Post on 18-Dec-2015
Assisted Living Enforcement
Process Improvement
Project
Leading Age Assisted Living Enforcement Training
October 18, 2013
Oklahoma State Department of Healthand
Oklahoma University Center for Public Management
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AgendaIntroduction, meeting process, ground rules• Ginger Thompson, OUCPM and Performance Solutions Quality Improvement Project Overview – How we got here• Henry F. Hartsell Jr., Protective Health Services Swim Lane Steps – Understanding complexity & consequences• Mike Cook, Long Term Care Service
Plan of Correction Tool -- Reduce or eliminate fines & waste• Patty Scott, Long Term Care Service Informal Dispute Process – New law November 1, 2013 • Sue Davis, Patty Scott, Long Term Care Service
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Ground Rules!• Know the agenda • One person talk at a time • Listen • Don’t talk over someone • Respect • Be on time, return from breaks timely • Provide session summaries • Turn electronics off or vibrate • Knock-Knock rule
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• Gain familiarity with:• Quality improvement project• Swim Lane process map• Optional plan of correction
template• How to participate in pilot• Informal dispute resolution
Objectives
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Project Overview:
How we got here
(and where we are going)
Henry F. Hartsell Jr., Ph.D.Deputy Commissioner for Protective Health
Services
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Quality Improvement in Public Health
• Deliberate improvement process - PDCA• Plan• Do• Check• Act
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• Achieve measureable improvements• Efficiency• Effectiveness• Performance• Accountability• Outcomes
Quality Improvement in Public Health
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Opportunity exists to ensure OSDH implements clear & reasonable enforcement process for assisted living centers to:
Positively impact residentsReduce need for penaltiesReduce waste for all involved
Plan: Identify
Opportunities
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OSDH staff membersAssisted living providersUniversity of Oklahoma Center
for Public Management
Plan:Participants
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Swim Lane map shows:StepsResponsibilitiesWhere delays, mistakes, inefficiency are most likely
See the waste
PDCA Plan Phase:Describe Current
Process
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Lanes (responsibilities) are horizontalSteps are verticalTime moves left to rightBoxes are steps or tasksDiamonds are decision pointsLines & arrows are connectionsOvals are start and end points
Swim Lane Process Map
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SurveyorsEnforcement staffOSDH Long Term Care LeadershipGeneral CounselAssisted Living CentersAdministrative Law JudgeInformal Dispute Resolution Panel
Swim Lane Lanes
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Building the Swim Lane
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Swim Lane Analysis:Find Causes of
Waste• Plan of correction incomplete• By first revisit, problems not:
• Corrected• Monitored• Documented
• Rework, delays, penalties• 40 centers had 2nd revisits in 2012!
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Team:
IMPROVEMENTS IN PROGRESS:What Who By When
IMPLEMENTED IDEAS
TEAM MEMBERS:
TEAM MEASURES:
---
Process Step 1
Process Step 2
Other Types of Waste
Open Issues for Supr
Process Step 3
PLAN: Root Cause Analysis
Issue
Issue
Issue
Idea
Idea
Issue
Issue
Issue
Issue
Issue
Issue
Issue
Issue
Issue Issue
Issue
Idea
Idea
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• Ensure a complete & acceptable plan of correction 1st time
• Optional POC template walks assisted living centers through all required elements
• Improvement Theory:
• Increase proportion of POCs accepted 1st time
• Reduce proportion of 2nd revisits by 15% in three months
Plan Phase: Identify Improvements
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Knowledge Test
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PDCA: Where we are going
• Plan:
• Reduce POC rejections
• Reduce 2nd revisits
• Use Optional Plan of Correction Template
• Do:
• Test Optional POC Template in Nov - Jan
• Check:
• Adopt, adapt, abandon
• Act:
• SOPs, train, track, solve problems, feedback
•
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Next Up: Mike Cook and
the Swim Lane Process Map