Module 2: How To Manage Change

Slide Presentation

Slide 1: How To Manage Change

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ADD Hospital Name

Module 2

Slide 2: QI Change Process

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  • Change process strategies can be applied to other quality improvement (QI) efforts:
    • Hospital falls.
    • Catheter-associated urinary tract infections.
    • Deep vein thrombosis or pulmonary embolism after knee and hip replacement.
    • Blood incompatibility.

Image: Puzzle pieces are labeled “assess readiness,” “manage change,” “implement practices,” “best practices,” “measure,” “sustain,” and “tools.”  The piece labeled "manage change" is highlighted in blue.

Slide 3: Module 2 Goals

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  • Identify actions needed to improve organizational readiness.
  • Maximize the possibility of successful implementation by addressing these questions:
    • How can you set up the Implementation Team for success?
    • What needs to change, and how do you redesign practice?
    • How should goals and plans for change be developed?
    • How do you bring staff into the process?

Slide 4: Expected Outcomes

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  • Finalize Implementation Team members and assign roles. (Tool 2A)
  • Present the completed process analysis on one patient care unit. (Tool 2C)
  • Present the assessment of current pressure injury prevention policies and procedures. (Tools 2D, 2E, and 2F)
    • Team Leader or designee completed assessment and folds recommendations into the action plan.

Slide 5: Expected Outcomes

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Begin to write a draft Pressure Injury Prevention Action Plan, tailored to this hospital (see Tool 2I).

Image: Photograph shows medical providers and staff team members meeting at a table.

Slide 6:

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  • How often will you meet?
  • What are the ground rules for managing meeting time and communication?
    • How will you communicate with each other?
    • How will you communicate successes?
  • How will the Team do its work?
    • Small group work.
    • Working meetings.

Slide 7: Finalize Team Members

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The first goal is to finalize the Implementation Team members and assign roles.

Image: Photograph shows medical providers gathered for a meeting.

Slide 8: Successful Implementation Team

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  • A strong link to hospital leadership.
  • Members with the necessary expertise (Tool 2A).
  • Access to resources needed to accomplish the aim.
  • Links to quality improvement expertise.
  • Members who influence the areas involved in pressure injury prevention.
  • Includes Pilot Unit Manager.

Slide 9: Multidisciplinary Team (2A)

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Images: A table captioned "Multidisciplinary Team" charts Discipline, Names of Possible Implementation Team Members From Each Area, and Area of Expertise for potential team members. An icon of a magnifying glass in front of open book identifies the table as Tool 2A.

Slide 10: QI Process

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  • Link the Pressure Injury Prevention Program with quality improvement.
    • This information helps you define resources this hospital has for quality improvement.
  • Plan, Do, Study, Act is one systematic approach to analysis and implementation.

Images: Photograph shows medical providers looking at laptop together. An icon of a magnifying glass in front of open book refers to Tool 2B. An icon of a magnifying glass in front of open book refers to Page 27.

Slide 11: QI Process

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  • Your Implementation Team Leader filled out many assessment forms already.
  • We’ll be working to find solutions for positive change.
  • Let’s hear from your Implementation Team Leader about this hospital’s QI program and how to link with QI.

Image: Photograph shows a medical provider holding papers.

Slide 12: Collaboration

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  • Pressure Injury Implementation Team.
  • Wound Care Team.
  • Unit Team.

Image: Photograph shows a team leader speaking to medical providers.

Slide 13: Collaborative Relationships

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Image: A Venn Diagram consists of three overlapping circles captioned:

  • Implementation Team: Interdisciplinary team charged with designing and implementing pressure ulcer change project.
  • Wound Care Team: Interdisciplinary group of experts who provide day-to-day care of skin and wound needs and are a resource for staff and patient/family.
  • Unit-Based Team: Staff on the unit who provide daily care to patients, which includes skin and pressure ulcer assessment and care planning.

Slide 14: Assess Current Pressure Injury Processes

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  • Understand current processes in patient care units.
  • Use process mapping to examine key processes (Tool 2C).
    • Assess current practices on a representative sample of units; do process mapping.
    • Which practices need changing? Determine how to build in new practices.
  • Do the care processes follow best practices?

Slide 15: Practice Insight

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Use of Shadowing To Assess Current Practices

Image: Photograph shows medical providers holding a meeting in a hallway. Icon of binoculars.

Slide 16: Current Process Analysis (2C)

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Images: Two screenshots show the Current Process Analysis. An icon of a magnifying glass in front of open book identifies this as Tool 2C.

Slide 17: Current Process Analysis (2C)

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  • Let’s hear from the team member(s) who completed the process analysis.
    • Share process mapping from the unit.
    • Point out key processes being used.

Image: Two photogaphs show a medical provider holding clipboard in front of laptop, and a medical provider holding clipboard and pen.

Slide 18: Assess Current Policies (2D)

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Images: A screenshot shows the Pressure Ulcer Policy Assessment form. An icon of a magnifying glass in front of open book identifies this form as Tool 2D.

Slide 19: Assess Current Policies

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  • The Implementation Team Leader identified the policies in place and areas for improvement.
  • You’ll want to address these areas in the Action Plan.
  • In Module 3, we’ll compare this assessment with best practices.
    • A group you designate may opt to do further fine tuning at a later time.
    • Let’s look at completed Tool 2D now.

Slide 20: Assess Pressure Injury Screening Practices

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Images: A screenshot shows the Assessment of Screening for Pressure Ulcer Risk form. An icon of a magnifying glass in front of open book identifies this form as Tool 2E.

Slide 21: Assess Pressure Injury Care Planning Practices

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Images: A screenshot shows the Assessment of Pressure Ulcer Care Plan form. An icon of a magnifying glass in front of open book identifies this form as Tool 2F.

Slide 22: Implementation Action Plan

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  • The Implementation Action Plan for change should address the following:
    • Membership and operation of the Implementation Team.
    • Standards of care and practices to be met.
    • How gaps in staff education and competency will be addressed.

Slide 23: Implementation Action Plan

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  • The Implementation Plan also addresses:
    • Plans for rolling out new standards and practices, where needed.
    • Staff accountability for monitoring implementation.
    • How changes in performance will be assessed.
    • How this effort will be sustained.

Slide 24: Sample Action Plan

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Images: Two screenshots show an example of a Pressure Ulcer Prevention Action Plan. An icon of a magnifying glass in front of open book identifies this as Tool 2I.

Slide 25: Practice Insight

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Image: A screenshot shows a table titled "Pressure Ulcer Prevention Program Action Plan: June 2015-January 2016"; the first section, Key Intervention/Task 1, "Analyze Current State of Pressure Ulcer Prevention Practices," is circled in red. Icon of binoculars.

Slide 26: Action Plan

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  • Let’s go over Tool 2I together.
    • Let’s discuss action steps for Key Intervention 1.
    • Then we can determine who is responsible for this task and when it tentatively will be completed.

Images: A sample Action Plan is shown with Key Intervention 1 circled in red. An icon of a magnifying glass in front of open book sits above the text "Refer to your Action Plan template."

Slide 27: Summary

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  • Completed assessment of current policies and practices:
    • Pressure Injury Policies.
    • Risk Screening Assessment.
    • Care Planning Assessment.
    • Current Process Analysis.
  • Set up the Implementation Team.
  • Developed a draft Action Plan for Key Intervention 1.
  • Working document that can be revised.
Page last reviewed October 2017
Page originally created September 2017
Internet Citation: Module 2: How To Manage Change. Content last reviewed October 2017. Agency for Healthcare Research and Quality, Rockville, MD. https://www.ahrq.gov/patient-safety/settings/hospital/resource/pressureinjury/workshop/slides2.html
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