The Quality Improvement Challenge. Richard J. Banchs
a group of people performing as a team EXCEPTcomplementary skills,common purpose,focus on individual goal achievement,mutual accountability, orcommon approach.
3 Regarding the composition of a QI teamfront‐line professionals need to have the largest representation.the ideal team size is 4–8 members.it is important to have team members that bring subject‐matter expertise.it is important for the team to have a mix of skills.all of the above.
4 Team members should be preferentially selected on the basis of all the following characteristics EXCEPTbring process knowledge,have a high‐ranking leadership position in the organization,have technical expertise,have problem‐solving skills, orhave great interpersonal skills.
5 A team leader’s role is to facilitate the team’s success in achieving the project’s goals.TrueFalse
6 The formation of high‐performing QI teams in healthcare is made more difficult byclinical silos,prioritization of patient care,resource constraints,conservative culture, orall of the above
7 What is the role of the QI team during an improvement project?share findings and communicate through all project phases.provide message content for written communication to senior leaders.provide material and audiovisual support for meetings and presentations.provide or facilitate coaching and training of the front line.all of the above
Key: 1d, 2c, 3e, 4d, 5a, 6e, 7e.
Exercise key: While the problem affects the ER and the professionals working in the ER, the root of the problem for a long turnover time of routine samples is in the lab. In this example, team members should be chosen preferentially for their subject‐matter expertise: processing samples. ER staff and providers are the customers of the process; lab personnel are the stakeholders. Given these roles, your QI team should include a majority of lab personnel, who are the stakeholders with the best process knowledge. The stakeholders do the work and therefore have the expertise. Chose a majority of front line workers and some supervisors. A customer (ER staff or provider) can also be a member of the QI team helping team members have a better perspective of “what the customer needs.”
REFERENCES
1 1. Bossidy R. (2002). Execution: The Discipline of Getting Things Done. Random House.
2 2. Heifetz R. (2002). Leadership on the Line: Staying Alive through the Dangers of Leading. Harvard Business Review Press.
3 3. Katzenbach R. (1993). The Discipline of Teams. Harvard Business Review Press.
CHAPTER 7 What Is the Scope of the Project? The SIPOC Diagram
YOU NEED TO KNOW YOUR PROJECT’S SCOPE AND BOUNDARIES
What process does the problem relate to? What is the target of the improvement? Where does work begin and end? The process boundaries clearly define the extent of the project scope and serve as an effective way for making decisions about the project activities. The project scope establishes the limits of the project work, defines the inclusions and exclusions, and helps define the expected outcomes of the QI project.
The easiest way for all key stakeholders to agree with the scope and boundaries of your project is to show the beginning and the end of the process that is going to be targeted for improvement. This can be done well with a high‐level process diagram, such as the SIPOC diagram.
THE TOOL: A SIPOC DIAGRAM
What Is a SIPOC Diagram?
SIPOC is an acronym for Suppliers, Inputs, Process, Outputs, and Customers. Although the name originated in the manufacturing industry, the SIPOC diagram has achieved widespread acceptance in healthcare.
The SIPOC diagram shows a process snapshot and captures all the key activities and relevant elements in a process in order to help define the scope and boundaries of a project.
The SIPOC diagram
provides an easy way to visualize the process in its entirety;
presents the process in 4–6 high‐level steps;
visually documents the relationship between suppliers, inputs, outputs, and customers; and
clearly identifies the start and end of the process.
It is critical to understand the start and end of a process because they impact the stakeholders, the criteria used to select who should be involved in the improvement team, and the scope of the project.
Advantages of the SIPOC Diagram
Despite a lack of familiarity with its terminology, most QI teams in healthcare find the SIPOC diagram to be a great tool to define the scope and boundaries of their project. The SIPOC diagram offers numerous benefits:
It provides an easy way to visualize the process in its entirety and to quickly understand the limits of the project. The diagram facilitates an understanding of the flow of the process for all team members.
The team and the Primary Sponsor are better aligned with the scope and boundaries of the project.
Relevant elements that are needed when considering the project scope are quickly captured.
It presents a graphical depiction of the relationship between process inputs and outputs, and between suppliers and customers.
The key stakeholders are delineated. The SIPOC diagram makes clear who needs to be included in project communications.
Discussion is better focused on the key elements of the project.
The SIPOC diagram helps get the Primary Sponsor, QI team members, and key stakeholders on the same page. It also helps prevent scope creep, which is the tendency for ill‐defined project scopes to expand over time, resulting in projects that cannot accomplish the objectives or produce the expected deliverables in the agreed upon time frame.
HOW TO DRAW A SIPOC DIAGRAM
A SIPOC diagram has five distinguishable elements (see Figure 7‐1):
1 A list of suppliers. A supplier is a person, team, or department that provides inputs into the process. Suppliers can be technicians, physicians, nurses, materials management crews, blood bank personnel, or an entire clinical department. Suppliers, in general, do not perform the work. They provide what the “people that do the work” need to perform their duties.
2 A list of inputs. An input is what flows into the process. This can be people, materials, supplies, equipment, information, or data.
3 A list of outputs: An output is the finished product(s) or service(s) from the process or, if more detail is needed, each process step.
4 A list of customers or end users. As we explained in Chapter 3, a customer is the end user who receives the work product or output of the process. The ultimate customer is the patient, but in healthcare, customers can also be other end users such as physicians, nurses, technicians, or other front‐line staff.
5 A high‐level view of the process. These are the 4–6 high‐level steps that are required to achieve the output.