit would include qualitative improvement (safety) but ideally would include an estimated dollar impact of the improvement (reduce costs staff time by $10,000 annually).

🛠️ Resource - Identifying Project Benefit

Describe your estimated project benefit using quantifiable metrics. Click here to download the form.

🗺️ Background - Defining Project Scope

Your project description will also need to include a determination of scope. You considered scope when you selected the project, and you will further define the scope as you analyze potential for intervention. For the purposes of this section, consider the location, the start and stop points within a process, and the timeline. Typically, we’re tempted to try to do too much, and we underestimate the resources in time, personnel, and finances required for success. Defining the project scope carefully at the outset helps to avoid the potential pitfall of “scope creep” (the project growing and becoming unwieldly as the work progresses).

Example of scope definition for a project:

Area of Focus: Outpatient clinic
Includes: Consult visits
Excludes: Routine prenatal patients referred from other practice
Start: Referring physician is confirmed at time of arrival of patient at the practice
Stop: Consult dictation is uploaded electronically back with time stamp

🛠️ Resource - Defining Project Scope

Describe the scope of your project, as described above. Click here to download the form.

💡 Learning Objectives

1. Complete the 5 WHYs and Cause & Effect Diagram to better explore your project.
2. Use the Driver Diagram to better outline the project.
3. Modify your project and complete the Project Planning Form.

Looking Toward Results

Refining the Project - Infographic.png

🛠️ Resource - Data Summary & Expectations Form

After you complete your baseline data collection, submit your data summary. How closely is the current outcome meeting quality expectations, based on your data and process review? To rephrase, define your current gap in quality. Click here to download the form.

🗺️ Background - The "5 WHYs" and Cause & Effect

Study the results of your data collection to help inform the focus of your intervention. At the same time, utilize your initial, high level process map to drill down to more specific, detailed steps in the process. Identify any process breakdowns that decrease efficiency in process or quality in output.

Two tools are available below, to guide you through your root cause analysis (RCA). Referring to your identified quality gap, or “problem”, complete the “5 WHYS” Form and the Cause and Effect Diagram (“fishbone analysis”) charts. Make full use of your resources as you complete this exercise, including your basic process map, and input from your stakeholders. This input can be both qualitative (open ended discussions and observation) and quantitative (survey data, or process measures). Try to approach these exercises with an open mind, setting aside preconceived ideas of causality. As you develop the RCAs, use your initial process map, add detail and clearly identify any process breakdowns discovered.

The "5 WHYs" will ask you to define the gap, or "problem", as both an event and a pattern, and will prompt you to understand the root cause of this issue by asking, "why is that?"

The Cause and Effect Diagram similarly explores the root cause of a gap, or "effect", but does so by categorizing the causes of the effect into people, environment, materials, methods, and equipment - these categories can be individualized to better categorize the causes of the effect.

🛠️ Resources - "5 WHYs" Form and Cause & Effect Diagram

Complete an IHI "5 WHYs" form. Click here to download the form.

5 WHYs Source: http://www.ihi.org/resources/Pages/Tools/5-Whys-Finding-the-Root-Cause.aspx
- Click here for complete IHI "5 WHYs" PDF

Complete an IHI Cause & Effect Diagram. Click here to download the form.

Cause & Effect Diagram Source: http://www.ihi.org/resources/Pages/Tools/CauseandEffectDiagram.aspx
- Click here for complete IHI Cause & Effect Diagram PDF

🗺️ Background - Visualizing Baseline Data

Various statistical approaches can be used to further analyze highest yield possibilities for intervention, including: Histogram, Pareto Charts, Box Plots, Correlation Analysis, and Linear and Multiple Regression Analysis. Your mentors can provide direction or referral for statistical support if helpful.

Now that you’ve completed your baseline analysis, you are well positioned to plan your intervention(s).

🛠️ Resource - Driver Diagram

Using the information from your qualitative and quantitative analysis, complete the IHI Driver Diagram, with your goal of the project, primary, and secondary drivers. A primary driver contributes directly to the achievement of the goal, while secondary drivers contribute to the achievement of the primary driver. For each secondary driver, determine one or more change ideas. Click here to download the form.

Driver Diagram Source: http://www.ihi.org/resources/Pages/Tools/Driver-Diagram.aspx
- Click here for complete IHI Driver Diagram PDF

🗺️ Background - Prioritization Using "Change Ideas"

The next chart is similar to the chart completed in the first section for prioritization of project selection. The difference is that you have now identified very focused opportunities for improvement for the project you have selected.

🛠️ Resource - Final Project Selection Form

Complete the chart, using the identified “change ideas” listed in your completed Driver Diagram. Click here to download the form.

🗺️ Background - Project Planning Form

The final step in analysis is to determine your focused interventions, based on this prioritization table. Select interventions with high impact potential or yield, but with relatively low effort required. Interventions may need to be sequential, with one intervention providing a foundation for the next. For example, an educational session may need to precede implementation of a change in process.

The IHI Project Planning Form, imaged below, should be completed in the process of meeting with your mentors and team members. It can be updated as the project progresses through Plan-Do-Study-Act Cycles of change.

Module 3 - Assignment 6 - Image.png

🛠️ Resource - Project Planning Form

Complete a Project Planning Form. Click here to download the form.

Project Planning Form Source: http://www.ihi.org/resources/Pages/Tools/ProjectPlanningForm.aspx
- Click here for complete IHI Project Planning Form PDF