台湾医院品质突破新思维BTS概念介绍.ppt

This diagram illustrates how our hypothetical team that is trying to achieve improved access actually carries out tests in several different categories of changes. In order to effect improved access, the team probably cannot rely solely on reducing appointment types. Changes in other areas such as standardizing panel size, establishing protocols for scheduling, or maximizing all members of the care team should be considered. These multiple changes can be made simultaneously or can be folded in at planned intervals. We encourage teams to try “packages” of changes to achieve maximum results. At a later stage, specific changes can be removed to assess the impact of a particular change on the overall result. This diagram shows the relationship between multiple cycles. The process is iterative with the learning building from one to the other. The slope of the ramp indicates that the cycles are also building in size and scope to increase one’s confidence that the changes will result in the desired improvement. Creating new system has these 3 parts to it Creating a new order of things involves three components: improvement, holding the gains, and spread. Some people think about these components sequentially (first do improvement, then hold the gains, etc.) The bottom of the slide shows a more productive way to think about it: these are really overlapping phases. Actually planning for spread can start even before improvement work is begun (e.g., selecting members of your pilot team based on who has influence in your organization can help with spread later on.) -Planning for spread involves getting clear about what comprises the total health care system you ultimately want to spread the improvement -Then pick out piece of that system or units to take part in BTS -Then after units get results we need to spread back into rest of system -Spread is different from Breakthrough model -will address spread model, principles and methods on BTSC phone call -So wh