By Jennifer Farfalla
Analyst for QI and Life Course, AMCHP
AMCHP, like many of its members, is on its own quality improvement (QI) journey. Over the past three years, we have taken steps to increase our capacity to perform internal QI projects, offer external QI technical assistance and create a culture of continuous quality improvement (CQI) within our organization. CQI is a process of creating an environment where an organization's staff and leadership are able to identify inefficiencies in their work and propose and implement solutions to those inefficiencies.
In December 2013, AMCHP staffers employed QI tools such as measuring our activities on an operational dashboard, but these tools were limited to use by a few staff members. In order to ensure staff were trained in basic QI tools and methods, AMCHP enrolled staff in Population Health Improvement Partner's QI 101 program. Staff applied these skills to three QI projects that aim to improve the services we offer our members. The QI project topics were (1) improving our identification of emerging issues in maternal and child health (MCH), (2) improving our recruitment of MCH best practices and submissions to our repository of best practices, Innovation Station, and (3) improving our virtual engagement, specifically webinar practices. AMCHP staff applied QI tools to analyze root causes of problems in these topic areas, prioritize our change ideas, test and measure changes, and sustain our change ideas with coaching from Improvement Partners staff. Improvements that came out of these projects included an AMCHP webinar toolkit, a technical assistance (TA) tracker designed to enable trend analysis of TA requests to help identify MCH emerging issues and a new Best Practices Ambassador program.
In order to keep the momentum going after the completion of our three QI projects, AMCHP's analyst for quality improvement (who is a staff member) enrolled in Improvement Partners' more advanced QI Advisor training program to build internal capacity to coach QI methods. As a part of the program, AMCHP created an A3, which is a two-page report on problem solving originally used by Toyota and later adapted for use by other organizations, including hospitals and health organizations, to improve processes. AMCHP's A3 consists of five sections: (1) Current performance, gaps and targets, (2) reflection on last year's activities and results, (3) rationale for this year's activities, (4) this year's action plan, (5) follow-up and unresolved Issues. Our A3 uses data, charts, visualizations and text to communicate a clear picture of ACHP's history with QI, our current state and plan for the future and possible challenges that may arise.
Two main activities that came out of our CQI A3 plan were a survey of AMCHP staff on our current culture and capacity for CQI, and the formation of a QI council that will lead QI activities in the future. Our CQI survey was performed in January 2016 and showed areas where AMCHP is already doing well with CQI and its opportunities for improvement. AMCHP's QI council was created in May 2016 and convened its first meeting in June 2016. The council is in the process of creating a charter documenting a vision for QI at AMCHP and how the QI council will operate to help us fulfill that vision. We aim to create a few quick QI wins at AMCHP, including starting another QI project in 2016.
While AMCHP's QI work created a number of positive tools and changes, challenges to this work still exist. First, staff time is always a limited resource. Although a QI project creates several time-saving changes, we have to invest staff time to bring about these changes. However, all of our QI projects include metrics to measure the increased efficiency of our work and member services, which will show us if our staff time on these activities is warranted. Second, change is not always easy, and we do not want to overwhelm staff with changes. We will address this challenge through careful planning with tools like our A3 and feedback from our staff-driven QI council. While change can be challenging, we are also seeing the benefits of data-driven, mindful improvements and look forward to our future QI activities.