There are three parts
Logistics of the case study
Throughout this course, you will work on a case study to develop your skills in using theQI methods and tools you are learning. The case study has five parts that will be distributed byyour instructor at a time noted on the assignments schedule. There are both individual andteam assignments for each part of the case study.
Background and OverviewThis case study focuses on improving access to specialized care for low-income patientsat a community clinic that provides primary health care services. The clinic prides itself ondelivering high-quality services to its patients but is constrained by lack of resources. Recently,patients have been complaining to staff about the amount of time it takes the clinic to schedulereferral appointments with outside specialists at other locations. The clinic management isaware of the problem and has brought in a Quality Improvement team (you!) to find ways to improve the referralprocess. Your group decides to use a systematic QI approach to guide your improvementefforts.Before you can begin, you need to gather more information to better understand the situation.Prior to your involvement, the clinic leadership team hired an external consultant to conductbrief interviews with some key stakeholders in the referral process: a primary care provider, apatient, the referral scheduler, and an outside specialist. Listen to the voices of thesestakeholders and note down they key points they are making.
Voice of the Patient https://www.youtube.com/watch?v=7vwioW1k8wgVoice of the Primary Care Physician https://www.youtube.com/watch?v=vNo1zb1DVH0Voice of the Scheduler https://www.youtube.com/watch?v=NIpOJA-x2QcVoice of the Specialist https://www.youtube.com/watch?v=zurdMsxzymQ
Based on your notes from the interviews, answer the questions below. Your answerswill be needed to complete the project charter (which is the Team Assignment).1. Based on what you hear from the interviews, how would you describe the problem?2. What is the process that needs to be improved, what are the start and end points?3. What are the expected outcomes of the improvement and how will you know if youare successful?4. Who are the internal and external customers and how will improvement of theprocess will affect them?
You should be able to respond to each question in lessthan 150 words or less. We are looking for clarity and understanding of the issue.
View the linked presentation outlining the referral process in detail:Referral Process.1. Based on the Referral Process interview, list:a. the process stepsb. the key decision pointsc. handoffs and interaction points with patients.2. Restate the aim of the project from your charter.Based on your aim, answer the questions below:a. List potential primary and secondary level drivers for your aim. List at least 3 sets of primaryand secondary drivers.(Note! A driver is your theory of what contributes to the aim. Primary drivers are the keydrivers and the secondary drivers are the components of that key driver. These are justyour hypotheses at the moment based on what you know about the problem – they willneed to be confirmed or disconfirmed by data that you will collect and analyze in the nextfew modules.)b. For each set of primary and secondary drivers, discuss why you think your proposed driversare “necessary and sufficient for achieving the intended outcome” as stated in the Bennettand Provost reading “What’s Your Theory?” attached, p. 39. Include the three elements.(Note – do not discuss change ideas or change concepts at this stage; we will cover that inlater)
From “What’s Your Theory?” p. 39: Key Leverage Points: The primary and secondary driversfrom which the tool (the driver diagram) derives its name are intended to identify the elementsin the system that are necessary and sufficient for achieving the intended outcome.(Drivers) include three elements: structures -that comprise the system, processes -that representthe work of the system, and operating norms -that demonstrate the explicit and tacit culture ofthe system.10Reading: What’s Your Theory? by Brandon Bennett and Lloyd Provost
