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DNP in Practice

QI and EBP

  • EBP, Research, Innovation, and QI Alignment Model DiagramQuality Improvement initiatives, evidence-based practice initiatives, and research can overlap and intermingle. Clearly understanding which is which and the role of each can become muddled.

Generally speaking:

  • EBP has a knowledge translation element and is a lifelong process
  • QI focuses on improving outcomes through process changes in a specific healthcare setting

Consider Capacity & Scope

  • Choose a method that you can easily implement in your organization
  • Consider staff hours that will go into the QI model and plan, number of staff available, available funding, and the scale of the project
  • Larger projects with more funding may enable you to enlist Six Sigma consultants.
  • PDSA may be more useful for a smaller change with less funding.

Plan-Do-Study-Act (PDSA)

  • Part of the Institute for Healthcare Improvement Model for Improvement
  • A way to test change in a real work setting
  • Action-oriented AND reflective
  • Allows the user to test a change in a microcosm before launching a full-scale operation.
  • Accessible and simple for smaller facilities.

LeaLEAN imagen

  • Based on the Toyota Motor Company 5 Whys Technique
    • Asks "why" until the root cause of a problem is found.
  • Traditionally geared toward production-based business models (like auto manufacturing) but healthcare has adapted the model for QI purposes.

Focused on:

  • Constant improvement
  • Eliminating waste
  • Identifying the root cause of a problem
Accomplishes this through:
  1. Identifying value
  2. Mapping the value stream
  3. Creating flow
  4. Establishing pull
  5. Seeking perfection

Organizations like the Lean Enterprise Institute, the Virginia Mason Institute, and the Institute for Healthcare Improvement offer information, training, and support for implementing Lean management principles.

Six Sigma logoSix Sigma

  • Motorola developed the Six Sigma process in 1986 as a quality improvement process.
  • Also geared toward production-based businesses, but has been adapted by the healthcare industry.

Focused on:

  • Eliminating defects
  • Reducing variability

The Six Sigma principles are:

  1. Work for the customer
  2. Find your problem and focus on it
  3. Remove variation and bottlenecks
  4. Communicate clearly and train team members
  5. Be flexible and responsive

Many institutions, like Purdue, offer online and in-person training in Six Sigma for healthcare.